What can useful bureaucracy in the NHS achieve?

What can useful bureaucracy in the NHS achieve? Clinical staff think two thirds of the data and information they collect is relevant to patient care.

Ask anyone to describe bureaucracy in the NHS and they are likely to paint a picture of files piled high on trolleys, reams of form-filling and endless red tape.

But our impression of bureaucracy doesn't have to be like this. In fact, we could develop a love affair with data and information in the NHS, if only we take the time to make it as useful and as valuable for patients as possible.

Earlier this year the NHS Confederation was commissioned to conduct a review into how to reduce the bureaucratic burden on the NHS. As we represent all parts of the service, from commissioners to providers, clinical leaders and managers, we are perfectly placed to interrogate how data and information gets used in the NHS, and how we could be exploiting it further.

Our work focused on the burden placed on providers by national bodies and our recommendations for what needs to be improved formed part of the government's recent response to the Francis report.

What we discovered was that bureaucracy's bad name in the press is somewhat out-of-sync with the reality on the ground. The cartoon image of a nurse struggling under her/his own weight of paperwork and bemoaning all the form-filling she/he needs to do is shattered by our finding that clinical staff think two thirds of the data and information they collect and process is useful and relevant to patient care. Whether for protecting patient safety on the ward, or detecting patterns of diseases, bureaucracy in its broadest sense is actually pretty darn useful.

This is why the NHS, the government and others need to work harder to explain the benefits of the 'useful' bureaucracy which is essential to delivering good care.

The clinical staff we spoke with largely consider the data they collect to be both relevant and useful, and worth spending time on. What they resent is that once the forms containing this valuable information leave their hands, it disappears into the ether.

This is why we need to improve the feedback mechanisms for data collection at both an individual and organisational level. Hospitals sometimes have to wait weeks or months to receive feedback on the information they collect, by which time its usefulness has significantly diminished. It's also crucial to help hospitals compare their data, so they are constantly learning from each other and improving the care they provide.

Some are already taking this principle on board. For example, NHS trusts in London have worked with the National Cancer Registration Serviceto squeeze more value out of the cancer data they collect. The hospitals now receive regular feedback on the cancer information they submit to the service, meaning achievements, areas for improvement and comparative performance levels are highlighted and acted upon swiftly.

But there is huge variation across the NHS. For instance, there are nurses working on an older people's ward in the north of England who conduct a 15-page paper questionnaire with incoming patients, despite the fact these patients have already answered many of the same questions in A&E or on the ward where they were first admitted to hospital. This process is frustrating for patients, relatives and staff, but is sadly not a one-off case. What is even more frustrating, is that the information the nurses are trying to gather in the questionnaire is important to understand their patients' care needs.

So, at the heart of the NHS's bureaucracy problem are the often outdated or time-consuming processes that staff use to collect data or information. Investing in better technology and IT systems that talk to each other could play a huge role in tackling this.

If we want a modern and sustainable NHS that meets the needs of patients, we need to make sure that right across the NHS, the way we use data and information is brought firmly into the 21st century. There are some places which are breaking new ground, but some where progress is slower than swimming through treacle.

Bureaucracy should not be punitive or burdensome – but should be cherished as a means for improving care and increasing transparency about the care people receive. In short, we need to learn to love what useful and valuable bureaucracy in the NHS can achieve.

To find out more, watch this animation on bureacracy Jenny Ousbey is senior public affairs manager at NHS Confederation  Guardian Professional.