The must read stories and biggest debate in health policy

Room for improvement

HSJ’s revelations that members of the public with no care experience are being offered up to £1,000 a month to rent spare rooms to patients after they are discharged from hospital, under an Airbnb style model to be piloted by the NHS, were swiftly followed up by national media.

Reactions to the story were predictably varied. Many balked at the idea of putting up patients in private residential homes after they’re discharged, raising concerns about how patient safety could be guaranteed and such a model regulated.

Some praised the company CareRooms, the Essex NHS bodies and councils involved for having the gumption to try something new to address bed shortages, with current efforts to fix the problem making little headway.

HSJ awaits with interest what the views of the Care Quality Commission and further details about how the model will work.

But for now, the argument will spiral around a well rehearsed loop. Innovation cheerleaders will, with justification, repeat that the NHS’s culture needs a radical overhaul so it embraces innovation rather than pulling up the drawbridge to any idea involving replacing existing models (it does).

Critics of the model will, also with justification, says it’s not innovation they object to: it’s that the new model does not meet the patient safety and quality standards that are rightly demanded. And this model does raise some fundamental questions.

Both camps will argue they have patient safety at the forefront of their minds and nothing will change. Unfortunately, with a system heading towards an unsustainable demand/funding equation, this won’t be good enough.

E-prescribing makes sense on paper

The case for electronic prescribing and medicine administration in hospitals has been bolstered by a new study and strong words from the NHS’s top ranked digital clinician Keith McNeil.

The headline findings of the NIHR study, which is awaiting publication, echo previous international studies and what many digitally minded NHS folk have known for years.

Namely that a well developed digital system that follows medicine from pharmacy to bedside, links to digital patient records and with clinical buy-in, saves lives (and money).

Prescribing errors in the NHS are not cheap and people admitted to hospital after such errors take up precious beds.

The business case for digital health tech, the benefits of which can be notoriously difficult to quantify, has rarely been clearer. E-prescribing is often described as the “low hanging fruit” of digital health.

But despite this evidence, e-prescribing of any kind, let alone the type of well developed system the study describes, remains the exception rather rule in NHS hospitals.

Money has been thrown at e-prescribing in the past, with limited success, and there is little specific incentive or central funding pushing uptake currently.

Dr McNeil has suggested more regulatory pressure would help.

Possibly. But for many trusts still relying on paper, investment in basic IT systems will be needed before they can even consider deploying e-prescribing.