On Monday 14 November 2016, something happened that highlighted how much we rely on IT to function day-to-day. The whole NHS email system crashed, owing to the creation of a distribution list that accidently contained the email address of every single NHS employee and contractor (Siddique, 2016). A test email was sent to the 850 000-strong NHS workforce, then hundreds of people responded with the reply-all function, which sent the email system into chaos thanks to the large volume of messages. A health service statistician estimated that as many as 186 million emails were generated by this error, including the replies and automated out-of-office responses (I'm sure everyone who replied to all was displeased to find out that I was on annual leave).
When the error was highlighted, the IT department deleted the distribution list, and associated emails were tracked and deleted. Many employees took to social media to complain that they could not access their emails and that, when they did manage to, the server was being very slow.
Over the last two decades, the way we communicate and rely on technology has changed dramatically. Nowadays many of us contact each other via a range of formats, including text messages, video calling and social media. The way that we communicate with the women and families who access our services has to keep up with the ever-changing innovations in technology. Personally, I am not in favour of video appointments, although I can see how for some people with mobility problems they may be beneficial. At my Trust we have ‘Edie the e-midwife’ (staffed by a senior midwife), which allows women to email in their questions, concerns and problems, and also has a presence on social media. Edie has been hugely popular with our women and provides an invaluable service.
The London maternal deaths report (NHS London Clinical Networks, 2016) highlighted the complex medical and social needs of women who give birth in London. Many of these women are very mobile and may travel extensively in the postnatal period, getting lost to follow-up. I know that some service-user groups have voiced confidentiality concerns regarding the use of electronic patient records (EPR), but allowing and supporting access to nationwide EPR would allow health professionals to access records anywhere in the country.
The ‘10 commitments’ of the NHS advocate the use of technology, with commit ment number 10 stating (Cummings, 2016: 13):
‘We will champion the use of technology and informatics to improve practice, address unwarranted variations and enhance outcomes.’
This is echoed in the Royal College of Midwives' (RCM, 2016) recently published Standards for midwifery ser vices in the UK, which refers to the way that technology supports good communication in all elements of care.
The NHS 10 commitments say that the aim of championing the use of technology will be met by (Cummings, 2016: 33):
Embracing innovations in technology is fundamental to the health service's strategic aims in terms of improving health and wellbeing, care and quality, and efficiencies. The NHS is aiming to become ‘paperless’. For midwives who are used to writing reams of notes, this will be a big change. I hope that by going paperless we will not only improve our carbon footprint but also produce legible records and reduce drug errors and omissions. There are lots of possibilities; for example, the kind of technology that can send an alarm if a drug is prescribed for a patient with a known allergy to that drug. When such technology is up and running, hopefully this will streamline our workload and make us more efficient, ultimately allowing us to spend more time with women.
‘ Over the last two decades, the way we communicate and rely on technology has changed dramatically ’
I recently watched an old episode of Downton Abbey, where the characters were afraid of electricity. This seems amusing now that life without electricity is unthinkable to most of us. But progress continues; our current ways of working will be replaced by technological advancements and we need to be ready for these changes. Who knows what is to come? One day, people will not know how we lived without some innovation that doesn't yet exist.