Why tackling NHS admin will help improve outcomes

Getting the basics right

Admin, how the NHS communicates with patients, plays a crucial role in people’s experiences of healthcare, and how they perceive the NHS. What we hear again and again from our members, and the people and communities they serve is the importance of simply getting the basics right.  

This week, we, along with our friends at the King’s Fund and Healthwatch England have published a new piece of research which shows us how commonplace, and how disruptive, issues with admin are.  Our polling, conducted by Ipsos, found that nearly two in three patients have experienced at least one admin problem over the last year. 

For those facing the sharpest end of health inequalities, the role of admin is especially important, yet we hear too often from our members that these groups are much more likely to experience issues that compound the inequalities they are facing. Getting the basics right means communicating with people in a way and in a format that works for them, and enabling people to book, change or cancel their appointments in that same spirit. Being provided with essential information in good time, not having to chase for results and knowing how to get in touch with the relevant person with a query should be a guarantee.

Just one short conversation amongst our small team about this work unleashed a myriad of personal experiences where admin had gone wrong, all within the last few weeks.   

Just some of the issues highlighted by my colleagues included an email that contained confusing and hard to read colour coding, involving colour combinations such as white on yellow that made text almost impossible to read, and important messages shared through the NHS App with no follow up via any other means, with the assumption made that notifications had been switched on.

It seems as if we all have a poor admin experience to share – join the conversation via Bluesky to share yours.

Admin matters

In 2021, National Voices, the King’s Fund and Healthwatch England undertook joint insight work on the topic of administration as a gatekeeper and enabler for quality care. We published our report, Paper Works, the King’s Fund published Admin Matters, a long read, and Healthwatch England published their own work focusing on admin. My own involvement in this work in my role at Healthwatch England makes me reflect on how long I have been flying the flag for good admin. 

Since publishing this work, four years ago, all three of our organisations have continued to raise awareness of admin as a critical issue; yet people’s poor experiences of admin continue to have a negative impact on both their care, and their perception of the healthcare service. 

It is vitally important that we continue to raise awareness of this frequently overlooked issue. As the stories within the long read from the King’s Fund, Lost in the system: the need for better admin in the NHS, reveal, many people find themselves stuck in an admin doom loop, trapped by no reply emails and unable to access the person or answers they need. The impact of this often goes beyond simple frustration, causing actual mental health distress and impacting on the overall quality of care received.  

In fact, our research tells us four in ten people who faced issues are less likely to seek care in future after a bad admin experience. The potential consequences of this are extremely worrying. 

Inequity of experience

Poor NHS admin is clearly affecting large groups of people, and we are all hearing those frustrations from our friends, our loved ones, our coworkers.  

Analysis of our research findings show that people with long term conditions, alongside other groups experiencing health inequalities, are more likely to have experienced issues, with 38% of people with a long term condition saying the NHS is poor at keeping people informed about what is happening with their care and treatment, compared with 29% of people who do not have a long term condition. 

If you then also consider people with multiple long term conditions (an estimated 14 million people in England), who have many interactions with different parts of the system, they are likely to feel the burden of admin multiply as a result. This can be very challenging, especially in addition to managing their complex health needs, and many individuals report their frustration at having to reiterate their communication needs to multiple healthcare professionals. 

For hardworking NHS staff, ineffective and inefficient administration can create bureaucracy and hamper productivity. It is imperative to improve things, for the sake of everyone involved. 

Admin needs urgent attention

The main aim of our research is to sound the alarm over the importance of patient experience of admin, and the sheer amount of people who are encountering issues.  

By improving people’s experience of administration, we reduce the amount of time spent in frustration, confusion and help to make things more manageable for people with long term conditions.  

Ensuring people spend less of their time chasing up test results, or deciphering baffling emails lifts a huge burden, and will not only improve people’s experiences of healthcare but also how they perceive it.  

While this change won’t make the front page, it could really turn the tide on tumbling public satisfaction rates with the NHS. The incoming 10 Year Plan provides a much needed opportunity for the Government to demonstrate their commitment to prioritising admin and getting the basics right for everyone.