Careless costs related to inefficient technology used within NHS England

The NHS is becoming more reliant on technology, however the advances seen in personal electronics have not yet made their way to the workplace. Inspired by a recent multidisciplinary team teaching session where 16 members of staff waited 18 minutes for a computer and associated audio-visual equipment to work, I was interested to determine the total cost incurred during this time. A careless cost is the cost to an NHS employer for time spent on tasks which are unrelated to patient care, eg waiting for a computer to load or being on hold on a telephone call, and therefore time when patient care cannot be delivered.

Employment costs were calculated from the NHS pay scales for doctors in training and consultant grades.¹ Pension and National Insurance contributions were taken into account and an overall annual cost of employment was calculated. Assuming a doctor worked 40 hours a week for 48 weeks a year, an hourly and then a minutely cost of employment were calculated. To ensure careless costs were not overestimated the lowest nodal pay point was used for each grade of doctor.

NHS workforce statistics provide monthly figures for full time equivalent employees.² The latest publication was reviewed and the full-time equivalent data for doctors in training and consultants extracted. Full time equivalents were then rounded to the nearest whole number.

These numbers were then used to calculate the careless cost across NHS England. It is important to note that there are some limitations to the NHS workforce statistics which the careless cost calculations inherit. Primary care providers, services provided by non-NHS organisations and two foundation trusts do not use the electronic staff record upon which the NHS workforce statistics are calculated, therefore these staff will not be represented in the calculations.

If all doctors in training and consultants wait an average of 10 minutes each working day, the total careless cost to NHS England is £143,285,208 (Table 1). This is equivalent to 1.49% of the total NHS England spend on doctor employment or 0.11% of the total NHS England budget.^3,4 There is a significant cost implication of inefficient technology used by the NHS. Time spent waiting for digital devices to do the work expected of them is time where clinical care cannot be delivered. The argument for improving NHS IT is clear, halving the average waiting time from 10 minutes to 5 minutes would result in a saving of roughly £70 million.

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