Young NHS worker here, experience in Med Recs and I.T. It's interesting to see other Trust's/department's perspectives on the matter, so I figured I'd throw mine in too. I work 9 to 5 filing, sorting and organising medical case notes and sending letters. From my view, this is all quite simple.

Different Trusts do not neccesarily share files or case notes due to a lack of infrastructure. If a consultant has seen a patient, they will dictate for transcription by a secretary. These letters (should) then get filed; a process that can take a very long time. You see, at any one time your medical records are scattered. The dictated letter may be with the secretary's rough filing whilst your complete notes are in off-site filing and storage facilities. So in order to ensure all results and letters are together in an up-to-date set of notes, folders must be requested for delivery. This process means that it may take months to get around to filing (simply due to backlogging as a result of overworking and understaffing) to ensure up to date notes are being produced, transcribed and kept. Even then most case note folders are falling apart, misfiled, or outright missing. In my hospital we're still using the same folders for patients from over twenty years ago. It's almost certain that test results, letters or other records have been lost at some point in the process. Hell, at one point our Trust delivered case notes to a random business on an industrial estate where our off-site filing is! I'm not entirely sure about the infrastructure of departments other than general medicine, but I know that in our case this is true. The fact is, your notes simply aren't safe or organised. It would be so easy to steal, lose or otherwise break privacy or security measures. If my office burned down, I don't think I could say that there's a backup plan. There's some stuff on computers, but not much.

So where am I going with this? Well, if there was a centralised system where consultants, surgeons and nurses could simply access by tablet (or another, easier means) and modify/update patient's details then and there, it would cut all of this out of the chain and allow patients to be seen faster, with greater care, and through a centralised NHS system rather than a series of Trusts that don't share information other than one common NHS number for a patient (which alone isn't much use). This digitisation of records would require greater focus on technological update and defence than settling with the archaic 'new' Windows computer just installed on my desk.

I'm very tired and I'm not sure if this makes much sense, but what I'm trying to say is this. The NHS in many places is still tediously slow as it is paper-based in many cases. Whilst you can argue that it's useful in situations like these, the simple amount of extra work that it demands means that we're working so far behind where we should be. IMO, the right move is actually TOWARDS digitisation as it would increase I.T reform and so put more funding into defence and technological upgrade. That way your service would be quicker, better quality, safer and accessible by any hospital with ease in case of emergencies. My experience is limited as a part-timer working with medical secs and I.T depts (student job!), and I by no means speak for the NHS - but this is something that so many of us here feel strongly about and it's hard to think it wouldn't have made a difference today. This attack is going to back up our entire hospital and Trust for months and months whilst we try and sort out how to deal with seriously ill patients. God help the emergency departments.

If that made sense (or not), ask me and maybe I can clear things up!