Instant messaging services a “vital part of the NHS toolkit” during a crisis

New guidance for the NHS will help doctors, nurses and other staff use instant messaging safely to co-ordinate patients’ care during emergencies.

Medics have turned to communication channels such as Whatsapp to deal with emergency situations like the Croydon tram crash, Grenfell Tower fire and terrorist attacks in London Bridge and Manchester Arena.

The new guidance will help NHS organisations and staff to make a judgement on how and when to use instant messaging safely in acute clinical settings, taking in to account data sharing and data privacy rules.

Simple steps that staff should take include:

  • Only using apps and other messaging tools that meet the NHS encryption standard
  • Not allowing anyone else to use their device
  • Disabling message notifications on their device’s lock-screen to protect patient confidentiality
  • Keeping separate clinical records and delete the original messaging notes once any advice has been transcribed and attributed in the medical record.

Dr Helgi Johannsson, Consultant in Anaesthesia at Imperial College Healthcare NHS Trust, set up a major incident instant messaging group to help coordinate his hospital’s response to Grenfell Tower after learning a key lesson during the Westminster attack.

Dr Simon Eccles, Chief Clinical Information Officer for Health and Care, said: “Helping people during a crisis like the Grenfell fire, demands a quick response and instant messaging services can be a vital part of the NHS toolkit. Health service staff are always responsible about how they use patients’ personal details and these new guidelines will help our doctors and nurses to make safe and effective use of technology under the most intense pressure.”

Dr Johannsson, who was involved in reviewing the new NHS guidance, said: “Fully encrypted instant messaging services can be a particularly useful communication tool in delivering care to people during a major incident.

“From the Westminster attack we learnt it was important not to overload the emergency care co-ordinators with offers of help, so with Grenfell we used instant messaging to help coordinate which staff should come in, who was needed where and plan the service for later on that day which vastly improved the care we were able to provide.

“These sensible guidelines will make the care of our patients safer through better communication by NHS staff.”

Mr Andrew Miles, Consultant General Surgeon and Royal College of Surgeons Council Member, said:“Patient safety is enhanced when NHS staff can quickly communicate confidential patient information between teams, such as by instant messaging.

“Doctors have a responsibility to abide by all relevant rules on patient confidentiality and a professional responsibility to ensure they do not breach that confidentiality when using instant messaging tools.

“This important guidance will keep our patients safer by empowering clinical teams to use the latest and best available technology.”

The NHS has not endorsed any particular instant messaging tools; instead, the guidance sets out what information governance issues need to be considered and what standards need to be met.

Dawn Monaghan, Director of the Information Governance Alliance, said: “Improved communication between medical professionals keeps patients safer.

“Instant messaging however is no substitute for the medical record and it is important any advice received on those channels is added to the medical record, with the original messages deleted.

“This guidance has been designed with clinicians to help NHS organisations and their staff take a proportionate approach, considering both the potential risks to privacy and the potential improvements in patient safety.

“I’m hopeful this new guidance will prove a valuable resource to assist NHS organisations in implementing policies that will help their staff decide when it is appropriate to use instant messaging tools and when it isn’t.”

The new guidance was published jointly by NHS England, NHS Digital, Public Health England, and the Department of Health and Social Care.