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Q&A with Mid Cheshire Hospitals NHS Foundation Trust

This month Mid Cheshire Hospitals NHS Foundation Trust is in the spotlight, taking part in our axe the fax Q&A series.

What prompted you to start your ‘axe the fax’ campaign? Was it in response to Hancock’s ban? Or was it already on the agenda?

Originally, as part of our Service Development Improvement Plan, we were required to remove all fax machines in the Trust to fulfil the Local Digital Road Map ambitions and e-referral requirement.

How many fax machines were in use across Mid Cheshire Hospitals?

The Mid Cheshire Hospitals Foundation Trust is split over 3 sites, Leighton Hospital in Crewe, Victoria Infirmary in Northwich and Elmhurst in Winsford. We had 112 fax machines across the Trust.

What were fax machines predominantly used for?

Fax machines were predominantly used to send and receive patient correspondence.

Have you managed to reduce this number? If so, how many fax machines are still in use?

We have now removed 110 of the 112 fax machines. The remaining 2 fax machines in Optometry are used for referrals originating from optometrists who are outside the scope of Paper Switch Off and are not included in the 110 fax machines that were removed. Any delay in urgent / emergency referrals being received as a result of the fax removal in Optometry would have led to a serious incident.

Were you always confident of meeting Matt Hancock’s deadline to remove all fax machines in use by 31st March 2020? Did you make your own pledge/deadline?

From April 2019, organisations were required to use modern communication methods, such as secure email, to improve patient safety and cyber security. The Mid Cheshire NHS Foundation Trust therefore made the decision that all fax machines must be removed no later than the end of June 2019. As a Trust we were confident we would meet our June 2019 deadline, which was sooner than Matt Hancock’s deadline of 31st March 2020; as we invested in the Axe the Fax campaign early to give ourselves more than enough time to plan our strategy, engage and educate staff and understand any operational issues and how we could resolve them.

Did Mid Cheshire Hospitals have a strategy in place for its ‘axe the fax’ campaign?

Yes. Firstly the IT Project Team attended high level IT strategy meetings to engage the Board and Divisional Managers with the campaign and to get their buy in from the outset as this was essential to progressing the campaign. Our first task was to locate all the fax machines across the Trust and document the information, i.e. the location, fax number, contact name and what the fax machines were used for. We held regular face to face engagement meetings with the wards, departments and Senior Management; producing regular communications was essential to the success of the project, including repeated visits to understand, address and escalate as necessary any operational issues. We maintained regular communication with the Communications Manager so to ensure a central single focused and consistent method of communications was distributed both internally and externally.

How did you engage staff with your axe the fax journey?

We constantly had repeated positive engagement with the wards and departments to get a full understanding of their different requirements. This enabled us to manage the removal so to ensure the operational workings of the Trust were not affected. We engaged and informed staff via the intranet page, with information, a countdown timer and contacts so as all staff were aware they could come to us and we would assist them, as required, every step of the way.

What alternatives to fax did you find/implement?

We have implemented the use of secure email function for all 110 fax machines removed. Referrals originating from optometrists are outside the scope of Paper Switch Off and are not included in the 110 fax machines to be removed. eFax has been identified a suitable short term alternative The Optometrists will be introducing their own solution in 12 to 18 months and therefore are unable to remove their fax machines until this is in place. So to maintain to continuation of Optom services to the Trust, an alternative eFax solution will be used by Ophthalmology allowing them to remove their remaining Fax machine.

What was your biggest challenge?

Our biggest challenge was reluctance to change, fax machines had been in place for a very long time within the organisation and as such people were reluctant to change to an alternative solution citing a vast array of reasons, many of which proved not to be an issue.

Has anyone been hesitant about moving on from fax?

As per the previous question, some people were reluctant to change to an alternative solution citing a vast array of reasons, many of which proved not to be an issue.

Have you kept any fax machines for business continuity?

We have kept 2 fax machines in our IT department for business continuity purposes should they ever be required in an emergency.

Why do you think it’s important to ‘axe the fax’?

I believe it is important to ‘axe the fax’ as the switch from out of date and unsafe fax machines to a secure email function greatly improves the safety of our patient information massively reducing the risk of information being sent to the wrong location.

Do you have any advice for other organisations looking to get rid of their fax machines?

To other organisations I would advise that if you have not already initiated ‘axe the fax’ within your organisation then start now as this is a large piece of work across every area of the organisation. Decide what alternatives you will look to use, i.e. secure email, scan and send functionality on MFD’s or eFax services, and plan how you will achieve this. Get Senior Management buy in early on as this is critical to the success of the project.

Has Mid Cheshire Hospitals realised any benefits since making the switch from fax?

Since removing fax machines from the Trust, we have now have more accurate records of all information sent and received and a reduction in IR1 forms. No additional funding has been required to deliver the project, other than £11 per month for an interim eFax solution for Optometrists. The Trust will save an estimated £52,000 per annum on DDI lines, paper and ink costs as we no longer use the fax machines. The old DDI fax lines are now being utilised as extension numbers for staff.

Is there anything else you’d like to add?

We as a Trust believe that this project has been extremely successful as we have achieved a great improvement in the safety of patient information, and we have done this without needing to invest in an alternative solution to faxes by using our secure email function which was already in place within the Organisation. This campaign has allowed us to standardise the way patient information is sent to and from the Trust by all departments and ‘axe the fax’ has actually saved us money on the DDI phone lines, paper and ink costs associated with operating fax machines.