Q&A with Solent NHS Community & Mental Health Trust
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?
It was already on our agenda as a transition project, however after attending the HETT event in 2018 we followed the lead of Leeds Teaching Hospital. We saw it was a great opportunity to use some of the ideas and advice you gave in your presentation and started the ball rolling quickly.
How many fax machines did you have in your organisation?
80.
What were fax machines predominantly used for in your organisation?
Prescriptions, time sheets, clinic lists and pharmaceutical orders.
Have you managed to reduce this number? If so, how many fax machines are still in use?
We have seven remaining to be removed, so less than 10% left to go.
Are you confident of meeting Matt Hancock’s deadline to remove all fax machines in use by 31st March 2020?
With only seven fax machines to remove, we are confident we will meet our own internal target to remove fax machines by the end of 2019. Our pledge was to remove all fax machines by end of 2019; this was endorsed by our lead executive, David Noyes.
Did you have a strategy in place for your ‘axe the fax’ campaign?
The campaign has been service-led. We wanted to work with services to develop alternative systems to using the fax machine. Our IT team has been providing support to services to make sure they had everything in place before they ‘axe the fax’.
Did you use any resources from the axe the fax campaign? Pledge cards? Stickers? Top tips?
We did use some of the ideas from the campaign, specifically we sought stakeholders buy-in, had many two way conversations with services and asked Solent’s Trust Board to set our own deadline. We also made use of axethefaxenquiries@nhs.net email address to ask questions to help us overcome hurdles.
How did you engage staff with your axe the fax journey?
It was really important that executives and service leads understood the idea behind, and benefits of, ‘axing the fax’. We used our internal communication channels to spread the messages widely. We also used our already established Service Engagement forums to support services with process redesign and to keep ‘axe the fax’ high on the agenda.
What alternatives to fax did you find/implement?
We didn’t purchase an alternative system; we eradicated the need for the fax functionality and championed different ways of working.
What was your biggest challenge?
We are still working with our final seven users on different ways of working. The key concern was/is around business continuity, but we have worked to improve understanding of system resilience to alleviate fears of not owning a fax machine.
Has anyone been hesitant about moving on from fax?
We still have some hesitation from colleagues, but we work with them to try and find alternative solutions.
Have you kept any fax machines for business continuity?
In line with the request of our executive lead, and Matt Hancock, we are aiming to remove all fax machines.
Why do you think it’s important to ‘axe the fax’?
It’s a number one priority to secure patient confidentiality and protect patient details and avoids the risk of actions being left unnoticed on an unattended fax machine.
Do you have any advice for other organisations looking to get rid of their fax machines?
A few key tips:
- First and foremost, get buy-in from senior people and a set date to work to.
- Identify the location of each fax machine
- Instruct your Patient Systems Teams and your corporate teams to remove the fax numbers from your templates and clinical letters
- Remove machines not in use and log traffic sent and received for one month on remaining devices
- Seek alternative ways of working, inform your ICT department of analogue lines no longer in use so they can be cancelled and you can realise the benefits.
Have you realised any benefits since making the switch from fax?
Benefits from the patients point of view assures that their personal information is secure and not left unattended for the wrong people to see. Benefits from the Trust point of view are that at financial year end, we will have saved approximately £14,000 by decommissioning the analogue lines, therefore removing the line rental charges and their monthly operating and usage charges too.
Is there anything else you’d like to add?
The majority of people were happy to remove their fax devices and move away from historic ways of working. Our community and mental health trust supports mobile working and the majority of our employees either have a managed print and scanning device, access to a laptop device with a plug and play scanner or a Smart phone.
The final seven faxes are going to be a joy to remove and destroy, watch this space for a photo next time.
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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?
The Axe the Fax campaign within the Trust is being carried out for a number of reasons:
- It was identified as an enabler to improve the frailty pathway in East Lancashire following an improvement event last summer
- In response to the communication from Matt Hancock
- To maximise use of digital technology, create streamlined processes and to encourage paperless working.
How many fax machines were/are in your organisation?
Initially, 245 fax machines were identified within East Lancashire Hospitals Trust but it further work showed this position was not as robust as it could have been and we have identified further machines that were not on our original list. We also had details for machines that were already no longer in use.
Have you managed to reduce this number? If so, how many fax machines are still in use?
Initial work with departments to verify our starting position, identify their usage of the fax and other ways of communication has enabled reduction of the fax machines by around 38%. It is estimated that there are around 150 fax machines still in the organisation.
What are fax machines being used for in your organisation?
Fax machines are being predominately used to send orders to Pharmacy from peripheral sites and to external GP practices and Care Homes as well as District nurse referrals. Work is being undertaken to identify other ways of communicating this information.
Are you confident of meeting Matt Hancock’s deadline to remove all fax machines in use by 31st March 2020? Do you have your own deadlines in place?
We are confident that the deadline for Matt Hancock’s removal of fax machines will be met by ELHT with the exception of KoFax being implemented for a small number of external users, although there is a considerable amount of work to do to ensure this.
Do you have a strategy in place for your ‘axe the fax’ campaign?
A strategy is in place to Axe the Fax by removing fax machines at an average rate of 15% month-on-month. Communications were sent out to all Trust employees encouraging a “fax amnesty” (see attached) and work has been carried out with IT to look at alternative options to faxing.
What alternatives to fax have you found/implemented?
Some examples:
- Scanning and sending documentation by email rather than by fax is being used both internally and externally where secure email addresses are in place. A direct scan and send email link is being implemented on our printers to send Pharmacy orders and generic email addresses are being set up within departments with multi-user access for staff.
- GP Practices have been working with the ELHT Radiology department on a trial to communicate results via email rather than faxing them which has proved to be extremely successful and will be rolled out to other GP practices.
- For internal departments on peripheral sites, shared IT folders has assisted in the reduction.
What’s been your biggest challenge so far?
Communications involving multiple departments (both internal and external) – the less departments involved for any particular communication, the easier it has been!
Has anyone been hesitant about moving on from fax?
There has been resistance from a small number of people who have always used fax machines and are hesitant about moving to the use of new technology but overall the Axe the Fax Project is being embraced throughout the Trust.
Why do you think it’s important to ‘axe the fax’?
Technology has advanced significantly since the fax machine was introduced 50 years ago and, as well as recognising the importance of technical innovation, the carbon footprint is extremely important to our organisation. Eliminating fax machines reduces paper usage and toner which helps optimise and neutralise our carbon emission.
- Fax = inefficient process; time to send etc
- Information governance risks will be reduced; incorrect number dialled, insecure recipient processes
- Lost communications will be reduced (and subsequent incidences and risks – for example with missing referrals)
Do you have any advice for other organisations looking to get rid of their fax machines?
Communication and engagement is key. Clear engagement with staff avoids any misunderstandings. Before removing fax machines carry out research into their usage to ensure an alternative system of communication has been put in place.
Do you have any questions for other organisations that have managed to “axe the fax”?
What difficulties were encountered in the removal of fax machines and what was the learning from this? Did any potential further improvements come to light from carrying out this process.
Is there anything else you’d like to add?
Keeping up-to-date with technology is the way forward.
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