Pagers, as a communication tool, reached the peak of their popularity in 1994. At that point in time, there were approximately 61 million in circulation worldwide. However, as support for the ageing systems have declined and benefits have been surpassed by those of mobile devices – that number has dropped to an estimated 1 million.
However, despite this, pagers are still the primary method of communication for doctors, nurses and clinicians in the NHS. From assembling emergency trauma teams to providing daily updates – pagers form a vital aspect of day-to-day operation. But with more cost effective, efficient and secure communication options available, why is this legacy hardware still relied upon so heavily, and what are the implications? That’s what we aim to investigate in this report.
This report specifically examines the role of pagers within the NHS; highlighting how privacy concerns, along with issues of digital infrastructure, have hindered Trusts from adopting more cost effective communication channels.
The Prevelance of Pagers in Acute Care Settings
The information presented has been gathered from Freedom of Information requests to a sample of 141/ 219 Acute, Mental Health and Ambulance Trusts – with a 5% margin of error and confidence interval of 95%.
Key Findings and Implications
We are also able to draw a number of conclusions regarding the relationship between Trust pager usage, income and Clinical Digital Maturity Index (CDMI) rank. This is most evident in acute care settings, which account for 93.29% of the 129,429 pagers in the NHS.
In fact, there are almost the same amount of pagers in Acute Trusts as there are beds, with a ratio of 0.94 pagers per bed. Although despite this, there are 0.14 pagers per NHS staff member, suggesting that devices must be shared among teams for the greatest efficiency.
However, this ratio varies dramatically depending on the income of the Trust. There is an average of one pager for every 8.7 NHS staff in the top 10 largest Acute Trusts as ranked by income. However, there is one pager for every 3.5 staff in the smallest (as measured by income). This would suggest a much lower reliance on pagers as a communication method in Trusts with higher spending power.
Additionally, this can also be found in the entire upper and lower quartiles - as well as an average CDMI difference between the top & bottom 10 Trusts of 39.1.
The Difference Between Pager/Staff Ratios in the Top & Bottom 10 NHS Trusts
But perhaps most surprisingly is the cost of pagers to the NHS. Our research indicates that maintaining pager networks and services is costing the NHS a staggering... per year. By switching to digital communication channels, such as Intelligent Paging, it is estimated that the NHS could save £2.7 million every year, not including additional savings generated by efficiency gains.
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After compiling our findings, we reached out to digital leaders in the NHS to understand how pagers are perceived by those pushing for greater IT efficiency and more effective digital solutions. Rowan Pritchard Jones, CCIO at Whiston Hospital explained the very real challenges that pagers pose on a daily basis:
“Pagers represent 20th Century technology and are a blunt instrument for communication. Apart from a ‘fast bleep’ doctors have no sense of the urgency or priority of a call, end up writing down messages that can be lost, and often find a telephone number engaged when they do answer it. Spare a though for the ‘bleeper’ sitting by a phone waiting for an answer from a doctor who may be at a bedside performing a task for ten minutes.”
Geoff Hall, CCIO & Associate Medical Director of Infomatics at Leeds Cancer Centre and Dave Moody, Data & Telecoms Infrastructure Manager at Leeds Teaching Hospitals NHS Trust highlighed the benefits of pagers, and why they are still such a common sight:
"Pagers seem like old technology, but they still exist purely for their inherent high levels of resilience. They are simple to use i.e. calls can be pushed out by ringing one number, there is an audit trail, the device is easy to carry, and the battery lasts months, not hours. They do only one task, but they do it well. They provide a last line of defence."
Discover the cost and prevelance of ageing communication systems in healthcare, download the report - The Cost of Pagers in the NHS.