From paper to cloud: NHS transforms clinical documentation over 70-year history
Nuance celebrates the NHS’ 70th birthday by acknowledging the major milestones in the evolution of patient clinical documentation

LONDON, United Kingdom: June 20th, 2018: Nuance Communications today celebrates the 70th anniversary of the NHS by revealing the evolution of clinical documentation since its birth in 1948. In more recent times, the NHS has undergone digital transformation at a grand scale to keep pace with the demands on its services and striving to deliver better care and quality of service to its patients. A radical shift in the way patient data is created and communicated is just one example of this digitisation.

In 1948, NHS staff were entirely reliant on pen-and-paper to create patient records to track patient progress and enable communication between healthcare professionals.

The first change to this process came in the form of the Dictaphone in the early sixties – and then cassette tapes – which were introduced to enhance the accuracy of clinical documentation. Cassette tapes were used by doctors, who would dictate their clinical patient records for secretaries to type up. This major shift reduced the time clinicians themselves needed to spend recording critical patient data and instead freed up time for more patient care.

The Data Protection Act of 1998 gave patients or their representatives the right to a copy of their record, except where information may breach confidentiality. This was arguably the birth of digital patient records, with the legislation forcing Trusts to develop a simpler and more efficient way of organising, securing and accessing patient documentation.

The early 2000s then saw NHS organisations ‘going digital’ with electronic patient records, with some early adopters beginning to incorporate speech recognition to improve the speed, accuracy and efficiency of clinical documentation. However, health records of citizens were often held locally within a single NHS Trust’s IT system, with the resulting impact being that there was no coordinated system between healthcare providers. This is still a challenge today.

In 2009, the NHS migrated from tapes to digital dictation, speeding up clinical document turnaround, improving data security, cutting costs and reducing the potential for lost reports. This was an important step forward for documentation, especially as just a few years later, Health Secretary Jeremy Hunt challenged the NHS to ‘go paperless’ by 2020. Such a move would “save billions, improve services and help meet the challenges of an ageing population,” he said.

A significant study of NHS England Trusts, conducted in 2015 by Nuance, revealed over 50% of doctors’ time was being spent on clinical documentation. Shining a light on the strain on healthcare staff in terms of clinical documentation, the report also found that doctors spend an average of over 10 hours a week adding to existing clinical documentation.

Fast-forward to today, and while clinical documentation has taken great strides - with some organisations, such as South Tees Foundation NHS Trust, incorporating AI-enabled speech recognition technology - there are many that still rely on inefficient methods that impact upon the amount of time doctors can spend with patients.

As the National Health Service celebrates 70 years, we now have technology that enables patient records to be created, secured, stored and managed in the cloud and, in doing so, providing technology that supports clinicians ‘on-the-go’ and with a secure, quick, easy-to-deploy and scalable solution for health organisations.

Dr Simon Wallace, chief clinical information officer at Nuance, said, “The NHS has transformed itself over the past seven decades, with patient services evolving beyond recognition. Against a multitude of challenges – from budget constraints to an aging population – its dedicated healthcare professionals work to deliver world-class patient services.”

“Still, too many of those are staff held back by a lack of strategic investment in technology. Clinicians are incredibly busy, and their top priority is always patient care. Clinical documentation is vitally important in tracking any patient’s journey through the care system, but it is time consuming to complete.

“However, today, AI and cloud-based solutions enable clinicians to record and share information within their own and partner organisations more reliably, flexibly and efficiently than ever before. This boosts the accuracy, completeness and timeliness of recorded data and frees clinicians to get back to what they love – caring for their patients.”

Please click here for the 70 years evolution infographic.

About Nuance Healthcare

Nuance provides intelligent systems that support a more natural and insightful approach to clinical documentation, freeing clinicians to spend more time caring for patients. Nuance’s healthcare solutions capture, improve and communicate more than 300 million patient stories each year, helping more than 500,000 clinicians in 10,000 global healthcare organisations to drive meaningful clinical and financial outcomes. Nuance’s award-winning clinical speech recognition, medical transcription, CDI, coding, quality and medical imaging solutions provide a more complete and accurate view of patient care. For more information, please visit or connect with Nuance on social media through the healthcare blog What’s Next, as well as Twitter and Facebook.

About Nuance Communications, Inc.

Nuance Communications (NASDAQ: NUAN) is the pioneer and leader in conversational AI innovations that bring intelligence to everyday work and life. The company delivers solutions that can understand, analyse and respond to human language to increase productivity and amplify human intelligence.  With decades of domain and artificial intelligence expertise, Nuance works with thousands of organisations – in global industries that include healthcare, telecommunications, automotive, financial services, and retail – to create stronger relationships and better experiences for their customers and workforce. For more information, please visit

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