Digital Versus Paper-Based Consent from the UK NHS Perspective: A Micro-costing Analysis

Area of Science:

• Health Economics
• Clinical Informatics
• Patient Safety

Background:

• Paper-based consent processes in the UK National Health Service (NHS) are prone to errors, missing information, and poor patient understanding.
• Limited research exists on the comparative costs and implications of adopting digital consent pathways.
• Digital consent offers potential solutions to the limitations of traditional paper consent forms.

Purpose of the Study:

• To compare the relative costs of digital consent pathways versus paper-based consent pathways within the UK National Health Service (NHS).

Main Methods:

• A micro-costing study was performed from the UK NHS perspective.
• Multi-stakeholder input informed the understanding of paper-based consent variations across departments and settings.
• Sensitivity and scenario analyses identified key cost drivers, including consent timing and hospital digital readiness.

Main Results:

• Paper consent forms cost approximately £0.90 more per episode than digital consent.
• Elimination of paper form ordering, printing, and transportation contributes to digital consent's cost-effectiveness.
• Consultation duration significantly impacts the relative costs of both consent pathways.
• Preventing one litigation claim could save an average of £201,590.

Conclusions:

• Digital consent presents a potential cost-saving opportunity for the NHS.
• Digital consent is most effective when used for elective procedures prior to the day of surgery, maximizing savings.
• Further research should focus on consultation duration as a key factor influencing consent pathway costs.