NHS Fail

[do_ron_ron]

What does everyone have against privatisation? It might mean people actually have to work for a living rather than have children for a living

Go look at America where about 30% rely on medical charity for their needs.

 

[do_ron_ron]

The fact that different trusts pay different prices for items is a rather obvious place to start to be fair.

Was there not a central purchasing system at one time?

 

[do_ron_ron]

Sensible suggestion and chimes with what I loosely believe as well. We *want* an NHS but we need to be realistic in the format that it comes in.

I have also thought a top up system of some sort where you are allowed free care to X amount but anything on top of this you pay a top up. Hopefully might dissuade misuse but the flip side is the introduction of a two tier system of those who can't and cannot afford further care.

Only problem with your referendum is that it's the elderly who mainly vote so we would inevitably end up with option 1 so they get continued better care and the younger generations foot the bill (though also able to draw on the benefit of great care)

So somebody with complex conditions or rare conditions can just die under your scenario. Wonder what you would say if it was your mother, father etc who was in that position.

 

[Deleted member 66701]

The others near me are terrible in terms of performance and have another problem...addicts.

If the local GP surgeries to you have problems with addicts then moving house might be a better option!

 

[do_ron_ron]

Fighting at 08:30 on a phone line to try and get an appointment for the same day, or having to take an afternoon's leave from work because the queues are usually 2-3 hours at the walk-in centres is hardly a suitable situation, is it?

Lucky, lucky you. I cannot remember when I could get an appointment the same week. Normally it is two weeks but sometimes three weeks.

 

[SexyGreyFox]

Paying people to push trolleys of paper notes round because of the refusal to embrace modern technology.

Can you tell me what this modern technology is?
Careful with your answer because I use electronic records every day from multiple systems.
I've also been invited to see 'new' ways of capturing data to electronic systems and I've never seen a modern system that a Clinician can navigate properly.
Our own trust is responsible for up to 3 million people and most of them have written notes, believe me it is a very slow process to get those written records to computer systems.
I've been dealing with a patient today where it took 1 person a whole week to transfer all those records to our EDMS system and put all the scanned notes into around 50 categories and in date order.
This will now have to be navigated by a Clinician who has got to find all the relevant notes on a particular case and it can take them ages to find it.
get that same Clinician with a hand held set of notes and they immediately thumb straight to it.

Spend a day in my shoes.

 

[tom_nieto]

Can you tell me what this modern technology is?

A huge problem is trying to integrate old paper notes into electronic systems. I've never come across a system which is quick or easy enough to use (partially because it's not usually indexed at all) which navigates scanned notes. The problem is then compounded because everyone thinks electronic systems are rubbish and refuses to use them. My current trust uses a fantastic electronic system which could replace paper notes entirely but for some reason we still write in the notes every day on the ward rounds. There is no easy solution! We can't simply switch to an electronic system and bin all the paper notes unfortunately!

 

[Dis86]

If the local GP surgeries to you have problems with addicts then moving house might be a better option!

Lol. They're not very local. Just the nearest decent sized surgeries. But yes, a lot of addicts. Quite unpleasant to be around so i feel worse for the staff that have to deal with them.

 

[Minstadave]

Can you tell me what this modern technology is?
Careful with your answer because I use electronic records every day from multiple systems.
I've also been invited to see 'new' ways of capturing data to electronic systems and I've never seen a modern system that a Clinician can navigate properly.
Our own trust is responsible for up to 3 million people and most of them have written notes, believe me it is a very slow process to get those written records to computer systems.
I've been dealing with a patient today where it took 1 person a whole week to transfer all those records to our EDMS system and put all the scanned notes into around 50 categories and in date order.
This will now have to be navigated by a Clinician who has got to find all the relevant notes on a particular case and it can take them ages to find it.
get that same Clinician with a hand held set of notes and they immediately thumb straight to it.

Spend a day in my shoes.

We've just binned our electronic record system because it wasn't fit for purpose. The IT monkeys just buy the cheapest crap and get their nose all out of joint when it doesn't work in the real world.

 

[Xordium]

We've just binned our electronic record system because it wasn't fit for purpose. The IT monkeys just buy the cheapest crap and get their nose all out of joint when it doesn't work in the real world.

Going back when they tried to implement one with us the company couldn't seem to get their head around why it would be impossible to take a portable tablet type device into different cubicles with level 3 infectious diseases ...

They thought one or two per ward would be sufficient because it wouldn't be like people were entering it at the same time either ...

 

[shadow_boxer]

Personally I can't stand our trusts IT systems. We've so may different systems that it takes an age to find anything. For example I can check a blood test on one system but then need to make orders on another! Utterly pathetic and so damn inefficient. For a typical new patient clerking I'll need to login to 7 different systems to get the relevant information, and this is for a local patient, if they're out of area then I've got no chance.

 

[FishFluff]

I feel your pain guys. I work for (what's soon to be called) NHS Digital and we're supposed to be in charge of sorting all this mess out but it's incredibly difficult when every single Trust has a completely different IT system because 'reasons'.

Thankfully I just work in the data analysis side of things, although I'm sure the likes of Dolph would think that my job is valueless busywork that should be scrapped.

 

[do_ron_ron]

We've just binned our electronic record system because it wasn't fit for purpose. The IT monkeys just buy the cheapest crap and get their nose all out of joint when it doesn't work in the real world.

Cheapest? They have wasted £Billions on systems that companies could not deliver.

 

[SexyGreyFox]

Personally I can't stand our trusts IT systems. We've so may different systems that it takes an age to find anything. For example I can check a blood test on one system but then need to make orders on another! Utterly pathetic and so damn inefficient. For a typical new patient clerking I'll need to login to 7 different systems to get the relevant information, and this is for a local patient, if they're out of area then I've got no chance.

Hmm, didn't know you worked somewhere near me

Every day I will load up:
IPM which shows me patient journeys going back to the 90s and I can also get old letters from there. Other staff use IPM to put patients appointments on.
iPortal which is replacing CIS but there are some differences where I'll be knocking on doors to get access (this is a centralised software which shows lots of data on the patient with links to other programs like below).
ICM but I've just had access to ICE which now does both Stoke & County Pathology
CRIS and at last we now have a combined Stoke & County system for XRay reports.
Our main electronic records system is called EDMS and it is shocking to use but I've been given access to a much better system for getting everything off there in multi TIF format that I can then read in Adobe.
County have their own called EDRM and mine has gone off this week so I've put a few calls through to IT.
I have full access to Clinical Photography but they have changed that system and I can't download anything because I've only got Doctors access so I've been sent a form to fill in so I can get full access again.
In November we are going to have a system called Medway which I've done my training for and hopefully a lot of stuff will be centralised in that.
I've missed quite a few off because there are loads more but there are records all over the place on different systems and it's part of my job to find them.

Now times this with every hospital that uses a different system it will be hell to implement one system.

I'm sure Dolph has the answer.

 

[Woden]

This explains a lot.

I was prescribed amoxycillin yesterday but had to get her to change it as I'm allergic to penicillin. Now my file isn't flagged for any allergies, but she could see my hospital treatment for severe reaction to penicillin :/

 

[SexyGreyFox]

This explains a lot.

I was prescribed amoxycillin yesterday but had to get her to change it as I'm allergic to penicillin. Now my file isn't flagged for any allergies, but she could see my hospital treatment for severe reaction to penicillin :/

Here in Stoke our CIS/iPortal will show that under Comorbidities but I remember a couple of years back one of our posters who worked in A&E down South said their system doesn't show stuff like that
Even the paperwork amazes me.
I'll get hospital notes from Stoke, County (Stafford), Bradwell, Haywood, Leighton & Cheadle and they are all different eg Prescription Books look totally different hospital to hospital and this goes for everything. The only paperwork that looks similar are correspondence.

 

[Minstadave]

Cheapest? They have wasted £Billions on systems that companies could not deliver.

But they'll always go with the rank amature solution, it'll still cost millions but rather than getting IBM/MS etc we get some small company's pilot software which isn't fit for purpose and doesn't talk with any of the other systems which are hashed together and decades old in some cases.

Want to review a patients background - well the notes are stored as 500 pages of unsorted PDFs which the network is too slow to give you at anything but a snails pace, radiology is on another system, blood results are on two seperate systems. Want to see their cardiac stress test? Well that's too difficult to scan so the scanning company don't bother and just shred them with the scanned notes so that's gone forever.

NHS IT needed a clean sweep, bringing all trusts together onto a universal system but it never happened.

 

[do_ron_ron]

But they'll always go with the rank amature solution, it'll still cost millions but rather than getting IBM/MS etc we get some small company's pilot software which isn't fit for purpose and doesn't talk with any of the other systems which are hashed together and decades old in some cases.

Want to review a patients background - well the notes are stored as 500 pages of unsorted PDFs which the network is too slow to give you at anything but a snails pace, radiology is on another system, blood results are on two seperate systems. Want to see their cardiac stress test? Well that's too difficult to scan so the scanning company don't bother and just shred them with the scanned notes so that's gone forever.

NHS IT needed a clean sweep, bringing all trusts together onto a universal system but it never happened.

Steady on, you are talking about undoing decades of mainly Tory fragmentation of the system, concentrating it into small business unit capable of being sold off. You want to set up a system fit for purpose, to deliver care to ordinary people rather than private shareholders.

 

[Faustus]

This is exactly what we feared years ago, that the quality of service will start being reduced in order to save cash. Rather than fund the system to the levels of other developed countries.

Surely this can't be the reason as the Conservatives have repeatedly promised that the NHS is safe in their hands?

 

[Faustus]

Not a peep about changing ways of working and re evaluating pay and conditions to ensure efficient use of cash?

This is the problem with the public sector, there is incentive to screw the end user as a means to get more money, and no incentive to actually manage the cost of delivering through service.

I'm afraid Dolph if they had to re-evaluate pay and conditions then the staff would be entitled to a bumper pay rise and much better working conditions and no I'm not kidding. Most PSW haven't seen a pay rise since 2008 and their conditions are dreadful.

Have you seen the average A&E on most nights of the week?