Sunday 19 June 2011

The NHS - Breaking Records

The ongoing shambles over the NHS computer schemes has many large sums attached to it. £12 billion seems to be the cheapest but it could be more. Nobody really knows, including the Department of Health and The Treasury. In the past decade figures of more than double have been suggested.

Also, any cancellation is alleged to cost potentially more than carrying on regardless. If it is cancelled then it will start all over again. In the meantime people who go to the doctors and the hospital spend much of their time explaining to the people what they are supposed to be doing and what has gone on in the past.

A near friend of mine is in the unlucky position of having to do this for critical reasons. He has told me, and many others, the gruesome tale. Time after time he turns up at the desk, waits while the assistant checks out the details and then asks if they are aware of his issue. He takes care to inform them of this well in advance and his records are supposed to be full of it.

Invariably, the staff at the desk do not know, so they tell him to tell the nurse. When he sees the nurse, then he has to go through again the business of who he is and what and it is clear they do not know there is a major problem. This needs sorting out and complicates matters. Eventually, the time for him to see the doctor arrives.

Also the doctor does not know and when told sometimes panics, sometimes just goes white. The last one he saw told him it would be better if he stayed away from any medical facilities because of the risks. My friend says the doctor was very right, despite the fact that he supplies at all times an updated and full record of his medical history.

He tells me that his experience is that the nurse has made notes for the doctor who makes notes and puts them on the file. He does not see the notes. Then he goes home and weeks later a letter may or may not come telling him what the hospital has told his family doctor. Sometimes things are not quite right.

His doctor cannot revise them, because it is the hospital. The nurse at the hospital cannot revise their records because it is a matter for the doctor. The doctor he will see next is always different from the last one and cannot correct the records they have because it was made by another doctor.

So we have a situation where he has accurate records but his family doctor, the hospital, the nurses and the system as a whole has no method of maintaining records that are readable, up to date or even correct.

Over the Atlantic a bunch of guys got together, hired a few people and looked at what was what. Because of the USA medical insurance system it is just as vital to have accurate up to date records that enable care and the relevant finance to pay for it. Yes it is money driven but given the USA legal system it is accuracy driven.

For a tiny fraction of the cost of our NHS efforts they have come up with a system, put together in four or so years, that meets many, if not all, of the requirements and allows a much more reliable way of dealing with patients. Critically, it involves the patient in the process and can be updated continually.

I made the mistake of telling my friend about this. He started banging his head against the wall and I was scared stiff he might need to see a doctor.


  1. I've just undergone major heart surgery. After starting on the NHS and experienced the new waiting system and I quote an NHS adminstrator here, "The wait to see the cardiologist is currently 2 weeks, we will call you in about 8 weeks time to put you on the list" and having my records lost, I went private, at my own expense ( No insurance). The Experience could not have been more different. All waiting melted away, I was dealt with efficiently and effectively and am now 4 weeks into recovery for an operation that I wouldn't otherwise be having until October at the earliest. Every time I touched NHS admin, disaster. Every time I eventually touched NHS staff at the sharp end, superb. We may assume the system is very broken methinks.

  2. Interesting post. While reading it, I realised that the Amazon Kindle is in principle suited to medical record keeping. All the books you buy are stored by Amazon as well as being on your Kindle, so you can't lose them even if your Kindle reader is destroyed. For books, just read 'medical records' and the job's done.

    I'm sure there are other commercial products entirely suited to what must surely be a simple requirement.

    Simple? Nobody in the public sector wants simple though. Careers aren't built on simple.