Re: Privatisation of NHS hospitals begins : Mon Nov 14, 2011 10:10 pm  

sanjunien wrote:

with respct if you bothered to read 'Him's notes you will see the reference was for medical records -my reply was that medical records - that is to repeat for the last time is to do with hospital,doctors & dentists visits and treatments
the dozens of other things you list are treated in a different way some manually with papers/files and others electronically - ie: one example : any X- ray or Scan results are given to the patient within afew minutes of them being taken - they become the property of the patient not the hospital or doctor though the patients doctor will receive a copy of the conclusions.Similar for blood tests which are known within a few hours normally and handed or sent to the patient as well as a copy to their doctor
it's a whole new system,one which generally works brilliantly and puts the uk system and most other national sytems to shame

All the things I put in my list bar Mental, Physio and Occ Health are to do with hospitals, doctors and treatments. They are the totality of your patients notes and are called medical records they are just not all combined in one big file since they are generally held by the individual department. If you only included the general medical notes it would not provide a great deal of detail, certainly not enough for any kind of meaningful stay in hospital, the totality of the notes are often required, not to mention still have to be kept for legal reasons.

My initial response was that medical records in the UK cannot be easily transferred onto a digital/computerised format, you responded that my response was absolute bollox because they have some form of computerised summary in France. That is irrelevant since it appears to me, that the Carte Vitale is more a way of paying for/re-imbursing the patient the cost of their care with an electronic summary of care attached, not a complete medical record file, something which you admit yourself now in this post.

As for Xrays and scans, the same applies here, they are taken and produced within a few minutes and you can take the original home, however the hospital also keeps a copy.

If you go to your local hospital in the UK (and at my GP anyway, I dont know whether its standard for GPs or just some) they will have a summary of your care within that PCT on their computer system, but the often vital details of treatment, surgery etc are only available on the paper file.

Re: Privatisation of NHS hospitals begins : Mon Nov 14, 2011 10:38 pm  

sanjunien wrote: yes it's the Carte Vitale Then it doesn't contain anything more than a summary of treatment (an invoice in format) and the financial details to allow you to claim back the cost. http://www.french-property.com/guides/f ... ealth-card Hardly the super system you made it out to be, mind it is a start which is how the UK system should have been set up.

sanjunien wrote: yes it's the Carte Vitale Then it doesn't contain anything more than a summary of treatment (an invoice in format) and the financial details to allow you to claim back the cost. http://www.french-property.com/guides/f ... ealth-card Hardly the super system you made it out to be, mind it is a start which is how the UK system should have been set up.

Re: Privatisation of NHS hospitals begins : Mon Nov 14, 2011 10:56 pm  

Big Graeme wrote: Then it doesn't contain anything more than a summary of treatment (an invoice in format) and the financial details to allow you to claim back the cost. http://www.french-property.com/guides/f ... ealth-card Hardly the super system you made it out to be, mind it is a start which is how the UK system should have been set up. It would probably make a lot of sense to have some sort of card or some system that just contains a summary, especially one that contains a list of any allergies and what pills etc have been prescribed and other important information which could be useful if going to a different hospital. But, a card or system that contains detailed medical records is miles off in the UK, and I can't see how one can be currently in place anywhere at the moment without suffering from the problems of access and security. There would be massive concerns about patient confidentiality, because for a start in the UK a medical facility is not supposed to even admit that any kind of medical notes even exist for an individual.

Big Graeme wrote: Then it doesn't contain anything more than a summary of treatment (an invoice in format) and the financial details to allow you to claim back the cost. http://www.french-property.com/guides/f ... ealth-card Hardly the super system you made it out to be, mind it is a start which is how the UK system should have been set up. It would probably make a lot of sense to have some sort of card or some system that just contains a summary, especially one that contains a list of any allergies and what pills etc have been prescribed and other important information which could be useful if going to a different hospital. But, a card or system that contains detailed medical records is miles off in the UK, and I can't see how one can be currently in place anywhere at the moment without suffering from the problems of access and security. There would be massive concerns about patient confidentiality, because for a start in the UK a medical facility is not supposed to even admit that any kind of medical notes even exist for an individual.

Re: Privatisation of NHS hospitals begins : Mon Nov 14, 2011 11:09 pm  

Him wrote:

It would probably make a lot of sense to have some sort of card or some system that just contains a summary, especially one that contains a list of any allergies and what pills etc have been prescribed and other important information which could be useful if going to a different hospital.

Something similar was put forward by a rival bidder to Fujitsu Seimens, the card just had a summary of treatment and the place it was administered. It was also to replace paper prescriptions, hold details of your prescription status (free, season ticket paid for and so on) and a few other things.

Re: Privatisation of NHS hospitals begins : Tue Nov 15, 2011 6:06 am  

Sal Paradise wrote: I think it is pretty evident that the waste in the NHS is not clinical but administrational - these types of initiatives should help to improve this position. Will that affect patient care - unlikely. The problem comes if you reduce the clinical side and keep all the admin then patient care suffers. Obviously, after all we've seen just how it works in education, especially with the senior managers of academies

Sal Paradise wrote: I think it is pretty evident that the waste in the NHS is not clinical but administrational - these types of initiatives should help to improve this position. Will that affect patient care - unlikely. The problem comes if you reduce the clinical side and keep all the admin then patient care suffers. Obviously, after all we've seen just how it works in education, especially with the senior managers of academies

Re: Privatisation of NHS hospitals begins : Tue Nov 15, 2011 7:55 am  

cod'ead wrote: Obviously, after all we've seen just how it works in education, especially with the senior managers of academies People get rewarded for performing well at their jobs? Shocking.

cod'ead wrote: Obviously, after all we've seen just how it works in education, especially with the senior managers of academies People get rewarded for performing well at their jobs? Shocking.

Re: Privatisation of NHS hospitals begins : Tue Nov 15, 2011 8:04 am  

SBR wrote:

People get rewarded for performing well at their jobs? Shocking.

If they perform well at their jobs in the public education sector and get suitably rewarded, there are numerous and very vociferous complaints that "they earn more than the Prime Minister"

Oh, please point out just where in that link, there is an indication of any improvement in their performance.

Re: Privatisation of NHS hospitals begins : Tue Nov 15, 2011 8:21 am  

cod'ead wrote:

If they perform well at their jobs in the public education sector and get suitably rewarded, there are numerous and very vociferous complaints that "they earn more than the Prime Minister"

Oh, please point out just where in that link, there is an indication of any improvement in their performance.

I for one don't care how much public sector employees get - they should be incentives to reduce waste and if they achieve that they should get a share. If a head teacher significantly improves the performance of school i.e. improved levels in basic requirements, better attendances, improved teaching techniques etc they should be rewarded.

What I object to the funding of union officials by us i.e. employees in the public sector that are paid for out of the public purse but work full time for the union - perhaps if the union paid them we would have more funds for hospital cleaners etc.

Re: Privatisation of NHS hospitals begins : Tue Nov 15, 2011 8:33 am  

Sal Paradise wrote:

I for one don't care how much public sector employees get - they should be incentives to reduce waste and if they achieve that they should get a share. If a head teacher significantly improves the performance of school i.e. improved levels in basic requirements, better attendances, improved teaching techniques etc they should be rewarded.

What I object to the funding of union officials by us i.e. employees in the public sector that are paid for out of the public purse but work full time for the union - perhaps if the union paid them we would have more funds for hospital cleaners etc.

Private companies 'pay' for most NHS cleaners. That's why their numbers were reduced - and that's a prime reason why MRSA etc increased: profit is more important than people.

And perhaps the NHS, say, could invest in loads more HR types to negotiate all those individual contracts for the million or so staff that largely have such things done by their union officials (and other issues dealt with).

Perhaps, while we're on the subject, the NHS could stop paying millions to consultants like KPMG, to work out how to save money and offshore the roles of people like medical secretaries.

Re: Privatisation of NHS hospitals begins : Tue Nov 15, 2011 8:35 am  

Him wrote:

It's not absolute bollox, I ran an NHS Medical Records Archive for 7 years during which time the computerisation of medical records was discussed and the issues I just outlined were the main reasons as to why the Executive Board assigned more money to the storage of paper records as they didn't think the computerisation would go ahead.

I have no idea what the French system is like, what data is stored, accessed and by whom but I know that attempting to transfer the current NHS medical records system onto a totally computerised form would be incredibly difficult and probably impossible right now.
There is not just the standard medical record, there is (just off the top of my head):
A&E Cas cards
Maternity notes
Deceased casenotes
Psychiatric Notes
Mental Hospital notes
School Health cards
Blood Transfusion Forms
Organ Transplant Forms
Paediatric Notes
Oncology notes
Opthalmology notes
Physiotherapy notes
Occupational Health notes
Xrays
Breast Screening notes
SCBU notes
ICU notes
Cardiology notes
Neurosciences notes
Orthopaedics notes
Pharmacy notes
Dietetics notes
Labs blocks & slides

that are all stored seperately to the general medical file and I'm sure there are more. All are currently in different formats, with different layouts, with different identifiers, stored in different ways for differing time periods. And that's just from the hospital, never mind GP's and walk-in centre notes.

Are you seriously suggesting that none of the above could be standardised and stored electronically - especially given that most will hand typed notes?