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

tb wrote: In fact the NHS (and the public sector generally) has a lower manager/admin to 'coalface' workers ratio than the private sector. And, despite the introduction of an artificial internal market by the 1979-1997 government, continued by the last Labour government, transaction costs are lower than in a private market between private companies. Administrative 'waste' is a myth … see the Commonwealth Fund report reference in the link below A doctor blogs btw - 'administration' is a key part of clinical care: without records how do doctors, nurses, physios, etc know what to do? Agreed but records can be created/stored recalled in a more efficient basis than they currently seem to be. All this paper seems very outdated and double handling? I visited my cardiologist on Friday for sign off after my op - the file was a paper thing made up of single sheets collated from various hospitals. I bet all these documents will be stored individually electronically at each hospital. Someone will have had to collate them there will have been costs involved in transporting them. Surely it is not beyond the wit of man to store these documents electronically? On your first point to make any sense you have to compare like for like - not sure how that is possible given the unique work mix in the public sector. Do we have many private courts, council tax offices, parks and gardens etc Do the public sector run many supermarkets etc etc?

tb wrote: In fact the NHS (and the public sector generally) has a lower manager/admin to 'coalface' workers ratio than the private sector. And, despite the introduction of an artificial internal market by the 1979-1997 government, continued by the last Labour government, transaction costs are lower than in a private market between private companies. Administrative 'waste' is a myth … see the Commonwealth Fund report reference in the link below A doctor blogs btw - 'administration' is a key part of clinical care: without records how do doctors, nurses, physios, etc know what to do? Agreed but records can be created/stored recalled in a more efficient basis than they currently seem to be. All this paper seems very outdated and double handling? I visited my cardiologist on Friday for sign off after my op - the file was a paper thing made up of single sheets collated from various hospitals. I bet all these documents will be stored individually electronically at each hospital. Someone will have had to collate them there will have been costs involved in transporting them. Surely it is not beyond the wit of man to store these documents electronically? On your first point to make any sense you have to compare like for like - not sure how that is possible given the unique work mix in the public sector. Do we have many private courts, council tax offices, parks and gardens etc Do the public sector run many supermarkets etc etc?

Re: Privatisation of NHS hospitals begins : Mon Nov 14, 2011 11:20 am  

Sal Paradise wrote: Agreed but records can be created/stored recalled in a more efficient basis than they currently seem to be. All this paper seems very outdated and double handling? I visited my cardiologist on Friday for sign off after my op - the file was a paper thing made up of single sheets collated from various hospitals. I bet all these documents will be stored individually electronically at each hospital. Someone will have had to collate them there will have been costs involved in transporting them. Surely it is not beyond the wit of man to store these documents electronically? Yep, it's dead easy. Cheap as chips too

Sal Paradise wrote: Agreed but records can be created/stored recalled in a more efficient basis than they currently seem to be. All this paper seems very outdated and double handling? I visited my cardiologist on Friday for sign off after my op - the file was a paper thing made up of single sheets collated from various hospitals. I bet all these documents will be stored individually electronically at each hospital. Someone will have had to collate them there will have been costs involved in transporting them. Surely it is not beyond the wit of man to store these documents electronically? Yep, it's dead easy. Cheap as chips too

Re: Privatisation of NHS hospitals begins : Mon Nov 14, 2011 1:46 pm  

cod'ead wrote: Yep, it's dead easy. Cheap as chips too Well, the article says it all really. Trouble is that government agencies just aren't used to specifying what they want and don't seem to understand that a supplier is only going to supply what you asked for, not what what you somehow assumed you'd get.

cod'ead wrote: Yep, it's dead easy. Cheap as chips too Well, the article says it all really. Trouble is that government agencies just aren't used to specifying what they want and don't seem to understand that a supplier is only going to supply what you asked for, not what what you somehow assumed you'd get.

Re: Privatisation of NHS hospitals begins : Mon Nov 14, 2011 2:07 pm  

El Barbudo wrote:

Well, the article says it all really.
Trouble is that government agencies just aren't used to specifying what they want and don't seem to understand that a supplier is only going to supply what you asked for, not what what you somehow assumed you'd get.

Indeed, mind the whole process began in 1997 and the rate of change in technology meant that systems put in place then were out of date less than three years later. The whole project was just huge and the never ending shift of features they end user wanted just kept the whole thing form being finalised.

[tb]

Re: Privatisation of NHS hospitals begins : Mon Nov 14, 2011 2:17 pm  

Who exactly are the 'bureaucrats' wrecking the NHS?

Who exactly are the 'bureaucrats' wrecking the NHS?

Re: Privatisation of NHS hospitals begins : Mon Nov 14, 2011 3:06 pm  

Sal Paradise wrote:

Agreed but records can be created/stored recalled in a more efficient basis than they currently seem to be. All this paper seems very outdated and double handling? I visited my cardiologist on Friday for sign off after my op - the file was a paper thing made up of single sheets collated from various hospitals. I bet all these documents will be stored individually electronically at each hospital. Someone will have had to collate them there will have been costs involved in transporting them. Surely it is not beyond the wit of man to store these documents electronically?

On your first point to make any sense you have to compare like for like - not sure how that is possible given the unique work mix in the public sector. Do we have many private courts, council tax offices, parks and gardens etc Do the public sector run many supermarkets etc etc?

Yet again your knowledge of the real world is astounding.
It is and would be incredibly difficult to electronically store, secure and access patients notes for a few simple reasons:-
1. Cost
2. Security
3. Access

1. The cost to develop a system to scan in the hundreds of pages of patients notes that are of different sizes, layouts and often with difficult to recognise handwriting would be huge, and that's just general medical notes. Nevermind the myriad of different departments notes that make up the totality of 1 patients' notes all of which are of different sizes, layouts & styles and with different identifiers.

2 & 3. To effectively utilise an electronic system the noted would have to be stored on some kind of national database like the DVLA database, except this would be 100 times more complicated and 1000 times more sensitive data. It would be very difficult to restrict access enough to keep patient data confidential but open enough so that the notes can actually be accessed effectively by those who need to. Not to mention the possibility of hacking in to the database which isn't a danger at the moment with the notes in paper form.
Also if the hospital network goes down it means they have lost access to patients notes, whereas they can still access them at the moment.
Plus if the notes are in electronic form it requires doctors/nurses etc to be equipped with ipad type devices, linked to a hospital network (security issues again) to then be able to input anything to those notes, whereas now they merely require a biro.

If starting a notes system from scratch it might be easier but I still can't see paper notes going away for another 50 years yet.

Notes have to be kept for a certain amount of years depending on the type of note too and are (generally) currently stored in that format. It would require a huge database to store these notes that are often never needed again until their destruction date which is sometimes for as long as 25-30 years.

The technology may be starting to appear to make it possible, but it's not perfected yet and it would require a massive cost to implement and the security issues still can't be addressed yet. Currently it's far cheaper, easier, more efficient and secure to use paper notes.

Re: Privatisation of NHS hospitals begins : Mon Nov 14, 2011 3:27 pm  

tb wrote: Who exactly are the 'bureaucrats' wrecking the NHS? And, why is Lansley not publishing the findings of the internal "Risk report" ? Oh because ... "releasing the risk register <snip> would have "jeopardised the success of the policy". Well, there you go, we mustn't worry our pretty little heads about it. So much for Freedom of Information.

tb wrote: Who exactly are the 'bureaucrats' wrecking the NHS? And, why is Lansley not publishing the findings of the internal "Risk report" ? Oh because ... "releasing the risk register <snip> would have "jeopardised the success of the policy". Well, there you go, we mustn't worry our pretty little heads about it. So much for Freedom of Information.

Re: Privatisation of NHS hospitals begins : Mon Nov 14, 2011 4:26 pm  

Him wrote:

Yet again your knowledge of the real world is astounding.

Don't talk soft.

In the real world, you just tell that speccy little geek in IT to get on with it and sharpish, if he still wants a job come Christmas

Re: Privatisation of NHS hospitals begins : Mon Nov 14, 2011 4:42 pm  

cod'ead wrote:

Don't talk soft.

In the real world, you just tell that speccy little geek in IT to get on with it and sharpish, if he still wants a job come Christmas

Now you see that might have worked if the IT department hadn't been outsourced to a private company

Re: Privatisation of NHS hospitals begins : Mon Nov 14, 2011 5:22 pm  

Him wrote:

Yet again your knowledge of the real world is astounding.
It is and would be incredibly difficult to electronically store, secure and access patients notes for a few simple reasons:-
1. Cost
2. Security
3. Access

1. The cost to develop a system to scan in the hundreds of pages of patients notes that are of different sizes, layouts and often with difficult to recognise handwriting would be huge, and that's just general medical notes. Nevermind the myriad of different departments notes that make up the totality of 1 patients' notes all of which are of different sizes, layouts & styles and with different identifiers.

2 & 3. To effectively utilise an electronic system the noted would have to be stored on some kind of national database like the DVLA database, except this would be 100 times more complicated and 1000 times more sensitive data. It would be very difficult to restrict access enough to keep patient data confidential but open enough so that the notes can actually be accessed effectively by those who need to. Not to mention the possibility of hacking in to the database which isn't a danger at the moment with the notes in paper form.
Also if the hospital network goes down it means they have lost access to patients notes, whereas they can still access them at the moment.
Plus if the notes are in electronic form it requires doctors/nurses etc to be equipped with ipad type devices, linked to a hospital network (security issues again) to then be able to input anything to those notes, whereas now they merely require a biro.

If starting a notes system from scratch it might be easier but I still can't see paper notes going away for another 50 years yet.

Notes have to be kept for a certain amount of years depending on the type of note too and are (generally) currently stored in that format. It would require a huge database to store these notes that are often never needed again until their destruction date which is sometimes for as long as 25-30 years.

The technology may be starting to appear to make it possible, but it's not perfected yet and it would require a massive cost to implement and the security issues still can't be addressed yet. Currently it's far cheaper, easier, more efficient and secure to use paper notes.

Absolute b*ll*x !! how come the french have had a superb computerised records system for at least ten years - the latest system now being introduced will be even more user friendly - it's a simple card with a microchip thingy which saves oodles of paperwork not to mention time...