When discussing NHS reforms big issues like markets, accounting, accountability and so on come to the fore.
But it’s important to remember that the vast majority of people are happy with the NHS, its services and accountability. Lansley may wish to deny it, but that’s the reality. And the popular narrative about admin inefficiency (even if it has a basis in truth) was not created popularly, but by the right wing press.
That means that NHS reform should concentrate as much in ensuring that there really is progress in ensuring front line services get to people at least reasonable cost. So the next reform I have to proposes has this goal in mind.
IT reform in the NHS has concentrated on big data issues, the NHS spine, and such issues. Well, that was the land of Tony Blair fantasy (he who had never touched an email). The truth is that there is need for IT reform in the NHS still — and a lot of it. But the most basic IT reforms are what are needed.
Many hospitals still keep hand written notes. And I can assure you it’s true what they say about Doctor’s handwriting (I’m married to one).
And many hospitals and other NHS services still use fax machines (when did you last send a fax?). Quite often they fax illegible hand written notes. Which results in high risk of medical non-communication.
Mind you — when email is sent the NHS email system is dire. Surely they can do better than an appalling version of something that looks like Outlook from a decade or more ago? It’s steam driven, at best.
And there’s plenty of other evidence of IT uselessness. A recent article in one medical paper recounted the tale of the trainee doctor who spent 10% of his time writing out blood sample request forms because the hospital he worked in had not invested in label printers at about £60 a shot. I know that GPs all over the country do exactly the same thing — the most basic of tasks that IT could automate to massive advantage are simply not being done.
And as far as I can see almost standard consultations are being done by medics time and time again all over the country and being written up in notes retyping (at best) the same stuff over and over again when simple macro driven automated entries into much of the standard software in use could save vast amounts of time when doing so. A few moments writing the macro (it’s a doddle — macro writing software for use across platforms costs less than £15 a machine on PCs) and an hours training and the time saving yield would be enormous.
But there’s no central direction in the NHS to demand this.
That’s the price of the absurd policy of local decision-making — it leads to massive local inefficiency as best practice is not shared and has to be re-learned locally, time after time again.
Start a basic IT revolution in the NHS, I say, and do it nationally, now.