"“We have lent a huge amount of money to the U.S. Of course we are concerned about the safety of our assets. To be honest, I am definitely a little worried.” "

Chinese premier Wen Jiabao 12th March 2009

""We have a financial system that is run by private shareholders, managed by private institutions, and we'd like to do our best to preserve that system."

Timothy Geithner US Secretary of the Treasury, previously President of the Federal Reserve Bank of New York.1/3/2009

Wednesday, June 25, 2008

NHS Choose and Use - not a popular choice with GP's, another disastrous chapter in £12.7 Billion NPfit IT program

The excessively well paid CEO of the NHS David Nicholson dropped so many jaws on House of Commons Public Accounts Committee yesterday to further consider the £12.7 Billion on the £12.7bn NPfit scheme it's a wonder a radiologist with a portable X ray and an orthopaedic surgeon weren't required.

He was explaining that the "Choose and Book" system ,which was expected to attract 39Mn bookings by 2008 had in fact resulted in ..er.. nearly 6 Mn. Limply he explained (still it appears retaining his job) “Utilisation of the system is not as great as we would have imagined at this stage.”

There are bright spots “On average half of first appointments are now made through the system.” The fact that GP's were incentivised (ie paid money to use it) and that ending it would not affect usage was, he said ,"unfounded".

One of the things we will do as part of the next stage review is to publicise patient’s rights to choice, to get pull.” Which sounds dreadfully like huge amounts of dosh spent on , more surveys, pamphlets, Posters, and late night TV advertisements - hopefully not like the NHS "Hooked" ads that received the most complaints last year by the ASA and were banned.

Health Insider website has some comments from users (ie GP's paid to use it)Chris Frith a GP in Hereford said "the design needs a complete rethink as hours and expertise are being wasted in General Practice at present to earn our LES (payment) if we are lucky. "

Reliability and system design are common problems .."If the system reliability could be sustained and not leave communities without a fully working system for a week" ...."It also only works with Internet Explorer so you have to buy Windows to make a hospital appointment. (many of us have Windows-free systems) "....." (a) combination of IT and general system failures risks driving away even committed GPs" ...."If C&B actually did do what was intended - support patient choice and make booking appointments quick and easy for patients and practices, - we'd all be using it and this thread would not be occurring. Unfortunately a combination of very clunky software and poorly designed Directories of Services (different for every Trust)" ..."We can no longer afford to create software/systems that no one is willing to use."..." "The recent spine update has meant several weeks of access problems. In addition the update to allow full choice together with the 18 week wait has created a meltdown in the directory of services." Why? As part of disaster recovery plans, should we now include spine updates as a risk?"

It is only sustained by payment to GP's for using it ..."The DES might have stopped but almost every PCT has introduced an equivalent LES. It is ONLY the funding that keeps this going, for very many GP practices." Doctors are remarkably resistant to change - eg : take a look at the digital stethoscopes available for improved diagnostic use. (see pic follow link for evident benefits) Maybe its because they cost £100 each... and they need incentivising.
Quite simply patients choice is predictable anyway....."I have yet to have a patient who has chosen anything other than the local hospital. " Apparently patients in hospitals don't want to travel and if hospitalised ,have what we doctors call visitors, who won't want to travel far.

Lord Patel's experience - asking for Manchester Eye Hospital instead of the local and well thought of Local Hospital stumped the GP and working together we finally made it....for Lord Patel to receive over ten letters cancelling the appointment, each of which I posted to the GP and each of which he told me to ignore...because, "the system isn't working properly". I did.

Turned up, excellent consultation. The consultant queried why I chose the Manchester Eye Hospital and was intrigued when I explained they saved my fathers eyesight in 1911 when a button hook he was reaching for, fell off the mantel piece and fell in his eye. Which meant he missed the opening of the Manchester Electric Light Cinema in Rusholme.

"Lorenzo" software

This project is now only 4 years overdue and early (and very, very brave) adopters Morecambe Bay Hospitals NHS Trust , Bradford Teaching Hospitals NHS Foundation Trust and South Birmingham PCT, issued a statement in early June saying that "deployment testing is identifying technical issues which are being resolved on an ongoing basis". This was just before a scheduled demonstration to MP's.

Criticism of delays with the Care Records Service have been met by Ministers giving a series of dates when the first sites will go live. These have been repeatedly deferred.

Many MPs are concerned that NHS will be pressured into going live on an a system that is not yet ready to meet promises made by ministers... or the Department of Health's financial contractual commitments to local service providers.

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(C) Very Seriously Disorganised Criminals 2002/3/4/5/6/7/8/9 - copy anything you wish