Hospital Waiting time extends

Forget pain relief – just pop pills

 

I am in pain – one of my drugs is playing up – and that makes me very stroppy.

Still can’t understand why local  hospital won’t give me an early appointment for the  procedure that relieves the pain.

Instead, this hospital now follows the Communist way of working;  phone for an appointment, and there is now a new recorded announcement that says:

  • For X-rays press 1

  • For PRIVATE APPOINTMENTS press 2.

  • For today’s appointments press 3,  etc. etc.

 

Under the Communists

Reminds me of what Ceasescu’s lot did to the peasants in Romania.  There was definitely a very separate private health  sector.  To access this the Nomenclatura pressed the key and got straight through to the paying section for Government funded private care;  plebs waited their turn – and waited and waited.

In this day and age, with fibre optic wires dancing all over the place making communication easier, I can’t understand why the NHS can’t sort themselves out and keep me quiet.

As NHSManager’s Roy Lilley says

“Once upon a time, if I wanted to go on holiday, I would go to the high street, park the car and sit with a youngster called Amanda, who would wax lyrical about a place she’d never been and flog me two grand’s worth of holiday in a hotel that wasn’t built.

It wasn’t long ago that if I wanted to borrow some money I’d have to crawl across the Bank manager’s floor and beg.  In return for the surety of my house, first born and the dog he might lend me a few quid.

I remember the time when, to insure my car, I’d have to find an insurance broker, fill out a book of forms and wait to see if he could ‘place my business’.

Today, I go on line look up a resort, poke around YouTube, look for video, comments, opinions and find my own holiday.  To borrow money I speak to a bloke in Mumbai who drops a loan direct into my bank account.  For insurance I go onto a cost-comparison website and get fixed up in minutes.

There is no part of my life that isn’t made easier and cheaper by technology.  My shopping is picked, packed and delivered, the result of a mouse click.  Tickets need no box-office, books need no bookshop and even the shirts that come from the ether, fit.

I am not unusual, I’m sure you do it, too.  So, how it can be that the NHS cannot use simple technology to enhance people’s lives and recovery without it costing an arm and a leg?

Since Florence was a lad in short trousers the DH has been palavering around with something called the ‘whole system demonstrator’.  In plain English; nearly 6,000 patients and service users have been involved in what is thought to be largest randomised trial of telehealth technologies in the world.

The upshot is (and you might need to sit down with a strong cuppabuilders for this), it emerged at a King’s Fund telehealth conference, using the cost per quality adjusted life year as the baseline calculation and adding in direct costs, it cost in the region of £80,000 per patient.

Eighty grand!  It would be cheaper to put the patient in the Savoy Hotel and ask the district nurse to pop-in three times a day.  NICE – the ‘we-are-not-the-rationing-watchdog’ – use £20k-£30k as their yardstick for a QALY.

The invisible minister, Paul Burstow, said in a speech in March: “The widespread adoption of telehealth and telecare…could save the NHS up to £1.2 billion over five years.”  I have news for him; it’s more likely to cost £1.2bn.

In December the DH published some early trial findings that claimed emergency admissions had been reduced by 20%.  However, the Nuffield’s Jennifer Dixon, who has been looking at the findings, said they were “very disappointing results”.  If a 20% fall is disappointing I’m pleased I don’t have the job of cheering her up.

The problem with all this is the DH won’t release the whole data.  Now it’s all been made even worse by a US analysis that claims Telemed ‘kills the elderly’.  And this one saying it cuts costs by 90%.  This is an industry in disarray.

If expensive boxes of kit have been bought at the wrong price, plugged into expensive broadband in people’s homes and expensive people have been sent to show them how to work it and more expensive kit has been put into GP surgeries where expensive nurses have had to have a look-see, in between the day job, then I guess it will have been expensive.  Duplicate that in a dozen, perhaps 30 surgeries, then you are looking at ‘very expensive’.

On the other hand; if you use tablet apps, G3, linked to regional call centres where incoming data is automatically dropped into an algorithm that throws up an alert for outliers so that a telehealth assistant can initiate the ‘how are you today’ call – then we might be talking ‘save money’.

If a third of outpatient follow-ups and most medicine reviews could be done on the phone we are talking about saving a shed-load of money and the end of a hellava-lot of inconvenience for the patient.  In the US telecare is all-but routine.

There is something very strange about this trial, or the data, or how it’s been done.  Holidays, banks, insurance, shopping, tickets, books and shirts tell Roy his is right.  But it seems the Geeks that set up the NHS IT system live on a different Planet to the rest of us.

And you still have the Nurses at Chelsea and Westminster who don’t read notes – written on computer or with the Consultant’s best fountain pen.

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