Sunday, 3 January 2010

Burke and Hare do Choose and Book 003.

Winter is getting worse here in Northernshire but the Party wants to warm up those on the frontline have published a little seasonal encouragement to all those using Choose and Book which we are considering here at ND Central. So join us by our warm hearth and partake of some Christmas spirit dear reader. Port or Madeira? Small glasses this time as there is a little less to consider.

We are onto to Chapter 5: “Technical Support”:

“IT problems are often cited as a reason for not using Choose and Book; problems such as speed of access, Smartcard activation or integration problems with existing clinical or patient administration systems cause great frustration amongst clinicians and their administrative staff. Many of these issues can be easily identified and resolved using existing IT guidance and resources.”

No argument with this. NHS IT is slower than dial up for clinical systems and when people try to use Choose and Book it gets crapper still. If anyone in the Government thinks that 3 minutes to down load 4 sheets of A4 is a fast system let them ring us on Whitehall 1212 and we will come and personally change the valves in their computer.

Most of the issues “can be easily identified and resolved”. However, this is dependant on people knowing what they are doing and in computing, if you are good, you earn big bucks in the private sector. The NHS gets the dross so no IT problems ever with C&B as only the users ever see the problems, never the technicians or the authors of this sterling work.

Onto Chapter 6: “Referrals to Named Clinicians”.

Charge your glass dear reader as this chapter opens with a red rag to a bull:

“If a provider organisation accepts paper referrals to named clinicians then they should do the same via Choose and Book.”

Many, many light years away in a Choose and Book free galaxy we used to send paper letters one sheet only to named consultant via post. This worked well but then the local Thickerazzi decreed that under “Choose (not) and Book (not)” the only choice a patient could have was that of hospital.

Attempts by our dedicated secretaries to allow patients to see able consultants chosen by our patients were repeatedly blocked by the local Thickerazzi as they were providing Party “Choice” via Choose and Book which was that of hospital only.

“The ability to support referrals to named clinicians has always been a part of Choose and Book functionality.”

Bullsh*t (sorry, the grunt word slipped out). Only hospitals are bookable according to the local IT commissars who have always denied this facility to our staff and rejected any paper referrals sent to bypass it.

We would suggest another charge to one’s glass as look what comes next:

“Named Clinician functionality must, however, be used responsibly and should not be invoked routinely by referrers. This is because it may make it harder for provider organisations to manage appointment capacity and can, therefore, potentially increase the number of appointment slot issues and ultimately inconvenience both referrers and their patients.”

Now everyone knows that good GPs will always refer people with bladder problems to a heart specialists so this advice for idle, overpaid GPs to use “named clinician functionality” “responsibly” must have been an eye opener to any real time GP in the UK.

Thank you Burke and Hare we shall reconsider our referral policies and stop sending patients to named clinicians who are the best doctor for that particular patient’s needs and more importantly “make it harder for provider organisations to manage appointment capacity”.

Will you be supporting us along with the Department of Health at any GMC hearings?

Read the rest of the paragraph “it may make it harder to manage appointment capacity blarred de blarred de blar”.

In other words popular and good consultants must not be used in order to meet waiting list targets so you must now refer patients to the crap consultants so local Politburos can massage their waiting list targets. Hence you can only have a “choice” dear reader of hospital under the local Party’s “Choice”.

Another port or madeira? Chapter 7 is next “Clinicians reviewing referrals Online”.


Provider organisations should ensure that all clinicians (e.g. consultants or Allied Health Professionals) providing services on Choose and Book are issued with Smart Cards and that they manage their referrals online within the Choose and Book application – rather than administrative staff doing so on their behalf.”

More words of wisdom from La La land? Consultants are busy and many we know often only see the referral letter when they see the patient.

As a consultant colleague said:

“We have 20 consultants in our speciality and when a letter was addressed to us on paper, we read it and if it was to the wrong consultant we sent it to the right one and they then sent an appointment out to a patient based on the letter.

Now GP receptionists make the appointments and see our specialty and book the first consultant they see or who has the shortest wait not the right one. This means when we see the patients they are usually in the wrong clinic and we have to arrange another appointment to see the right consultant after already having seen them. It is a pig’s ear and that is being polite”.

Another shot as these are short chapters? Chapter 8 “Training”.

“PCTs and provider organisations should ensure that all relevant staff (for whom they are responsible) receive regular and appropriate training on Choose and Book, especially when new functionality becomes available.”

Nice to know that since the inception of Choose and Book we have only ever had one one hour session (which was actually 2.5 hours with the trainer boasting that if they were in a purpose built C&B training centre that could make it last 4 hours as each person would have had their own computer not 10 huddled round each computer) and most people found watching the ceiling more exciting.

Training it would seem “makes for a much improved professional and patient experience.”

So does something that works.

Praise be to the Party and all its wise IT mandarins some of whom might be able to change a fuse on a plug once someone shows them what a plug is.

They will just fill in a form for consideration by the IT commissioning department, electronic sub commissariat, plug subdivision, fuse special team, 3 amp (replacement not procurement) department.

Simple like Choose and Book?

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