Thursday, 28 July 2011


There are certain things that we here up in Northshire regard as essential skills. One of these is navigation for home visits can sometimes involve trips into the wilderness with few road signs in the dark and in adverse weather conditions which in Westminster would be any shower requiring an umbrella as to opposed to a Force 9 easterly and a couple of feet of snow.

A recent trip down South from ND Central to a previously unvisited location and a straw poll of our hosts there revealed that about 50% of our contemporaries and their spouses use Sat Nav to work their way from A to B. The other 50% use a map and compass and other navigational aids such as the trusted sextant and nautical almanac to work our way around the globe.

Navigation has proved over the years to be a problem for some of our doctors in training who despite being extremely able medically would spend many minutes being briefed by our staff on how to find a visit location using the time honoured method of reference points that they knew and instructions to their visit location from these familiar land marks.

This time consuming process was both fascinating and painful to watch at the same time for if one receptionist did not list familiar landmarks another would be tried until a crude idea of location was eventually obtained. The concept of a map was beyond our doctor in training and they were not confident that they could master Sat Nav despite being otherwise very able.

However one navigates occasionally you have to enquire of a local where is such and such?

This weekend we did enquire of locals where is such and such for our maps and compasses suggested together with a noon sextant fix that we were where we should have been. The roadsigns and locals said otherwise.

For once our readings were spot on, we had hit the target but the maps and locals were out of date. Even our hosts did not know of the changes in local road topography.

How accurately can you navigate using the Internet? Some of our doctors in training cannot but we could and did so using basic skills. Perhaps there will be an NHS Nav App to help staff get from A to B? Perhaps its name will be 1592 Map App with up to the last millennium maps to match? Perhaps the technology is already with us in a covert form known as Choose and Book?

If AA Route Planner can get bits so wrong after years of being spot on how well will any NHS Map App do?

Come to think of it how well has any NHS produced software done?

So back to the old fashion history, examination and special investigation routine which will compromise the patient by foregoing the excellence of a clinical dashboard, a referral management centre and a clinical alogorithm and protocol.

Basic grunt navigation works and gets one to ones destination.

Is that a journey?

And guess what we got back too using the mark one human being and without any NHS (re)Direct assist. How did we as a doctor do that?

Praise be to the Party for inventing satellite navigation and ensuring that all who use their software can never screw it up. Thank goodness for grunt training and the fact that not all maps are accurate - even 20 years after inaccuracies are pointed out.

When will the politicians listen? And more importantly can they remember where they went wrong like the maps – 20 or so years ago?


Anonymous said...

I went on one home visit as a GP trainee. The directions included:
'turn left past where Charles used to live'
I didn't know where Charles lived now...

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