Hospitals

I don't. I paid a local health screening charity to do a full health screen including all the standard blood tests which they carried out using their own in-house mini-analysers.They employ an ex-NHS lab technician to carry them out and adhere to all the same quality standards that the NHS uses.

I suspect you don't really understand the issue.

I never said there were. The solerole of doctors is in making referrals and making clinical decisions where this is called for as the result of test results.

Sep 11 2018

Similarly, there were 11,576 vacancies for doctors across all types of NHS services inside and outside of hospitals. That was again a record and a significant increase on the 9,982 posts that were vacant three months before.

The Big Society and the NHS

and similarly there were 11,576 vacancies for doctors

You still don't get it do you ? Actually I think you do, you just don't like to admit as much all the irrelevant waffle and arm waving.

Look at it this way.

Even if we assume that all path labs and radiology departments are staffed solely by robots and/or trained monkeys, the fact remains that all such tests and procedures will only be performed as a result of a referral.

Now will these referrals originate from

a) Elvis Presley Impersonators ?

b) Corgi Registered Gas Fitters ?

c) Qualified Medical Doctors ?

Of whom as was stated above, as of Sep 2018 there were 11,567 unfilled vacancies throughout the NHS. Doctors, that is. Not Elvis Presley Impersonators or Gas fitters.

michael adams

...

Some years ago, my GP surgery suddenly started doing blood draws. Seems the GP contract had always included a payment for doing draws and simply telling all patients to go to the hospital phlebotomy unit was not acceptable.

I still went to the hospital - no appointment needed, opened earlier, better phebotomists. (I thin the surgery trained their receptionists. They were pretty poor.) Also, for when it mattered, samples striaght to lab. (The surgery simply did not know that the blood for some tests required immediate spinning, colling or whatever.

Hardly surprising a hospital car park has lots of blue badge holders parked in it. And I know all too well that some people have disorders that mean they desperately need blue badges - sometimes. (Though the person I am talking about never had one.) My only use of one was for my mother - and I think many people are like me and would NEVER use one except legitimately.

Perhaps you'd now explain how so many trusts are in debt, then, if money isn't a problem?

Oddly my hospital wasn't on the list of choices. And I'd guess my GP has to pay for using the ones they offer from their own budget.

I have given blood at my hospital when they wanted it, rather than the GP. Waiting times are very variable. I doubt the samples go straight to the lab unless urgent, so probably little different from ones taken at a clinic etc in the area which go to the same lab.

The one I picked from the list was actually quite convenient - closer to home than my GP. And a steady stream of patients for the blood taking service, but only a short acceptable wait. And a nurse (or whatever) obviously very skilled at doing it.

From my observations too many admin staff duplicating tasks, jobsworths or generally performing inefficiency.

I get the strong impression that at the local hospital _CURRENT_ records are kept in both paper and electronic forms. The paper records are transferred to electronic form _LONG_ after the event hence when going for after care the staff look on the computer for the records and get the wrong answers. My mother now keeps a record of appointments and what was done etc. that she takes with her to her after care appointments. This is to get over the problem when turning up for an appointment, say, on a Wednesday only to be told that she needs an X-ray first and which she actually had the day before.

In my local doctor's surgery all records are kept electronically with the doctor entering information during the appointment (I can also see my test results etc. over the internet)

Ha! On one occasion the bloke typed busily after the consultation and then printed a prescription. It wasn't until I'd gone round to reception to get the prescription filled that I noticed it said "For Mrs Joe Bloggs". The fathead had been typing my notes into the wrong patient record.

You can hardly blame admin staff for the poor IT system they are lumbered with.

My dad applied for a badge, he never got it even though the council had built a ramp to the door so he could get in and out of the house and used to take him in a wheel chair to a day centre. He was also on oxygen

Some people appear to get badges that don't look like they have any problems and they can get in and out of two seater sports cars with ease to. Its only recently that they have been awarding badges to people with mental disorders so it wasn't them with invisible disorders.

I suspect a lot of the badges don't belong to the people who park there, maybe the photo should be on the front?

Having said that there are days when I can walk a couple of hundred yards, others when 10 yards is difficult. I still use the badge as I don't really know which is going to be the case as it can change pretty quickly. Also the transit connect doesn't fit into normal spaces well.

I usually try and get any blood taken at the QE. They take it from the PIC line so no needles. Andrew won't like it because it uses more stuff to do it.

There is a lot less chance of infection for me though.

I used to have a groshon line and the staff at the CT scanners wouldn't use that to put the dye in as they hadn't been trained. The one time it took them six attempts to put a cannula in. Then after the scan the radiologist had spotted my goitre which I have had for decades but decided I needed blood tests. They had already taken the cannula out so they had another four attempts at getting blood out. I was like a pincushion and they still didn't have blood. I told them to stop and took the form up to the cancer ward and asked them to take it out of my line which they did. A complete waste of money and time when they could just have used the damn line for it all.

Of course it does, every stage in a call has to be logged and be able to role back to it in the event of a fault in the hardware or software. It predates database use by a long time, even the valve based computer the post office built did transaction process.

Who do you think worked at GEC telecoms then? We were working on System X processors then. The 2B and the 2BL had been done already and we started work on the POPUS and PPU designs just before I started. I was designing scratch pad cards (registers) and control cards (microprogram sequencers) for the CPU as my first job. It was all TTL no microprocessors then.

Later on I was designing bits of the current System X processor system which did have microprocessors as well as some bitslice stuff in it. I believe I was the first engineer to use an 8086 in SystemX, you couldn't really get them as they didn't actually come out until after the 8088 which was the one in IBM PCs not 8086 as most people think.

After that I designed a distributed Unix system to replace the X25 communications system (that I had previously done) which involved an interface board to take the SystemX IO bus to allow an Intel SBC or a Motorola SBC to be fitted to each IO bus on each Processor shelf and a pair of servers running Unix all networked to be fault tollerent and of course it used transactional processing too.

The PO/BT cannot afford to lose billing records and neither can GCHQ. Then there is the issues with legal intercept, etc. all of which are very strict.

They are only chalk and cheese because you understand neither.

I sold some software to Martlesham that was used (I was told) to help generate System X test data.

Thanks for confirming that you have no experience at all of commercial transaction programming.

Different environment entirely from software engineering and embedded systems.

Not in the pathology specialties there weren't.

Most of the vacancies, other that gps are mythical. NuLab massively increased the NHS head count at a rate far faster than the normal training route could supply.

The number of 'consultants' more than doubled from 2000 onwards, which means a lot of people who might have been snr registrars or similar grades suddenly became consultants. A convenient way to give them massive pay rises, without actually giving them a pay rise.

There are many many thousands of highly qualified doctors in India, and the NHS could, if it wanted to, refer x-rays in Digital format out there for review.

And Corgi gas fitters don't exist. It's been Gas-Safe for years. wake up.

What sort of IT system could ever cope with the huge variety of information held in a patients hospital notes folder ?. This would require a ginormous database if the whole population were included.

This was Nu Labs fatal mistake when they embarked on that enormous NHS IT system. We have ended up with a compromise. There is enough information to allow people to visit a variety of NHS treatment locations and be easily identified, but the hospital case notes folder (which can end up a couple of inches thick) stays in the hospital until discharge and only then goes to the admin dept that does clinical coding.

But nobody has ever suggested that there were.

The doctors in question, are those who generate referrals to pathology and radiology depts who by definition can't work in those departmentents; and the subset of that very same group of doctors, who will be required to make subsequent clinical decisions as a result of tests or xrays produced by those departments.

Please note the word "subset" there.

This has been pointed out to you more than once now Andrew; as you're doubtless already aware.

michael adams

....

As as I have pointed out, most of the 'vacancies' are mythcal and are a result of Nu Labs spending spree on the public services in the noughties, when the public service jobs page in the Grundian ran to 80+ pages a week.

And many of the vacancies aren't vacant at all. They are filled with locums who have discovered the Freelance Computer Programmer trick where they resign from their NHS employment and then come back as'Freelance' and can earn three times as much and also be paid into their own 'personal service' company aka a single-person limited co. Nice juicy tax and NI advantages.

Some nurses are doing the same. For many it gives them more flexibility for a variety of reasons.

When the government tried to impose Labours IR35 on them , or even make the health authority deduct tax and NI from the gross payment, they all threatened to stop working, so the government backed down.

One rule for freelancers working in the private sector and another rule for the NHS.