NHS email addresses?

[Steve Walker]

They still send referrals, appointments, results, etc. by post, both within the health system and to patients. They also have no system to flag things automatically - a doctor prescribes a medication and the system doesn't automatically flag up that that medication is not suitable for a patient with a particular second condition or already on a particular medication. My wife has had to point out that medications prescribed for her and known to interact fatally with other meds that she is on. Similarly for my son who is thought to have an allergy to particular medications, but has accidentally been prescribed unsuitable ones.

The systems don't automatically schedule calling patients in for blood tests, breathing tests, heart checks or other tests that need to be carried out regularly when on certain medications. Basic clerical tasks that get missed and could be automated. My son has just been called in for a blood test that should apparently be carried out every 6 months. This is the first time, despite being on the medication for 24 months - and was only picked up because the GP practice has staff with time on their hands at the moment (due to Covid restrictions) and they have been trawling through patients' notes.

The systems are also awful for staff. A colleague of my wife (a community psychiatric nurse) was sacked, as one of his patients died and hadn't been seen for a couple of months beforehand despite being on the list for a fortnightly visit. The consultant had discharged him, which left the CPN to tidy up the "paperwork" and issue the discharge letter from the system. Because the consultant, despite repeated emails, had failed to finalise a document on the system, the CPN could not issue the discharge. So the patient, despite being discharged by the consultant, was technically still on the books and the CPN was sacked for not visiting a patient that he should not have been seeing as he should no longer have been a patient!

My wife was hassled for months for paperwork that she had not completed. Again the system would not let her do so, as someone in another department, on another site, had not finalised their documents and would not respond to repeated requests.

Any sensible system would allow people to finish their part and bounce the control and responsibility back to those that have failed to do their part, rather than bombarding those unable to do anything about it with threatening prompts and holding them responsible.

[Andrew]

GPs and Hospital doctors are highly trained. They are supposed to know these things.

Again, a failure of people not 'the computer said no'.

Sounds like a human procedure failing, not a computer problem.

Another human being failure. The system was working as it was designed.

You'll find this type of service order processing the norm in business too. Certainly was the case with cable & wireless service provisioning a couple of decades ago where orders could get stuck because some part of the process didn't complete on time or correctly, or at all.

[Steve Walker]

No-one can know it all and they all make mistakes. They enter the notes and the prescription on their systems and it is crazy that it is not designed to flag up such problems. It only needs to use compare the prescriptions and the notes, using the information available in the BNF.

No, a failing of the system and which could be eliminated by automatic checks of conditions/medications and scheduling of reminders for such tests. Why rely on fallible humans, when entering the prescription could present the schedule at the time of prescribing and automatically place diary entries, unless the GP chooses to override it.

If the computer system had allowed the discharge, as instructed by the consultant, the patient would not have still been on the books. If it had allowed it to be bounced back to the consultant, the reminders and responsibility would have lain with him and not with someone who had no power to get the consultant to do his part, new patients to see and no spare time to see patients who were supposed to be discharged.

The nurse could not do anything, as until the consultant (despite having finalised the discharge letter), finalised other documents, the computer simply will not allow the discharge to be completed.

But the design is wrong. The person who it has ended up with has no power to force another person to finalise their documents, but until they do, cannot complete the discharge, so it ends up in the monthly stats as their failure. As I said, any sensible system would allow the person at the end of the line to complete their bit and bounce the responsibility, the flagging and the bad stats to the person who has been holding it all up.

[David]

Looks as though you are sorted, but I can confirm that [e-mail] is a valid address format because I correspond with a few NHS people.

Cheers

Dave R