The patient, the taxpayer and the hospital PAS*
* Patient Administration System It was a great promise for the 2000s. The new hospital IT system was going to do everything the staff wanted and make it easier to provide a patient-focussed service. The hospital confirmed a successful implementation. So when the reported data from the new system showed hundreds of patients waiting over…
Waiting to see the GP (and data provenance)
I’m registered with an excellent GP practice, so when I phoned in the afternoon I wasn’t surprised the receptionist allowed me to book an appointment in a month’s time. The GP had suggested I go back to see him if the complaint worsened, but I wanted to record some daily observations before the appointment so…
What digital healthcare workers can learn from doctors
When he originally saw the doctor in Outpatients, she took a full history and then referred him for diagnostic tests. He left thinking she was a good doctor. It wasn’t long before he was back in Outpatients to see the doctor again. ‘The test results confirm that your problem is what I thought last time,’…
The midwife, ICD-10 and clinical coding in the NHS
It seemed like a straightforward question. I had gone to see the senior midwife because someone wanted to know the number of normal deliveries. I took with me the heavy, thick-as-a brick ICD-10 Volume 1 – the so-called tabular list. “I need your help to identify the correct ICD-10 codes for a normal delivery,” I…
GPs and their businesses in the NHS
My friend was puzzled. He asked me because he knew I’ve worked in the NHS for a long time. “I was introduced to this guy and told he was a GP. He spent the rest of the evening talking about his business, so I thought I must have misheard his occupation. But it turned out…
Curiosity, integration and pink hair
At the time, I wondered why she bothered. The patient had seen the surgeon in Outpatients where he had been given a 28-day supply prescription. ‘It’s important that you take these,’ said the surgeon. ‘The operation will have a greater chance of success if you do. I’ll write to your GP so he can arrange…
Healthcare workers, controlling variation and Statistical Process Control (SPC)
Don Berwick and SPC for clinicians Perhaps the most respected doctor working on the improvement of quality in health care is the paediatrician Don Berwick, a U.S. citizen, who was made an Honorary Knight Commander of the Most Excellent Order of the British Empire in 2005. In 1989 he co-founded the United States IHI (Institute…
The NHS number – from World War 2 to the Covid-19 vaccination
Booking a slot online for your Covid-19 vaccination means you are presented with a screen asking ‘Do you know your NHS number?’ If you do, then you can use it to book a date and time for your jab. It is remarkable that the NHS has been in existence for more than 70 years and…
Front-line NHS staff need quality improvement techniques to make work better every day
The hospital clinic letter made it sound so straightforward: ‘He had X-rays which demonstrated a Weber B distal fibula fracture and no evidence of any talar shift. He was put in a moon boot and given tinzaparin.’ Except that he wasn’t given any tinzaparin. He was given a piece of paper on which was written…
How NHS data analysts can succeed, become data experts and more than just the ‘number crunchers’
The request The manager was very clear. “We’ve had a request for how many toes were done during the last financial year. Please will you get me the number.” The analyst knew that the first thing to do was to get the procedure codes for toes from the clinical coders, so she sent off an…
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The NHS: observations of an Information Specialist 