Catching up
Choose & Book gets its share of the headlines on what appears to be a slow news day with the Guardian running a piece on the divisiveness of choice.
The government wanted 90% of referrals by GPs to run through the system by March, but usage is well below that. However the figures hide a more complex picture, with some GPs enthusiastic about the system and others critical.
Usage is currently at 37% and he now expects the 90% target to be met nationally later this year.
…half of GPs use the system for more than 40% of referrals. But among these regular users, 90% say it increases the time taken to refer a patient to hospital and 70% think it is detrimental to patient care or makes no difference.
For something that is not so directly influential in patient care, C&B gets more than its fair share of mostly negative attention precisely for that reason. Most clinicians cannot understand the focus on C&B when there are far more pressing needs in the system, even more so when the manipulation of appointments etc. to manage demand detract from its supposed focus.
E Health Insider has a similar story focussing on a recent BMA survey.
The unpublished survey of 279 GPs and 128 consultants carried out between 30 November 2006 and 10 January this year shows that members’ views have changed little since then. Of those who responded to the survey, 78% of GPs and 77% of consultants said they currently used Choose and Book.
A total of 57 % of GPs and 81% of consultants described their experience of Choose and Book over the previous month as negative or very negative and 87% of consultants and 71% of GPs said they would not recommend Choose and Book to a colleague.
Asked about whether patient choice had improved with Choose and Book the majority of GPs (68%) reported that in their view it had not as did 56% of consultants with a further 30% of consultants saying that they did not know.
Consultants appear to be even unhappier with the e-booking system’s impact on patients than GPs with almost 92% of consultants disagreeing or strongly disagreeing with the statement that patient feedback had been generally positive compared to 64% of GPs.
I would consider this a minor indicator of the state of affairs considering the small sample size and the fact that the response rate was quite low. However the results are similar to previous surveys of this nature & illustrate why it is not performing.
One GP commented: “We have just decided to stop, having been in the top 100 practices for usage, as the local hospital has started to tell patients that there are no appointments available, when the patient rings to book, and asking the patient to contact our practice! - what are we supposed to do?’ Another said: “Complaints from patients over difficulties in getting through . . . all of this fed back to me in wasted surgery time.â€
There is also coverage of the slow progress of Isoft’s Evolution Maternity Information System with the pilot customer dropping it.
Royal Shrewsbury Hospital NHS Trust, Shropshire, which has been waiting for almost two years for its local service provider Computer Sciences Corporation to implement iSoft’s Evolution MIS have now deployed the Eclipse system from Huntleigh Diagnostics in a bid to save up to £0.5m annually through reduced clinical negligence liability costs.
In other medical news, the Telegraph highlights the scheduled march in both Glasgow & London at the weekend.
There is also some tough talk from the Healthcare Commission in the Telegraph re the issue of hospital acquired infections. The point that most healthcare professionals would make though is that what is required is a re-imagining of care processes with the patient being the centre of the web & attention being paid to providing the best care, not frequent transient campaigns when something becomes too hot to handle. Sloppiness is now a part of the chain, exacerbated by the pressures on staff & improvements in one area are accompanied by an increase in failings in others.
High bed occupancy increases the risk of infection. The survey showed that when bed occupancy was over 85 per cent cases of MRSA were 16 per cent above the average. Where bed occupancy rates are more than 90 per cent MRSA infection was 42 per cent above average.
The commission is proposing that trusts will have to show that they are fully complying with the NHS hygiene code which includes guidance on hand washing, staff education and involvement in infection control at board level.
I had missed this one about United Health earlier but nice job if you can get it, pity about the departure under a cloud but $2 billion would keep me cocooned from it all.
I have a feeling that this price for DEXA scans is going to cause a few furrowed brows at the PCT’s who will be paying more for the same procedure through the Diagnostics IS contracts. Time to get the calculators out again?
A quick reference to the cost of the war in the Independent & how the money could have been put to better use paying for healthcare.
“This is the politics of Mad Hatter priorities,” said Alan Simpson, a Labour opponent of the war. “The Government is throwing money into an unwinnable war zone in Iraq at the same time as withholding money that creates a war zone in our hospitals.”
The state of the British smile got a mention in the Mirror who review the NHS dentistry contracts, brought on by this non-story. The performance figures for the dental contracts are here.