- Smart Healthcare, Wednesday 8 April 2009 09.00 BST
Day 21: I received a copy of a letter from Fastrack Hospital to my GP, with the not very nice results of the Rapid Diagnosis Unit's tests. The letter was sent on day eight. That's 13 days. OK, it was over Christmas, but who in the 21st century would ever think of sending a life or death message by post to a GP or to a patient over the Christmas period? The NHS, that's who.
In fact, I am over-dramatising my own case, because, five days after my tests I attended Fastrack outpatients to be given the verdict on the tests and a date for surgery. So the letter was just a confirmation.
But my contemporary, the prostate sufferer in deepest Berkshire, waited for two weeks for a letter to confirm whether X-rays showed that his cancer had spread to his bones. Finally, he had to ring his GP to get a copy of the letter. When he received it, he saw that it had been typed a week after the X-rays had been done. To me, a fellow patient, that seems not just lazy but criminal.
Another contemporary, a patient whose three months of stomach trouble has sparked a fear that it may be cancer, is suffering similar delays while the reports on tests percolate through the relevant departments. He cannot lay his hands on the letters about his case. His GP has had to intervene. And he is not out in the backwoods, but a patient of the newest, glossiest hospital in London.
The only conclusion that I can draw is that doctors still do not feel that speed is important. The Royal Mail has always been the method they have used, so this is the way they continue.
And they are stuck with a 19th century gentlemanly view of themselves: that the appropriate mode of communication between each other and the outside world is a stately letter emblazoned with the logos of their hospitals and all the letters after their names.
I suspect that no one in Connecting for Health has had the guts to confront this deeply based snobbery, which must cost millions in secretarial costs and untold anguish to patients.
I notice that even when they refer my interesting case to another department within the hospital, they also do it by formal letter. This is mad. Have they never heard of email within their hospitals, and are they not aware that some of the billions of pounds spent on the National Programme for IT was on a secure email system across the NHS?
Perhaps someone should tell them that in 2009 about 50% of their patients are accessible in their own homes by email.
The reasons "Fastrack" gives for being email-free are delays to responding to email messages and the lack of confidentiality. Come on! This is 2009. There are ways of making sure that a message has been picked up, and there are ways of making emails more secure. This is all a smokescreen.
The Royal Mail is not that fast or secure anyway. If the doctors followed their own logic, they should register all letters which contain clinical information.
I suspect that the doctors are scared to open the Pandora's box of email, in case they have to face up to its hazards and rethink the way they communicate with patients. Meanwhile, patients sit by their front door every morning, waiting for that life saving letter to pop through the letterbox.
To be continued…
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