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South Manchester awards dictation deal

Mon, 08 Feb 2010 16:36:07 GMT

SRC has won a contract to provide a digital dictation system to hundreds of staff at an acute trust in Manchester

University Hospital of South Manchester NHS Foundation Trust will introduce the WinScribe digital dictation system, along with workflow technology and speech recognition.

The system will be integrated with the trust's IPM patient administration system, which will insert patient and hospital information to Word templates, saving further time for typists transcribing recordings.

The trust looked at each of the six systems offered under Yorkshire and Humber Commercial Procurement Collaborative's framework agreement for digital dictation services, awarded last August, which is open to 40% of trusts in England, and which was used for this deal.

SRC said it was not disclosing the value of the contract, but said that the new system will be used by hundreds of staff.

NHS to develop online jobs service

Fri, 05 Feb 2010 16:45:36 GMT

The health service will look for a provider able to develop the existing online recruitment website NHS Jobs

In a prior information notice in the Official Journal of the European Union, the NHS North West Collaborative Commercial Agency said it plans to launch a tender for "the provision and development of the NHS jobs electronic recruitment managed service" in April.

The agency confirmed it will run the tender on behalf of organisations nationally, rather than just for its region. The prior information notice invites interested suppliers to join meetings to discuss the tender, "to test at a high level some of our assumptions around the scope of the tender before we finalise our tender documents".

NHS Jobs is run by NHS Employers, part of the NHS Confederation which represents health service bodies. Methods Consulting and Jobsite UK won the £6m five year deal to run the site, then covering the health service in England only, in October 2003. Local pilots began that year and it was fully introduced in 2004.

The site now covers Wales as well as England, with every health service organisation in the two countries using it. NHS Employers has said the site receives more than 6m visits and 250,000 applications each month, and that it has saved the NHS more than £240m since its launch.

LibDems would close Connecting for Health

Thu, 04 Feb 2010 00:10:00 GMT

The Care Records Service and Choose and Book would be scrapped under Liberal Democrat plans to improve informatics in England

The measure is set out in The NHS: a liberal blueprint, a party policy paper which outlines principles to modernise the NHS. It was launched on 4 February 2010 by shadow health secretary Norman Lamb.

Connecting for Health would be abolished as part of a "move away from a centrally imposed IT system". The paper also calls for the abolition of strategic health authorities (SHAs) and some other central organisations.

The document says that the Choose and Book booking system should be replaced by a simple online appointments booking service. It argues that the early signs are that Choose and Book has been less effective at offering patient choice than the government has claimed.

It restricts patient choice by removing a hospital from the list of choices if it has a long waiting list, the Liberal Democrats claim. "It seems bizarre not to offer patients the option of waiting a bit longer to see their preferred specialist or the one their GPs have recommended," the paper says.

The paper also says that the Care Records Service (CRS) should be abandoned. It points out that the CRS is likely to be completed some four years late, has encountered enormous technical challenges and has raised serious concerns about the confidentiality of patient records. Moreover, a clinical and business case has still not been satisfactorily made for establishing a national database.

The Liberal Democrats recognise that contractual obligations with existing suppliers would have to be respected, but say that contract variations could be negotiated.

Following a similar policy to the Conservatives, the party would also put patients in charge of their own health records where possible. The document cites a pilot e-health record system at the New York Presbyterian Hospital, which gives full control of data to individuals.

It also highlights the potential for telemedicine to support people with chronic conditions and enable them to remain in their own homes. It says that the US Veterans Health Administration is using software which links 1,400 medical centres, community clinics and nursing homes. The system shows diagnoses, medications, scan and lab reports and has been able to reduce hospital admissions as a result.

Lamb said: "These proposals set out a liberal approach to the NHS which can drastically reduce costs, improve the quality of care and give people a say in how their local services are run. The NHS is far too important to the people of this country to ignore this challenge anymore - we must act now to secure its future."

Victor Almeida, senior health analyst at Kable, said: "These proposals have many similarities with the Conservatives, but the major difference is that they would close down Connecting for Health and the CRS.

"These measures could be beneficial to the NHS, which is currently tied up with complex software systems in long and delayed trials and roll outs.

"But it could take time before government can extricate itself from contractual obligations – reset negotiations can take months or even longer – and start afresh."

Digital dictation: cost-saver or efficiency-gainer?

Wed, 03 Feb 2010 09:00:00 GMT

Many trusts have replaced tapes with digital systems to save money, but can such systems also help healthcare professionals

Digital dictation is taking off in the NHS, largely because at the press of a button the files can be sent to a transcription service on the other side of the world. But digital dictation (DD) systems have gained a reputation for involving big upfront costs, for both software licences and hardware, and such capital spending requires specific managerial approval.

To tackle this, a number of suppliers are offering DD facilities on a software-as-a-service basis across the internet. This means that trusts no longer have to tap scarce capital funding and can instead pay for the service as they use it out of operating budgets.

NHS Salford is one trust using DD on this basis. It uses WinScribe's service at its Walkden Gateway Clinic, a health centre which is jointly maintained and serviced by the local council and the NHS. The web-based dictation system has been active since the centre opened in September 2008.

Where analogue tapes were used previously - taking up to three weeks to transcribe patient notes and relay the printed words to the patient's GP - WinScribe's OnDemand technology means that the notes often come back, fully transcribed, during the same half-day session.

"It's a web-based system that allows our staff to dictate the notes into the computer and send them off securely to a transcription centre in the US, where it is transcribed and sent back," says consultant physiotherapist Victoria Dickens.

So why not simply get the staff to keyboard-enter the data themselves at the point of clinical care? According to Dickens, there's just too much data to enter and, in any case, it's not a good use of NHS funds for a trained physio to perform secretarial duties.

Staff at Colchester General Hospital tell a similar story. The Essex hospital has five secretaries, more than 30 patient-facing staff, as well as ultrasound technicians, radiographers and consultants spanning five sites. This made the physical handling of audio cassettes - including shuttling them between sites - a logistical nightmare.

Switching to DD was a logical move, especially after the hospital's IT systems crashed for nine days in March 2005, making analogue transcription impossible. Radiology services manager Sue Maughn worked with the hospital's clinical director Martin Gould to commission a system from G2 Speech, whose system is based on Philips DD technology.

According to Maughn, switching to DD has allows secretarial staff to prioritise which tasks needs to be done and in which order through the software. "You can even dictate and use Windows applications at the same time," she says, describing the ergonomics of DD technology as perfect.

A national conversation

While staff at Walkden and Colchester are keen adopters of DD, what about the national view? Are trusts adopting the technology because of the clinical care advantages, or are the economic benefits alone driving its adoption?

Chris Hart, chief executive of DD specialist SRC, argues that both ongoing cost and clinical advantages are apparent. Hart, whose company has signed technology agreements with a number of NHS procurement hubs, says that most consultants and medical staff are well used to dictating their notes, so it does not matter whether the technology is analogue tape or DD.

"The main advantage we see stems from the use of the technology in acute departments, where you get a lot of patient throughput and there is lot of human contact involved," he says. "The last thing you want is a doctor typing between patients."

He adds that SRC is also starting to see trusts integrating DD technology with their electronic health records (EHR) systems, including West Sussex and Chichester hospitals.

It is possible to improve efficiency at the same time as improving patient care, he argues. "Take the example of Brighton and Sussex University Hospitals Trust - they use barcoded capture and DD to speed the transcription process. Once the transcribed text comes back, the admin staff can load up a patient letter template and populate the letter with data from the transcribed text," he says. "Using this approach means that the letter file can then be checked and approved by the doctor - and off it goes."

Legacy systems can be accommodated by using software modules that interface between the SRC dictation platform and specific third party applications or - where the modules have not been developed for a given legacy package - using standard open database connectivity protocols.

But James Kippenberger, healthcare director of rival DD vendor BigHand, says that integration with EHR and other systems is far from universal, however, although some trusts including Mid-Yorkshire have integrated the technology,

"What they have done is to create an intermediate step between the file being dictated and typed. If a member of staff accesses the patient's record in the interim, they can click on the audio file and listen to it," he says.

Kippenberger is also seeing trusts starting to move away from the need for text based EHRs and notes, and an increasing interest in digital streaming. Young staff coming into the NHS are comfortable with audio-visual files being streamed on the internet, so medical staff are starting to append the spoken words of the patient to their medical files.

"GPs know that their patients can describe their type of pain far more effectively using the spoken word rather than text based notes. Moving to audio attachments to patient notes makes a lot of sense in these situations," he says.

A major step forward: comment by Welsh health minister Edwina Hart

Wed, 03 Feb 2010 09:00:00 GMT

Informatics in Wales is benefiting from the country's incremental and collaborative approach to healthcare

As health minister it's my belief that we need to do all we can to deliver top-quality services, for all patients whether they live in towns, valleys or rural areas. This is particularly true during a time of economic downturn, and relies on our ability to make the best use of resources.

We have to do more with what we have, and we know that better use of information and technology can help us meet increasing demands for care against a finite supply of health resources.

I am confident that the Welsh Clinical Portal will help us do just that. It has the merit of using new technology to connect existing valuable sources of information that will make it easier for our doctors, nurses and health professionals to access vital information, centred on the needs of the patient. This is a major step forward.

But it's not just about the technology. It's about how it's used to support care, particularly for those living with long-term conditions, and how it can increase efficiency and patient safety. In Wales we have an estimated 800,000 people with at least one chronic condition, one in three of the adult population.

From the start we said that increased use of technology and better information would go hand in hand with changed working processes. And this is where the collaboration and engagement undertaken by Informing Healthcare has proved so valuable. We are delivering what health professionals want to do their job in a modern health service.

To find out how patients want to use technology to carry out day-to-day health tasks we asked around 2,000 people how they wanted to use the internet to support their own health needs. Overwhelmingly, they wanted to make it easier to contact their GP surgery.

So, I'm very pleased that later this year citizens and patients will be able to use the internet to make it more convenient to manage their own care by making GP appointments and requesting repeat prescriptions online.

Following devolution, the Welsh Assembly Government adopted a different approach to the way the NHS is organised and run in England. We firmly rejected the privatisation of services and the internal market, we don't have foundation trusts and our emphasis is on working together through collaboration and participation.

As a small country we recognise the value of looking outwards and Informing Healthcare's successful incremental approach is informed by evidence from large scale public sector programmes elsewhere.

Informing Healthcare has focused on delivering tangible benefits for patients through small service improvement projects that allow us to adapt and learn from new ways of using or linking information. Once we know they work and meet the expectations of both clinicians and patients we then move ahead with a national solution. This is the approach taken for the Welsh Clinical Portal, My Health Online and the Individual Health Record.

It's also a cost-effective form of delivery that's quick, adaptable, reduces risk and ensures the people using the systems get what they want.

Financial allocations are made on the basis of a series of business cases which justify investment in the overall programme of activities. These are developed in the context of specific healthcare policies and ensure that investment in information technology is aligned to benefits and avoids the risk of IT projects begin perceived as stand alone investments disconnected from patient care.

I'm passionate that all we do is shaped by what people want and, I believe strongly, the systems and services developed by Informing Healthcare, will improve the patient experience and support best clinical practice.

South Tees tenders for £5m radiology system

Tue, 02 Feb 2010 13:22:33 GMT

A foundation trust in the north-east of England is planning to buy a fully integrated radiology information system and PACS

The systems, which will cost an estimated £5m, should provide full desktop integration and voice recognition, South Tees Hospitals NHS Foundation Trust said. Its current picture and archiving communications system (PACS) is available to around 3,000 service users across acute and primary care sites.

According to the notice published in the Official Journal of the European Union on 30 January 2010, the supplier will provide full data migration from old to new systems with business continuity services as a costed option. The contract will also include elements of standard X-ray technology.

The chosen technology will interface with external and internal systems to allow the sharing of information and images between computers. The contractor will supply diagnostic workstations, a facility for hospital clinicians to view images on existing trust PCs, and a comprehensive management reporting tool.

The notice said that provision of a cardiology image storage system, which will include technology to support catheter labs and echo cardiograms, should be considered as a costed option. It added that storage of other digital media may also be required.

Scotland signs for patient info system

Mon, 01 Feb 2010 15:05:36 GMT

NHS National Services Scotland (NHS NSS) has struck a framework deal with InterSystems for the supply of a patient management system, but NI has opted out

In an initial round of contracts worth £44m, the company will provide its TrakCare product to a consortium of five health boards – Ayrshire and Arran, Borders, Grampian, Greater Glasgow and Clyde and Lanarkshire – to help manage acute and mental healthcare.

With NHS Lothian already using the system, it will now cover healthcare providers serving 70% of Scotland's population. NHS NSS said that other health boards are in discussions over use of the framework contract.

Health secretary Nicola Sturgeon said of the InterSystems deal: "This contract will enable health boards across Scotland to implement a single, nationally available patient management system that will play a major role in improving patient services.

"Clinicians and patients will both be winners from a system which will track patient journeys from referral to discharge. It means clinicians will have easier and quicker access to medical records and patients will benefit from having more time with healthcare professionals," she added.

The tender notice for the integrated patient management system, published in April 2008, put the deal's value at £30m to £120m, and said the agreement would also be open to healthcare providers in Northern Ireland. NSS said that 73 companies expressed an interest in the original tender.

The notice said the system would include "a core patient administration system (including mental health), complex scheduling, clinical notes, order communications, accident and emergency, theatres, mental health clinical, maternity, clinical support tools, neonatal and the management of drugs including prescribing and administration". However, users are able to choose which of these modules they wish to buy, rather than having to take them all.

The deal is one of several national contracts recently placed by NSS on behalf of the Scottish health service, reflecting the country's centralisation of its informatics work. In 2009, it awarded Lumension a deal covering information security and Sun Microsystems a £9.5m contract for an identity and access management system.

The organisation is also in the process of tendering for a national GP systems deal, which may also be used by other primary care providers, worth £10m to £50m.

* Update, 5 February: Northern Ireland has chosen not to take up services under this framework contract, an NSS spokesperson said.

Replace IE6 browser, DoH tells NHS

Fri, 29 Jan 2010 11:20:10 GMT

The Department of Health has told trusts using Windows 2000 or XP to move to version 7 of Microsoft's browser

In a technology bulletin published by the department's informatics directorate on 29 January 2010, it advised NHS trusts using Microsoft Internet Explorer 6 on either Windows 2000 or Windows XP to move to version 7 of the browser.

"We've advised NHS trusts to upgrade to IE7 as early as possible," said a spokesperson. The guidance said that IE7 works with the department's Spine applications, and provides additional security.

The notice also recommended that organisations that continue to use IE6 should apply a security update patch from Microsoft to all affected computers, or if this is not possible apply mitigation methods suggested by the vendor.

Microsoft reported a significant security problem with IE6 on 14 January which could compromise a computer's operating system, although the browser was already known to be less secure than newer versions. The new vulnerability could act as an entry point for hackers to a network, allowing sensitive information to be stolen, according to the DoH bulletin.

IE6 is widely used within the UK's public sector. In July last year, several government departments said they continued to use IE6, including the MoD's Defence Information Infrastructure programme to provide secure computing services for 300,000 users.

The Cabinet Office has already issued a advisory notice to central government departments on how to deal with IE6. However, the governments of France and Germany have gone much further, advising that their citizens stop using any version of Internet Explorer.

In a parliamentary written answer to Lord Avebury on 28 January on whether the public sector should stop using Internet Explorer, Home Office minister Lord West said that there was no evidence that a fully patched version of its latest edition (IE8) is any less secure than other browsers.

"A government Internet Explorer user, operating on government systems, such as the GSi (Government Secure Intranet), will benefit from additional security measures, unlikely to be available to the average home computer user," he said. "These include tools which actively monitor for evidence of any malicious attacks and provide a layered approach to internet security."

Defra blocks Facebook, DoH bans eBay

Fri, 29 Jan 2010 00:05:00 GMT

Government departments have published their policies on staff access to specific websites

According to a parliamentary written answer from minister Dan Norris, the Department for Environment Food and Rural Affairs usually blocks websites for IT security reasons or if they contain explicit content.

A spokesperson told GC News: "Access to Facebook has been blocked to protect the network capacity available for business use."

The Department of Health revealed it had banned the online auction site eBay. A spokesperson said: "The use of IT facilities must not risk bringing the department into disrepute or placing it in a position of liability.

"As part of this, on-line gambling, operating a personal or freelance business, selling items on internet auction sites (ie eBay), or participating in political activities is not permitted."

The Department for Culture, Media and Sport has banned a dirty jokes site and a site concerned with an overseas lottery, as well as others "deemed unsuitable".

Conservative MP Grant Shapps asked a number of departments through parliamentary written answers for a list of online sites they have restricted, but the majority declined to give specific names for security purposes.

The Department of Health was among several departments which bars access to categories of sites, including those concerned with gambling, illegal activities, tasteless or adult content, violence, weapons, racism, fraudulent activities and audio downloads.

Kent and Medway thins its IT

Thu, 28 Jan 2010 11:50:24 GMT

A mental health and social care trust with 3,000 computers on 100 sites expects to save money with thin client technology

Kent and Medway NHS and Social Care Partnership Trust reckons it will cut £250,000 from its annual costs, as well as saving staff time, by moving to thin client computers.

Les Manley, director of information and IT for the trust, said the £650,000 initiative will generate two type of savings. One is an annual cost saving of £250,000, the other is cost avoidance.

"We are becoming more IT enabled, putting increasing pressure on our networks, so that if we don't do something like this very soon, we would need to upgrade our networks," he told SmartHealthcare.com.

"And that is a significant cost because we are a large organisation with many sites. By using a thin client solution we will be able to put off or even delay indefinitely some of those upgrades. So we are achieving a further £290,000 one off cost saving and £145,000 in ongoing support costs."

The project was not primarily driven by cost savings, but by benefits to patients and staff, Manley said. These include an extension of mobile and remote working, better data security and environmental benefits.

The first phase of the project will see 250 mobile workers and 750 users at locations with smaller network connections going live in early 2010.

"A major issue with remote and mobile working is how you connect back to your office systems, and typically there are two approaches," Manley said. "One is that you are connected to your office systems and the other is that you are disconnected and you synchronise by going back to the office.

"There are problems with both of those generally. If you are connected, it is potentially costly and you have to have quite big connections, unless all your applications are thin to start with. And if you if you synchronise, then you probably have multiple copies of things out there.

"How thin client helps is that it means we can be connected to our systems, but deliver performance as if we had nice big fat network connection. And we avoid all the complications of synchronisation, the risks of information being out of date, and the information governance issues of confidential data having to be on those machines."

This is one of several ways in which the project will improve data security, said Manley. Others include better data quality because staff have the ability to enter data immediately rather than transferring information, and central storage eliminating the need for multiple copies.

"There are benefits in terms of carbon savings and sustainability," he added. "Once we have this solution in place a lot of out technical support is centralised.

"But also the energy usage of all of these machines running across the organisation, whereas the devices that we buy will be lower energy and have a longer life, because all the processing is done at the centre."

The project will also manage software licences on behalf of the trust. "From time to time we can reallocate a licence, but we also know that we won't over use a licence," he said.

"Business continuity is another one, because if we can provide the desktop to any machine operating a browser we can run from pretty much anywhere."

The trust paid IT consultancy Centralis to design and building a proof of concept based on Citrix's XenApp and Appsense to centralise desktop delivery to staff.

Wirral places clinical trials at its core

Gill Hitchcock — Wed, 27 Jan 2010 09:00:00 GMT

A north-west foundation trust will make clinical trials easier to run through specific software integrated with its patient record system

Wirral University Teaching Hospital NHS Foundation Trust is aiming for two firsts. If all goes to plan, in May 2010 it will be the first trust in the UK to implement Cerner's PowerTrials clinical research module.

The software, which aims to integrate research processes, will also be the first phase of a slightly delayed trust-wide programme to introduce Cerner's Millennium suite of clinical information software.

In February 2009 the trust, which runs Arrowe Park and Clatterbridge hospitals, exploited purchasing freedoms associated with its foundation status and signed an 'out of cluster' contract with Cerner, rather than opting for Lorenzo as part of the NHS National Programme for IT.

Luke Readman, director of information at the trust, says that Cerner Millennium will replace existing software, including systems to support patient administration and clinical tests, which have been in place for about 17 years.

"We are running about 50 clinical trials, mostly drug trials across a range of specialities, and the biggest problem is identifying patients for recruitment," Readman says.

"It might be something as simple as, does the patient have a certain condition and do they have any other illnesses, say diabetes as well. What we have to do now is to manually trawl records and rely on individuals to identify patients.

"But because PowerTrials is an integral part of the clinical system, all that information is contained within it and so we will be able to identify patients who meet the criteria for the clinical trials much more easily."

In addition to increasing the participation of patients and clinicians in clinical trials, the new system is expected to streamline clinical trial screening and enrolment, and integrate the collection of research data into research systems. It will also include rigorous metrics for study feasibility, research prioritisation and oversight.

Chief operating officer and deputy chief executive for the trust Gary Doherty says: "The collaboration with Cerner will allow our organisation to more effectively manage the clinical trials process and reduce the time and cost associated with conducting research."

Readman expects the benefits of the new clinical trials system to be apparent within six months to a year after implementation. "And we will be assessing it to check that we do, bearing in mind that as an organisation we do get some income associated with conducting trials."

The trust is keen to expand its research base and the new clinical trials system could help achieve this, he says. "There is a large and complicated set of mechanisms around research in health in the UK. There is the Department of Health, which sponsors research through biomedical research centres, research collaborations through the National Institute of Health and some directly funded through commercial organisations, such as drug companies.

"The new system gives us an advantage compared with other organisations, because you have to compete to win the clinical trials work. If you are better at it and are able to recruit more patients to it you are more likely to be successful."

Wirral had been due to go live with Cerner Millennium, which in addition to PowerTrials includes modules for outpatients, accident and emergency, operating theatres and patient administration, in November 2009. In preparation it implemented a new data centre and computers to support the new software. Readman says the decision to postpone was made because of safety considerations.

"We put in place a process to check that we transferred all the data from the old systems as safely as possible," he says. "During that process, we decided that it was sensible to give ourselves a bit more time to see how it works, rather than proceed to the original timetable, ensuring confidence in the safety and completeness of the replacement."

"Our trust has a rich history of developing IT to support the way patients are treated and to improve clinical safety and it will give us a platform to continue to develop the expertise and deliver the best for patients that we can do into the future," he adds.

Gill Hitchcock

Patient from Hell: Friends and family beat Choose and Book

Wed, 27 Jan 2010 09:00:00 GMT

If you want a quick hospital appointment, deploy a friend or relation with medical clout, says the Patient from Hell

Last autumn, I recorded in this column the difficulties experienced by my friends Charles and Tom in getting timely and effective diagnosis and effective hospital treatment for their cancers, from which both died. In November another contemporary, Bill, had to wait nine weeks for a surgeon to deal with a prostate crisis, which turned out to be malignant.

It is a long-established theory that the NHS is a two-tier system. The higher tier, which gets great service according to the theory, is white, middle-class, university-educated, articulate, internet-savvy and speaks proper. The lower tier is the rest of us – in other words, about 95% of the NHS's patients.

In the last year, when I see what has happened to Charles, Tom and Bill, I find that the above theory needs modifying. They were white, middle class and so on, and therefore should have qualified for the top tier service, but nevertheless the system beat them. I have come to the conclusion that it was partly their fault; they were not stroppy enough.

They had a problem: they grew up during the war, and went to boarding schools. Consequently, they grew up with an automatic deference to authority. So when they came to be messed around in the last six months of their lives by the glacial diagnostic processes and poor communications of the NHS, they were reluctant to make waves, or, as I would put it, demand their right to better treatment than the rest of us. So they didn't.

This infuriated Charles's son, a neurology consultant, who wanted to march in with big feet, to use his medical eminence to extort better treatment for his father from the lackadaisical (though prestigious) hospital, which was treating him.

Both his father and his mother opposed their son, on the grounds that rocking the boat would be counter-productive, and also because it was wrong socially and morally to 'pull rank' medically. I understand that colossal family rows ensued.

In the end, it was only when Charles told the hospital that he couldn't take any more chemotherapy, and the hospital responded brusquely that he was on his own then, that Charles's son weighed in with the patient advice and liaison service to get decent palliative care for his father. This worked a treat. I ask myself whether his intervention earlier might have accelerated his father's treatment in hospital, extended his life, and reduced the trauma to his family.

Last week I heard of another contemporary having to call on family medical clout to get a consultant appointment in an acceptable length of time. This time it was a sister-in-law in a university town, aged 85, who had an MRI scan at the beginning of December and then an interminable wait for a consultant appointment on which hangs a major operation. When the appointment finally came through just before Christmas, it was for a date late in January with a junior doctor who had no knowledge of her case.

Her GP was furious, and suggested that my sister-in-law should ask her formidable consultant paediatrician son to intervene. He did, and bingo, he got an appointment two weeks earlier than the original date, with the right consultant who knew her history. To make doubly sure that she got the right clinical advice, the consultant son travelled some distance to support his mother at the appointment.

I found it significant that it was the GP who suggested that the son should march in. To me, it was a tacit acknowledgement from one part of the NHS that the normal appointment system, Choose and Book or whatever, for this hospital is a shambles, and the only way to sort out the problem is to "pull medical rank".

I find this rather shocking. It is no longer good enough just to be white, middle-class and articulate, to get top-tier and timely treatment!

I blame the coexistence in some hospitals of Choose and Book with traditional telephone appointments, causing both systems to foul up and leave patients in the lurch. I suggest that hospital managers and Connecting for Health spend some time sorting out this rather elementary problem, before they embark on any brave new computer initiatives costing millions.

In a fortnight, I describe a way of getting good service from the NHS, even without medical clout.

Oxfordshire puts out-of-hours GPs on GPS

Tue, 26 Jan 2010 17:06:52 GMT

A south-eastern primary care trust is paying CSC £728,000 for a system which will allocate out-of-hours doctors' visits through satellite tracking

CSC said that Oxfordshire PCT will be the first NHS user of its OmniLocation system, which is used to allocate mobile staff based on their location then track them as they travel.

"It makes the reporting easier, and makes the allocation of staff easier," said Andrew Spence, CSC's UK director of healthcare strategy. The system is already used in other sectors, such as mobile engineers working for utility firms.

As part of the deal, CSC will also provide the PCT with its SystmOne electronic patient record system to record treatment carried out by GP out of hours services, as well as emergency dental services, minor injury units and first aid centres.

The firm will start installing its systems in April as part of a three year contract with the trust, which has an option to renew for a further three years. The deal covers installation, project management and maintenance of the system.

Spence said CSC is exploring how it can offer other systems and services it provides to other sectors to the NHS, including server virtualisation and mobile working using dynamic desktops.

The firm recently said it will introduce new healthcare systems to NHS customers, including its clinical information portal, joining up data on a trust; its electronic patient folder, for digitising patient records; and self-service kiosks, allowing patients to 'check in' saving receptionists' time.

The firm acts as local service provider to the North, Midlands and East area of the NHS, covering 60% of England.

Stolen hospital laptop held 33,000 records

Mon, 25 Jan 2010 00:05:00 GMT

Southampton University Hospitals has promised to improve data security after the theft of a laptop holding thousands of unencrypted patient records

Chief executive Mark Hackett's formal undertaking follows an incident in October last year when a member of staff left an unencrypted laptop containing personal information in a retinal screening vehicle.

The unlocked vehicle had been parked when the laptop, with about 33,000 password protected patient records, including details about patients' type of diabetes and results of retinal screening tests, was stolen. The thief cut through a security cable which attached the device to the vehicle.

The Information Commissioner's Office (ICO) said on 22 January 2010 that the trust had breached the Data Protection Act.

Storing large volumes of personal information on portable devices is unnecessarily risky, said Sally-Anne Poole, head of investigations at the ICO. "Why were so many records downloaded on to an unencrypted laptop in the first place?" she asked.

"It is vital that NHS organisations ensure their staff handle personal information securely, especially where so much sensitive personal information is concerned," Poole said, adding that she was pleased the trust had taken action to guard against security breaches of this type in future.

The ICO is urging senior executives of organisations to sign up to its "Personal Information Promise", as a demonstration of their commitment to protect personal details. Organisations which have signed already include schools, police services, councils and government IT suppliers Fujitsu and Oracle.

Cwm Taf pilots single care number

Fri, 22 Jan 2010 11:10:51 GMT

Wales will spend £310,000 to set up a new single point of contact for health and social services for one of its health boards

Due for completion in 2011, the centre will enable those covered by the Cwm Taf health board to call one number to access health and social services. The Welsh Assembly Government expects that it will take an average of 700,000 calls a year.

The "communications hub" will be the largest in Wales, according to the health minister Edwina Hart. It will manage call handling and the coordination of several health services, including GP out of hours services, non-emergency ambulance bookings, district nursing services and local authority services, in one location.

New IT will connect previously separate systems, with the aim of allowing patient information to be accessed quickly and securely. The government has provided its funding to Rhondda Cynon Taf Council, which will develop its existing call centre at Ty Elai in Tonypandy for this purpose.

"Patients currently access NHS services through a handful of different phone numbers," said Hart. "The new centre will allow patients in the area who are unsure of where to go for advice to call one number to access a range of services.

"Traditional routes of help such as 999 and NHS Direct Wales will still be available, but for those who require help that is not an emergency, the call centre will direct patients to the most appropriate care, ultimately reducing pressure on services and improving patient care."

Dr Chris Jones, chair of Cwm Taf Health Board, said: "We do not underestimate how difficult it is for people to navigate complex services and the extended Communications Hub aims to simplify this process so local people can easily access a wide range of services."

The NHS in England is working along similar lines with its introduction of the 111 phone number for non-emergency care. A Welsh government spokesperson said: "We will await the outcome of the proposed pilots in England before considering the introduction of the 111 number in Wales." The spokesperson added that it has yet to decide the number for the new Cwm Taf service.