A Top Tip for Solving the Funding Crisis in the NHS.

I love “Call the Midwife”. There are many reasons for this, chief amongst them is that it evokes what my early childhood must have been like as I grew up in that early post-war world. I can remember visits to the doctor which took place at his home – including one out of hours when I gashed my knee open (I have the scar to this day) – when we simply dashed to his house and knocked at the door. I had no idea that the ability to do this without having to pay for it on the spot – or do without -was a brave, bright, new thing. “Call the Midwife” captures this brilliant gift perfectly, chucks in a couple of love stories, some kind midwives and a clutch of photogenic nuns. What’s not to like?

Fast forward and that gift is under severe strain and the prospect of losing this gem, this treasure in our national life is scarily real. I don’t want to lose our NHS – if we lose it we will never get it back!

So I have an idea for how it can save money: it involves using free email and streamlining admin. Wait. I mean creating an admin system for booking appointments that actually works. The money saved could be used for research, state of the art equipment, doctors, nurses and, if I had my way, bossy matrons! Consider this little case study and the implications of it scaled up across the whole of the NHS.

For several years now the husband has suffered from a non-life threatening but miserable condition for which he regularly sees a specialist. We recently returned from a short holiday at Easter to find 8 envelopes from the NHS as follows:

27th March: a copy of the report sent to the GP following consultation – 2 sheets of A4 paper with the second containing only our address

27th March: a follow up appointment for the specialist has been made on 25th September

31st March: a letter regretting the need to cancel an appointment with the specialist on 7th July due to circumstances beyond their control. They are unable to arrange a new appointment but one will be sent soon – see above!

31st March: a report on a blood test and a commitment to seeing him three months hence sent in a separate envelope

1st April: a letter regretting the need to cancel an appointment with the specialist on 25th September (see above from 4 days previously!). They are unable to arrange a new appointment but one will be sent soon.

1st April: an appointment for the specialist has been made for 16th June (see above!).

2nd April: an appointment for the specialist has been made for 7th April

9th April: a letter regretting the need to cancel an appointment with the consultant on 16th June (see above from 8 days previously!). They are unable to arrange a new appointment but one will be sent soon.

Then – number 9:

22nd April: following feedback from patients they are introducing a new system for making appointments so they have had to cancel the appointment for 14th July (where did that one come from?). They will be in touch with him soon and are really sorry.

I know…you need a moment to absorb this!!

So, the first thing that occurs is the sheer amount of admin work needed to keep organising and re-organising appointments that never happen. The cost must be huge when scaled up to the number of patients with out-patient appointments every day. For the sake of argument, let’s say it costs a conservative £5 per letter – cost of materials, labour and postage. On this basis, husband’s letters alone cost £45 at the end of which he still didn’t have a valid appointment!

And what flows from this is to wonder why this correspondence can’t be dealt with via email. This is the 21st century and there is barely a government activity that does not require the use of the internet and/or email. (The only exception I’ve found is the form you need to challenge benefits sanction but that’s another story!) So why is snail mail being used rather than free email? It can’t be the old saws of confidentiality and data protection because in this day and age there are plenty of ways to overcome these concerns. The saving on postage alone would probably solve the NHS funding gap.

There it is then, my good idea for saving the NHS: use email and sort out an effective appointment system – that is one that results in appointments that can be attended actually being made. It can’t be that hard, dentists manage it, hairdressers manage it, hotels manage to book rooms months in advance – how hard can it be?

thing. “Call the Midwife” captures this brilliant gift perfectly, chucks in a couple of love stories, some kind midwives and a clutch of photogenic nuns. What’s not to like?

Fast forward and that gift is under severe strain and the prospect of losing this gem, this treasure in our national life is scarily real. I don’t want to lose our NHS – if we lose it we will never get it back!

So I have an idea for how it can save money: it involves using free email and streamlining admin. Wait. I mean creating an admin system for booking appointments that actually works. The money saved could be used for research, state of the art equipment, doctors, nurses and, if I had my way, bossy matrons! Consider this little case study and the implications of it scaled up across the whole of the NHS.

For several years now the husband has suffered from a non-life threatening but miserable condition for which he regularly sees a specialist. We recently returned from a short holiday at Easter to find 8 envelopes from the NHS as follows:

27th March: a copy of the report sent to the GP following consultation – 2 sheets of A4 paper with the second containing only our address

27th March: a follow up appointment for the specialist has been made on 25th September

31st March: a letter regretting the need to cancel an appointment with the specialist on 7th July due to circumstances beyond their control. They are unable to arrange a new appointment but one will be sent soon – see above!

31st March: a report on a blood test and a commitment to seeing him three months hence sent in a separate envelope

1st April: a letter regretting the need to cancel an appointment with the specialist on 25th September (see above from 4 days previously!). They are unable to arrange a new appointment but one will be sent soon.

1st April: an appointment for the specialist has been made for 16th June (see above!).

2nd April: an appointment for the specialist has been made for 7th April

9th April: a letter regretting the need to cancel an appointment with the consultant on 16th June (see above from 8 days previously!). They are unable to arrange a new appointment but one will be sent soon.

Then – number 9:

22nd April: following feedback from patients they are introducing a new system for making appointments so they have had to cancel the appointment for 14th July (where did that one come from?). They will be in touch with him soon and are really sorry.

I know…you need a moment to absorb this!!

So, the first thing that occurs is the sheer amount of admin work needed to keep organising and re-organising the appointments that never happen. The cost must be huge when scaled up to the number of patients with out-patient appointments every day. For the sake of argument, let’s say it costs a conservative £5 per letter – cost of materials, labour and postage. On this basis, husband’s letters alone cost £45 at the end of which he still didn’t have a valid appointment!

And the next thing that flows from this is to wonder why this correspondence can’t be dealt with via email. This is the 21st century and there is barely a government activity that does not require the use of the internet and/or email. The only exception I’ve found is the form you need to challenge benefits sanction but that’s another story! So why is snail mail being used rather than free email? It can’t be the old saws of confidentiality and data protection because in this day and age there are plenty of ways to overcome these concerns. The saving on postage alone would probably solve the NHS funding gap.

There it is then, my good idea for saving the NHS: use email. My subsidiary idea is to sort out the appointment system. It can’t be that hard, dentists manage it, hairdressers manage it, hotels manage to book rooms months in advance – how hard can it be?

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