Monday, January 05, 2009

Did you just hear something then?

So that’s it then. New Year rung in in suitable style at Jest Acres after trip to the Panto, New Years Eve banquet in the great hall to follow, concluding with the now traditional sybaritic orgy that is the chocolate fountain, and Jools on the telly in the other room Hootenannying for all he was worth. All in all it went rather well, though the return to a duty surgery on Friday the 2nd was a suitably sobering return to earth.

Still the New Year is off to a suitably surreal start, that if nothing else shows the perils of “copy and paste” correspondence. For a long time there have been parallel moans in U.K. health services. The hospitals moan that GP letters are often a bit sketchy, frequently penned in haste at the bedside as they are, and so are inclined to leave out essential titbits, such as the patients inside leg measurement and so forth. In turn GPs have moaned that the discharge letters thrust into the hand of homecoming patients tend to lack vital, or at least legible, information on trivia like diagnosis, treatment and follow up arrangements. This has, to my knowledge been a settled and steady state for at least three decades. I suspect even poor old Hippocrates had young whipper snappers moaning about the appalling state of the handwriting in his wax tablets down at the Kos DGH.

But over the past three or four years we have moved to printing a lot of the more relevant patient data onto an encounter sheet to attach to our urgent referral letters, and the hospitals have moved to IT generated discharge summaries which are way better than the pro-formas of yesteryear. The problem comes when these IT generated documents are pre-formatted for routine entries of common data, and not edited for those that do not apply, as happened today. Or at least I very much hope that that was the case. Otherwise we have a patient who died in hospital, but was found to have a normal temperature, blood pressure and respiratory rate on discharge from the ward to the mortuary…..

Must go now, it’s dark and there’s a strange tapping sound at the window.

Errr Hello!

Is there anybody there………….?


Swiss Missus said...

Cathee? Heathcliffe? Kate Bush?

With all respect for doctor-patient confidentiality, you can't keep me in suspense like this...

Doctor Jest said...

Swiss Mrs-- no need for alarm. Turned out it was only the cleaner.
Ah the perils of working late at the office ;-(

Anonymous said...

Yeah I think most of us are still out here...

Happy New Year (it's only 11 days old so it still counts as a new-ish year)...

I shudder to think I may one day have to use the NHS but seeing as I have left France and now live in England, it may happen. I think Hippocrates would shudder too.

God save the Queen? No. God save the NHS. Please.

You, sir, care too much to belong in the system.


Doctor Jest said...

wendy-- good to hear from you. I hope '09 will be good to you. Any prospect of you blogging again? No pressure, just always enjoyed what you had to say....

I suspect Hippocrates would wonder at just how much the NHS has got its collective knickers in a twist, but there are still way more caring and dedicated folk in the service than you might at first imagine. It's a pity exisiting systems seem intent to stifle them.

This too shall pass.

Anonymous said...

I do think about blogging - and maybe once I am permanently settled I will do so. I need to find my inner voice again - it's become rusty from lack of use.

I also need a proper internet connection to be able to blog properly - at the moment I'm on prepaid BT Openzone, but from February we'll be in our new house and will have 24/7 internet again.

Should I blog again I will let you know.

You are right to say there are caring people in the NHS - but it's such a vast and unwieldy dinosaur and it just chews up all the good souls.