The shock of the real
22 October 2015 by David Bott
One of the joys of working at the Technology Strategy Board was that I met lots of very bright, committed people with visions of how our world could be improved. We worked to help them realise their dreams as commercial realities. In my more optimistic moments, I revelled in what we were helping them achieve. However, every now and again, I was brought down to earth by everyday experiences. Here is a recent one!
We all know that basic data can be stored, exchanged, analysed and turned into useful information. The increasing accuracy of Amazon’s suggestion of what I should buy is testament to that. But there are areas where the lack of progress is pretty depressing, and I ran into one the other Sunday.
The back story is that my Mother is old, increasingly infirm and beginning to suffer from dementia. She also lives 100 miles away, so when I got a call from her neighbour saying that she was acting confused, it took time to get there and by the time I got there it was late evening, and she was asleep. So I left her. The next morning, she was significantly weaker and more confused than normal, so I called 111. The woman who answered took me through the standard question set, apologising for the more inappropriate ones (“Is there much blood?” didn’t fit in with the actual situation, but I could at least see how it might be a sensible triage question). She told me a Primary Care nurse would call me back within 2 hours. Sure enough, about 80 minutes later a triage nurse called and we went through an expanded and more focused set of questions about my Mothers condition. She said a doctor needed to see my Mother and one would arrive within 2 hours. As promised, the unmistakeable doctors car was parked outside within 90 minutes and he examined my Mother. Bizarrely he asked exactly the same questions as the nurse, albeit more interactively and with the potential patient in sight, and carefully wrote everything down on a paper pad. His diagnosis was that she was suffering from an infection and needed to be admitted to hospital. He called for an ambulance. 2 hours later, the ambulance arrived. The paramedics were great, but asked almost exactly the same questions as the doctor and the nurse and wrote the answers down on another paper pad. They carried her downstairs and into the ambulance. I followed in my car and arrived in A&E about 20 minutes after her. As I stood next to her, my mobile rang and a doctor started quizzing me about her condition. I pointed out I was actually there and he came to talk in person. In what was becoming an increasingly unreal situation, I explained the background, the recent history and was bemused by the fact that he had apparently not got access to any of the input I had, by then, made to 4 other layers of primary care. The amount of their time wasted on asking the same questions of the same person totalled about 60-90 minutes, and these were all highly qualified (and very nice) people who could have been doing something much more valuable with their time.
I can synchronise my own files between computers through the cloud, I can send and receive files from my sons, each of who are more than 4000 miles away and I can video chat with them in real time, but that an organisation that depends on collecting and interpreting data to do its job has to collect the same information up to 4 times and not take advantage of modern information technology seems wrong. I know there are questions of confidentiality about medical data and have seen that the system within A&E lives up to those standards, but the other Sunday left me with a profound sense of wasted opportunity (and the associated cost) that the NHS is a badly organised group of very capable people.