http://www.guardian.co.uk/society/2012/ ... -hospitals



So you cut staff and then trip out the tabloid guff about "beurocracy" and "paper work" ......... as if its all a conspiracy to waste time.

Has it occured to anyone that some of this "paperwork" saves lives?

The NHS has much to learn from the private sector right? Well if the private cosmetic surgery company that has many of us panicking in the uk about breast impants had done some "paperwork" then perhaps we'd have some batch numbers, audit trails, traceable patients and so on!!!

Not only that but the "paperwork" that nurses do is dictated by their profession.

It is part of their nursing code of conduct. And for good reason. It is entirely outside of the PMs gift to deliver on what he is promising!

I want to inspect the HoC, and Tory HQ, particularly their fund-raising department

maybe if the NHS hadn't wasted all their money and resource on needless paperwork and micro management all these poor women could have had their breast ops on the NHS in safety

At Stafford Hospital

Could you outline this "needless" paperwork? This "waste"?

What is it? Where is it? What is your source?

For info the NHs spends mid range in Westeren Europe on health and produces health outcomes well above most of western Europe and significantly better and cheaper than the USA. Any other British industries that can say that?

Not often agree with Groomy on this type of thing, but he is right in this. I use hospitals a lot, one in-particular, it used to be a nightmare but last 2 years change remarkable, service just brilliant, you have an appointment time and thats give or take a few minutes is when you are seen. Last time was there wife noticed that they are now connected with one of the well known private medical groups, am guessing its a reason for change, but to me thats a sensible marriage of private and NH everybody gains, its good management thats the difference.

The Daily Mail??

‘Patients not Paperwork’ – nice sound bite from Dave and his PR machine. Tony taught him well.

call me a doctor - my sides just split

I could of been a Doctor....

I just didn't have the patience

As is often the case there are two (or more) sides to this.

Accurate records are important for numerous reasons both for reference and guidance but what is even more important is how the paper work is used.

When you are an in-patient you should have a series of care plans drawn up in conjunction with your self. How often does this happen on busy general or elderly care wards? Many will not see or be involved in their care plans but they will be written as they need to be audited.

Care pathways, care clusters, disclaimers, ward reports, delayed discharges, complaints, investigations, personal development reviews, medication management competencies, nutrition evaluations, pressure area assessments, HAD scales, Becks inventories, case load audits, infection control audits, ligature risk assessments COSHE assesemts, fire safety audits, TPR charts, mental capacity evaluations, patients property lists, physical assessment, psychological assessment, social assessment, spiritual assessment, carers assessments must be recorded and itemised for everyone and every unit. (and there is a lot more believe me)

Paper work is now mostly used defensively to escape litigation rather then enhancing a patients care and personal experience.

It is also worth pointing out that mosy if not all this is filled in by nurses and nurse managers and these managers are not pen pushers in an office but ward managers as in sisters and charge nurses. Also as upper/middle management is cut more and more of this gets handed down to nurses who should be careing for people and not spending 50% or more of their day inputting into computers or filling in endless forms.

A little incoherent I admit but I am ready and willing to take questions.

We use a lot of it to plan care and re-design services

But a lot of it that you get from source will be coloured by the above.

Being the Guardian it's going to be completely biased and scaremongering in the extreme - the Daily Mail's left wing reflection - but Spiny's comment is well put together. This bit in particular :-



It's seems the NHS is like the police force is like teaching. Everyone needs to fill in a form to record a form for the sake of filling in a form which summarises a form. It's total madness. I want nurses to care, teachers to teach and policeman to be on the beat. This beaurocractic nonsense really snowballed in the mid 90's and I'm pleased to see we can hopefully start cutting back on the ridiculous raft of health and safety legislation which is a Jobsworth's dream.

There's a form for that too.

Let's be clear

Form filling does not make a good or bad nurse or nursing team. There are excellent nursing teams that run excellent wards with incredible customer care and skill.

There are others that don't

Just like where you work there are some staff that are demotivated, lazy or just plain shite.

The data collected is important. What we can work to do is streamline data collection but shortcuts are not possible on any scale in terms of what is collected.

What do we collect that isn't necessary?

The problem isn't so much with collecting unecessary stuff the problem is with duplication and just to much of the stuff. Each year the amount of time you have to spend with patients is diminished with the amount of time doing paperwork to show how much time you are spending with patients. At ward level it really has gone bonkers.

My mate at uni says his department got rid of loads of admin, now after a year, they want them back cos the leaders and professors could't do work cos it was taking too much time and effort. You need small cogs in a machine for it to work properly.
Its madness, that people think tories represent in someway a nationalistic party, cos they have the union jack in their logo they care about british joe.
They don't give a SHIT. All these old people that vote tories cos thy think in someway they care about the country and have 'values'. They are bankrolled by goldman sachs and glaxo and other private companies. The NHS secretary was given 20k by a private comapny. WTFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFf! Come on! Wake up! They want to privatise everything. And once you do that there is no giong back. So no point voting labour if you think they will renationalise nhs, cos they liked privatising somethings to, pfi schemes. what an effin mess they were. Private companies to ran a school, remember seeing a panorama on it.

Under labour people got richer, but the rich got even richer.
Under tories, people get poorer, but the rich get richer.




We will become like the united coorporations of america sorry usa.

Duplication IS a problem. But that is for TRUST departments to share data better and communicate more.

I agree that a hospital visit often means a patient journey to different de tons of the hospital - but they all ask for your name and address each time you move buildings.

Conversely, what do nurses spent time collecting that is more important than spending time with patients?

Not sure what data anyone collected when I was in hospital. Bar throwing food at me, the only contact I got was a once a day visit by a doctor who read my notes and tried to think of something else it could be before sending me off for tests for that.

Baby P died because professions had failed to take notes and share those notes

As a result, although he had been taken to hospitals and doctors many times, it was not picked up, so each visit could be seen as a simple accident as the mother claimed in isolation. Abuse can only be seen as a pattern.

There are gazillions of examples of where that is the case - tracking patients across services is vital for a number of reasons from financial to safety.

Then there is case mix, length of stay, bed days, frequency of attendance, drug regime and frequency................ all the comparative data that tells trust how efficient they are and how they compare to elsewhere, national averages etc

All of this data is crucial to running a huge business with multiple interdependencies

As a simpler point, Data should be collected at the point of contact and in real time. A nurse is not there 24/7 but the patient is. When the next shift comes on, continuity of care is crucial both to patient experience and to safety and quality.

Then someone give us the time and resources to do this. It would also be good if everyone joined in. Ward based nursing staff spend all day writing up not just for themselves but also for their non note taking medical collegues. Baby P and the likes is also as much about services not being joined up, there are many folks writing copious amounts of waffle but then not sharing it.

Murf, fill in this questionaire and I'll reply to it, if you show me your insurance health certificate , passport and NI number first. Why didn't you report to admin admission office before you came in with your health complaint? The doctor will not be able to see you until you show me your papers. Forget the chip on your health card. I want to see papers produced by you. That'll be 198 pounds before we can do any assessment. Credit card?
Well come to the future, that'll do very nicely sir.

yup

Which is why Cameron is a hypocritical slime ball of the worst kind having cut staff left right and centre

With you on that one.

Baby P died because there are some sick and twisted human beings in the world.

And that's something we can't change

We can change the way our services (teachers, social services, GPs, hospitals - all the agencies that come into contact with children ) work together in a more integrated way with better data flows between them so that abuse is picked up early and interventions can be swift.

Agreed. Quality inputing stops duplication. Wasn't system1 supposed to sort all this out?

Reducing inaccurate, irrelevant and illogical inputs I agree with.

Any organisation HAS to have accurate paperwork public sector ever more so, accountable not only against litigation but DPA, FOI's, TSC's etc.

What gets to me is that many places can't be good at both care and paperwork in equal measures and it's those that concentrate on paperwork that come out glowing in any audit.

Good point spiny and now even more resources will be thrown at this "new" idea to cut paperwork to prove to the auditors and the government that their "new" idea worked reducing the care given by all.