To wonder what happened to this letter during the 37 days between being typed and arriving?

[cottonwoolbrain]

Hospital letter typed on the 29th April and arriving today - it was actually written on 15th but that's another story

. Not hugely urgent as such but a change of prescription which GPs refused to implement until they'd got the letter - understandable they'd not do it until they had the letter but means I've not started switching meds as I was instructed to do weeks ago and as they're strong ones it's a very long switch over period.

But how did it take so long to arrive? What happened to it during the 37 days between then and now... the Royal Mail is bad but not that bad surely? How has it got to the stage where it takes weeks to put something in an envelope and post it? I feel very sorry for the staff trying to keep up with all of this it must be horrendous.

Similar experience. Fortunately, I can clearly remember the discussion I had with the nurse practitioner on the phone and managed to persuade the my GP surgery not to change my medication until I'd had a proper discussion with the consultant. I waited five months for the letter.

@Gingernaut If the Consultant types up the notes there and then, with an automated, electronic system all of the other steps become redundant

Maybe so, but consultants are not paid over £90k per annum to do the typing

But it is now 2024. It takes no more time to type up notes (or use a template system for assistance) than it does to dictate for someone else to type up. In most organisations the days when Person A dictates something for Person B to type, to give to Person C to print and send ended 20 years ago. No professional under the age of around 50 is not proficient in using a computer. There are voice systems that type automatically. In the OPs example already quoted above, it really does not take more to type up a recommended change of medication than it does to dictate it.

By way of contrast - when I have been hospitalised or seen a Consultant here, the notes are always typed up on the spot, printed out and the Consultant takes me through what has been written as a summary to make sure that I have understood. When I needed follow-up surgery, the hospital Consultant showed me his appointment calendar on-screen and we agreed the date for the next operation there and then. While I've seen receptionist/admin staff at the hospital and GP surgery, I've yet to come across a "Medical Secretary." I'm not even sure they exist here as doctors and nurses type up everything on the spot. On the wards, the staff all have tablets and digital equipment - when a patient's temperature and blood pressure are taken, the results are automatically transferred to the notes.

This benefits the patient (who after all should be the focus of everything being done in the hospital) but benefits the system in other ways. Obviously there is the saving in costs once all of the unneccessary steps are removed, and a saving in costs when there is less space required for offices, a post room, stationery, postage etc. There is a reduced risk of letters and notes going missing - internally or in the post. There is a reduced risk of mistakes (things misheard or misinterpreted). There is a time-saving in that the Consultant would not need to review the letter before signing it. But there are also benefits such as the patient getting treated quicker, in my case being able to choose an appointment time (and even the date of an operation) that suited me, so I am more likely to turn up; across the board this would reduce the number of people not turning up for appointments, which makes better use of the time of Consultants, Nurses and support staff.

The newer hospital systems work this way but not every trust in the UK has the funding to upgrade to an electronic record.

All hospitals have some form of electronic record, besides which the cost savings in having one process (the information is entered and disseminated) versus half a dozen (the information is dictated, typed, checked, printed, signed, sent to the mail room, franked and mailed), less delay, fewer missed appointments and less confusion is massive.

Before this system I’d miss appointments because letters came after the appointment date costing the NHS £165 per time (according to their letter), treatment would be delayed, I had to juggle my work diary to attend at short notice, appointments would clash (3 different departments all arranging appointments on the same day). All of the cost of employing people to sort out the mess adds up.

All of that I assume for every patient must cost more than an electronic diary/record system.

All hospitals have some form of electronic record,

They have to have. How else will we sell patient data to Plantir and other Tory chums ?

The newer hospital systems work this way but not every trust in the UK has the funding to upgrade to an electronic record

Al trusts have available funding. It's been in the NHS digital plan for years. They just have to put in a funding request. It's down to management to pull their finger out.

I trained as a medical secretary decades ago. Some consultants preferred their secretary to be on hand during clinics to take shorthand dictation in between appointments and also to chase up results or ex rays that were supposed to be on hand but weren't. I hated it. Total waste of time but they had difficulty with the dictaphone ie didn't want to use it. They would have been horrified at the notion of touching a keyboard because it was below their pay grade. It's decades past the time medical professionals are expected to be keyboard proficient and IT literate. The NHS cannot afford the waste of resources and inefficiency involved in saving a small amount of consultant time - especially where the time saving benefits private practice.

I've a friend whose mother died abroad when they (friend) were very young. She was cremated and the ashes were posted to the family home in England [sometime in the early 1970s].
As yet, the ashes still have not arrived.

My local hospital sends them to India to be typed up.🤷‍♀️

Now if this was any other outfit, I would presume "virtually" sent.

But in this case I can really believe they are posted there, and posted back.

I temped at GOSH when they introduced sending letters to India - they were uploaded as digital audio files, typed up and sent back digitally, downloaded and printed out for consultant to sign.

I meant an electronic record that instantly prepares letters for the patients from the clinical information inputted. Not every hospital has this all embedded onto one system which can then also email a copy to the patient and GP or send to an online portal. The hospitals that don't have multiple separate systems that need staff to formulate information into a letter.

One downside of the new system where everything can be typed and issued to the patient there and then is that there is no room for error as you can't undo or delete anything, hence why many busy overstretched Doctors are reluctant to put their typing straight into a letter without having a secretary review and fix any silly mistakes it first. We need to remember a lot of the specialists people see are in their 50s and 60s and not as proficient in computers as some posters assume because they don't spend all day on one like most of us.

Hmm

And then I remember the NHS still uses fax machines

Yes but obviously they aren't giving out an indefinite amount of money each year. It's being assigned yearly and that's why some trusts have already had it and others are still waiting for their systems to be upgraded. There isn't just a big pot of money that every single trust gets an equal share of every year that NHS managers can access simply by pulling their finger out. If there was I promise the NHS wouldn't be in the shape it is!

We need to remember a lot of the specialists people see are in their 50s and 60s and not as proficient in computers as some posters assume because they don't spend all day on one like most of us.

This is nonsense. Most professionals will have used computers during their studies and since then in their daily lives. They are not being asked to type out "War and Peace" on an old battered Imperial Typewriter, in triplicate using carbon paper. They are being asked to use specially designed software that does much of the work for them - just as they do when they use their online banking, or read their newspapers and journals online, or when they read the lab reports and look at scans and x-rays.

Another poster informs us that these specialists spend much of their time being "mentors, teachers, on call out of hours, developing their own skills, overseeing and doing research, writing their own research papers, leading ward rounds, speaking at conferences, reviewing lab results, preparing surgeries, in theatre and are often part of a hospital's governance" - almost all tasks that require a high level of computer literacy.

Why hmmm?