to expect NHS to coordinate info

And now there's going to be a 2 tier system introduced for A & E: OMG!!!!!

There aren't many organisations as vast and as complex as the NHS, which is why, in spite of spending zillions, there is still no practical IT solution that works. I was reading today that a quarter of the NHS budget is being spent on litigation costs! What hope is there?

Just to clarify. It is not a consultant I see at the hospital. The clinic is run by specialist nurses.

Considering the incredible amount of money that the NHS has spent on computer software I feel I have every right to expect the NHS to be able to coordinate information; that they don't - or can't - I think, in this technological age, is amazing. I was battling for ages to get my personal details corrected due to 'outsourcing' and now check whenever I visit the GP, just in case. The information is only as good as the inputter of data of course.

yes voice recognition not there yet...

JessM, yes, you're right, it does take them time to dictate, but it's a lot quicker to say what you want to than it is to type, and, of course, very few doctors are proficient typists, more like two finger typists, so it does take them longer than a trained secretary. And also, when dictating, they don't have to bother with the address, date, medical conditions, medications, etc, etc. unless there are changes. I have no doubt that in the future there will be a move away from medical secretaries (unfortunately the powers that be don't see all the other work a med sec does!) and a move to the doctors doing their own summaries/notes, whether by typing or by voice to text, with these being sent electronically. I see the latter, though, as a difficult course to take; one of the doctors I worked for had a very strong Asian accent coupled with a speech impediment - over time I got to know what he was saying, though if I was off work no-one else would touch his dictation, haha. I dread to think what a computer would have made of him.

You referring to typing aka ?

Oh for an NHS peopled with those with the old fashioned skills of the family doctor and bygone nurses but with the IT ability of an IBM technician

Surely, a consultant would have to ok an email before it was sent?

And, don't get me started on the subject of 'managers' in the NHS.

In outpatients they usually dictate very quickly between patients. I think that a letter typed (on paper of onscreen) is likely to be more accurate.

I have never been keen on the idea of everyone typing their own notes. We moved to this in Social Services and most of the secretaries were made redundant. We were left to type up our own note and letters. We were so slow at it and not a patch on the secretaries - it took us away from the actual social work.

We must be the lucky ones here. Again I have nothing but praise for the information sharing between our hospital consultants and our GPs. We also receive a copy of the letter sent from consultants, clinics etc. It must be very frustrating when this does not happen.

It must take them time to dictate though??

Mishap, I totally agree, there are lots of better ways, but until the huge numbers of managers understand how important getting that information out to GPs etc really is, then it won't happen. Because the role of the medical secretary is not seen as important, nobody is interested in trying to improve things. Having said that, I have been retired for three years so my knowledge might be out of date now. Electronic communication would be great, it would certainly save secretaries having to nag doctors for weeks to sign their letters so that they could be posted!

I experienced exactly the same as you with my dad. On his fifth, and final, admission I referred to his previous admissions to his nurse. She told me she knew nothing of these admissions and that they only had the notes for his current admission. How on earth could they make informed decisions about his treatment without knowledge of what had gone before?

JessM, yes, it could work for doctors to type up their own notes, for some. Others would find it more difficult, and actually we, as secretaries, quite often had to make the sentences make sense, obviously without changing the meaning, as not all doctors speak perfect English unfortunately.

It's a really difficult and complex problem actually, with faults and difficulties on all sides. I don't think there is a quick fix, apart from more staff, which isn't an option with the current financial cutbacks.

Sorry, I've gone in a bit, but it's something I feel very strongly about. I could have said a lot more!!

Having found that my husband's consultant is a sweetie with a great bedside manner, but an organisational disaster, we hve cultivated a close relationship with his secretary. This way we can make sure that appointments are made and letters are written.

We have two local (ish) hospitals but our GP will only refer us to one of them as the computers at the other one can't talk to the GP's computers.

MrsSB I have enormous sympathy with medical secretaries - I know how high pressure their job is. But we are in an age of electronic communication - there must be a better way of doing things.

It is not just in the area of getting letters out to GPs that there are problems - having had my Dad in hospital for months earlier this year I know what chaos it is trying to get information when the right hand does not seem to know what the left doing. People kept telling us completely different things all the time.

I wouldn't personally want consultants typing their letters - their time is much better spent with patients! I know that many trusts have invested in voice - based systems that generate letters directly from voice recordings. Of course this will lead to a reduction in medical secretaries!

Twice, after gastroscopies at a local hospital, I was given a printed summary of their findings before going home. The GP received this information electronically.

Meanwhile people in every other walk of life, except probably, the law, have learned to type their own notes and messages.

Unfortunately medical secretaries are often working under such pressure that they do get behind with letters, that is assuming the doctors dictate letters promptly after clinics, which is not always the case. Secretarial services have been cut back so drastically that what was never an easy job has, over the last few years, become almost impossible. I knew of one secretary who was expected to work for five consultants, covering all of their inpatient and outpatient work. Needless to say, this immense pressure led to her being off work due to the stress, leading to an even greater work backlog and even more delays in letters being typed. Until the role of the medical secretary is actually seen as an important role within the NHS (I guess that might happen when hell freezes over), then I don't think the communication between hospitals and GPs will ever be perfect.

One of the biggest problems in the NHS is communication. It arises over and over again. It as a huge problem when I worked in the service many years ago.

Letters are sent to GPs after appointments but they are very slow. My GP (and I) received a letter on 19th October about an appointment that happened on 4th September. And previously a consultant had refused to see me in outpatients (after I had waited 2 hours!) until the information he had dictated about a previous visit (a month before) had been written up - so I had to sit and wait while they tracked down the secretary and got her to type it up. More waiting!

Between us my OH and I do get lots of letters from the hospital reminding us about appointments - they obviously regard this as cost-effective, although some sort of electronic communication would seem to make sense for those that can receive this.

We seem to get two letters saying exactly the same thing telling as when and where hospital appointments are. I queried this and no one seemed to know or care! When the physio failed to cure something he said he would write to the GP to tell him so I asked why he didn't just email and he said it didn't matter as it went by NHS courier! So clearly the stationery and printing and courier cost nothing!!

As the wife/secretary of someone who refers on a regular basis, all I can say is that any sort of communication from a hospital would be great.

We used to get a letter saying when the patient's appointment was going to be, when they had been seen we would get a letter telling us the treatment plan and then we would get a discharge letter.

Patients are often very confused when we know nothing at all about their case, especially if they haven't received an appointment after a year in one case, and they have expected us to be chasing it up.

I am blessed with good health so my contact with NHS is limited but over 2 years ago DD was severely injured in an accident and throughout her treatment communication between hospital/ GP and herself has been exemplary.

Every time she sees the specialist a letter is sent to her GP with a copy to her so that she has a file of letters relating to her care. It has the added advantage that she can pass copies on to her solicitor who is dealing with her compensation claim because it gives a clear and unbiased picture of her injuries, treatment and progress. Mind you, in the 2 years plus since she had the accident she has never had any reason to visit her GP. The hospital deals with the injuries and apart from that she is in good health.

Over a number of years I worked as a secretary to three different hospital consultants (a Rheumatologist, then a Paediatric Orthopaedic Surgeon, then a Paediatrician) and we always sent a summary letter to the GP, and to any other consultants involved in a patient's care, after every consultation. I don't know if this has now changed though.

I do know that when my Dad was in hospital five times between December last year and when he died in February, on each admission the ward staff were not aware of his previous admissions or the treatment he had previously had. His care over the last couple of months of his life was appalling. Communication of important information seemed to be non-existent.

It's the biggest employer in Europe. It's IT systems are years behind the business world. The miracle is that there is any electronic communication.
I think we are still in transition between paper letters being sent around (consultants using dicatphones and letters getting sent through post) and electronic systems being used to inform GPs what is going on.
When MIL was in hospital last year as an emergency for instance there was supposed to be an electronic message system letting the GP know she had been discharged and what GP needed to do re dressings, district nurse etc, but there still seemed to be a major communication glitch before they picked up the baton.