It will take more than technology to solve the NHS’s productivity puzzle

SIR – With regard to the Chancellor’s announcement of additional funding for the NHS’s IT systems (report,

March 7), please could we rid ourselves of the delusion that digitisation enables doctors to see more patients?

A paperless medical record has advantages: easy transferability, security against loss (though not unauthorised access) and a reduced need for filing staff and storage facilities. In some areas – notably diagnostic radiology and pathology services – there are huge benefits.

Crucially, though, paperless systems do nothing to increase the efficiency of outpatient clinics or surgical operating lists, and can have the opposite effect.

When the NHS hospital in which I formerly worked introduced an electronic patient record, the number of patients I was able to see in a morning fell by 25 per cent – partly because the system would not allow me to book “extras” (usually patients with urgent or complicated problems), but principally because of the time it took to access the information needed to manage each patient properly. Flipping through a paper file is far quicker than opening and closing a lot of different on-screen ones in search of a letter or surgical note.

Jeremy Hunt identified an improvement in the throughput of operating theatres as one of his expectations, but there is no reason why this should occur. Writing up the surgical note is not the rate-limiting step in a surgical list, as it takes far less time than it takes the anaesthetic team to move one patient out and bring in the next, set out fresh instruments and so on. If we are serious about improving productivity, we should follow the example of some US cataract surgeons by having two operating theatres for each surgeon, who can then operate on one patient while the next is being prepared next door. This would obviously require more theatres – and, problematically, the nurses to staff them.

SIR – Throwing money at the NHS and its computer systems will not alter the human element.

I attended, on time, an appointment at an ophthalmology clinic. After waiting completely on my own for 25 minutes, I asked a passing nurse if she could check what was happening.

She returned to tell me I had been entered as “DNA” (did not attend). The receptionist had said she was so busy that she must have missed me. I had been completely on my own at the reception desk too.

Gillian Baglee

Leigh, Lancashire

SIR – Lord Frost (Comment, March 8) discusses the NHS and its need for reform in the wake of the Chancellor’s latest cash infusion.

All I can say is this: on Wednesday I slumped to the floor rather theatrically on entering my local practice, with what later turned out to be gallstones.

I was immediately helped by one of the GPs, a nurse and an in-house paramedic. Within an hour I was in Southampton General Hospital A&E, where I had been taken by ambulance.

After various tests and scans I’m now waiting for the consultant to determine the next treatments.

Without exception I have been treated with care, compassion, cheerfulness and great skill by a wide range of nationalities, using some impressive-looking machinery, in immaculate facilities. For me, the service has been magnificent and absolutely makes me proud to be British. Mick Caulkin Southampton