‘Missing’ NHS patients
SIR – Chris Hodson’s suggestion that 5,200 patients fail to attend their appointments at the Queen Elizabeth Hospital Birmingham each week (Letters, July 25) may not be entirely accurate.
My husband received a letter telling him he had cancelled an appointment – but this appointment had never been arranged. The same thing has happened to other people I know.
It appears that hospital administrators are failing to make appointments, then placing the blame on patients by saying that they have cancelled. If patients are recorded as having “cancelled” on more than two occasions, they have to start the referral process again.
Hospital administration has not been fit for purpose for decades. It is time for a wholesale reorganisation. Christine Morris
Peterborough
SIR – I take issue with the suggestion that “lean” thinking principles have contributed to the NHS’S failures (Features, July 23).
The example given is that “spare capacity – in the form of beds per head of population – was seen as wasteful” and “a ‘just in time’ system seen as the ideal”.
I led a consulting organisation that helped to introduce lean principles into the NHS. We taught a limited number of people how to use them. This led to massive increases in day-case throughput at Alder Hey Children’s Hospital, and a huge reduction in mortality rates at Royal Bolton Hospital. It also drastically increased the output rates in A&E departments.
The aim was never to cut capacity, but to improve productivity and patient-care outcomes, so that hospitals could do more with the same resources.
Unfortunately the NHS decided to internalise its “lean team” too soon, before people were properly trained, and this led to a dilution of results. Consultants were judged on their absolute costs or daily rates, rather than the return on investment they achieved, which resulted in a premature withdrawal of the support the NHS needed to make the lean approach a success.
I recently spent a month in an NHS hospital. I was asked the same questions over and over again, saw dangerous errors being made as I moved from person to person, and witnessed people suffering because they weren’t part of a clearly defined treatment pathway. These are all things that lean tools and techniques could help to prevent.
Nicholas Middleton
Scunthorpe, Lincolnshire