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United Kingdom Medicine

'Operating in the Stone Age': NHS Staff's Daily Struggle With Outdated Tech 57

The Financial Times: In the paediatric centre at one of London's largest hospitals, doctors are confounded each day by a ward computer that is not connected to a printer. The computer is used for managing the daily list of patients. Doctors can only access and update the list, using one shared account. So twice a day, two doctors on the ward said one of them had to log in to this computer, update the patient list, send the list to themselves via NHS email, and then log in to another nearby computer to print it off for the team. "I am at a top London hospital and yet at times I feel as though we are operating in the Stone Age," said one paediatrician on the ward.

Tackling the frustrating delays caused by outdated technology [Editor's note: non-paywalled link] is one of health secretary Wes Streeting and Prime Minister Sir Keir Starmer's core missions, having vowed to shift the service "from an analogue to a digital NHS." The monumental task of moving the world's largest publicly funded health service into the digital age is not lost on doctors working on the frontline of the NHS. While many sectors of the economy have been "radically reshaped" by technology in recent years, a landmark report into the state of the health service in England last month concluded that the NHS stood "in the foothills of digital transformation."

But doctors and nurses point out that the basic infrastructure needs to be brought up to a minimum standard, given significant regional variations between hospitals, before politicians extol the virtues of cutting-edge tech. "Some of us just want the printers to work," noted one NHS hospital doctor. "The complete flip-a-coin nature of how equipped your hospital is is mind-boggling," they added. "I have worked in hospitals that are at least 12 years behind others." A report published in 2022 by the British Medical Association, the UK's main doctors' union, estimated that doctors in England lost 13.5mn working hours a year as a consequence of "inadequate IT systems and equipment." One reason for the outdated infrastructure is that the country has spent almost $48bn less than its peers -- such as Germany, France, Australia -- on health assets since the 2010s, according to a government-commissioned study by Lord Ara Darzi last month.

'Operating in the Stone Age': NHS Staff's Daily Struggle With Outdated Tech

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  • by Snotnose ( 212196 ) on Tuesday October 22, 2024 @01:40PM (#64884531)
    Computers are infrastructure. If you don't have a line item in your budget to repair/upgrade them then you are failing as a manager. And I'm including printers, networking, etc etc etc in the umbrella of "computers".

    I remember at Qualcomm, every 2-3 years some guy would come by with a cart and say "go away for a couple hours". I'd come back and the only difference is my computer would be faster. The engineer's computers went to marketing, marketing's to the secretary, and the secretary's ran automated tests or somesuch.
    • But here in the United States we literally have routine bridge collapses. We have bridges held together by the civil engineering equivalent of Scotch tape and Elmer's glue.

      Tax cuts make great campaign issues especially when you need to get money from the upper caste for your campaign and you can promise them big fat cuts.

      But fixing infrastructure is incredibly dull. Nobody wants to hear it let alone pay for it.

      If you want stuff like that you need a better educated class of citizen with more criti
      • Not sure about UK or USA, but here in Quebec (Canada), the healthcare system still relies on Fax machines for communications between different departments or hospitals. Same thing with the passport office in Canada, when they require a document, you have to send it by Fax machine, even if you have the document in your hands and are standing right in front of the person requesting it at the passport office.

        Another thing, the healthcare system in Quebec still requires having embossed cards for health insura
        • In Canada it is not only the fact that people keep voting for tax decreases but also conservative governments want privatization so they undermine the public system. Let's face it, even if taxes stay the same, they are less after inflation.
          • No they are not, taxes are anpercentage so evennif they stay at the same rate they go up and down with the consumer index automatically.
            $1 product 15% tax, I pay 15 cents in taxes
            product goes up to $2, I mow pay 30 cents in taxes
      • If you want stuff like that you need a better educated class of citizen with more critical thinking skills and more media literacy.

        But to get those better educated citizens you need to spend lots of money on educational infratructure... and you need a better educated class of teacher...

        "Recursive": see "recursive".

      • 'But here in the United States we literally have routine bridge collapses. We have bridges held together by the civil engineering equivalent of Scotch tape and Elmer's glue. '

        In the UK they are crumbling as well, and hundreds of school have concrete floors that had their end of life in the last millennium, ditto for hospitals, several cannot treat fat people on the upper floors, too dangerous, the building might collapse, the heavy diagnostic machines were moved to the ground floor years ago for exactly the

    • Computers are infrastructure. If you don't have a line item in your budget to repair/upgrade them then you are failing as a manager.

      Sensible. But that's not possible in the NHS; everything is done on a vast scale and from a great height, mostly be people who have never practiced medicine or even met a patient.

      At my local NHS surgery I was deterred from sending email when a doctor told me that all incoming email is automatically sent on to a central hub from where it is supposed to be sent back - in due course. But in practice it doesn't work, so staff warn patients not to email them.

      It's most unlikely that anyone in a given NHS building

  • epic healthcare can install an system with an lot overhead cost!

  • After brexit a few hundreds millions will flow through NHS every week!
    • Re: (Score:1, Troll)

      by rsilvergun ( 571051 )
      You know I really don't get what's preventing the UK from rejoining the EU besides pig-headedness.

      As far as I can tell the UK is still bringing in just as many if not more immigrants so you didn't get any of that.

      And the shape of your bananas didn't change. I guess you got a different colored passport there is that.

      As near as I can tell brexit happened because nobody thought it was going to happen and a shit ton of dipshits did protest votes.

      As an American facing down somebody who has liter
      • Re: (Score:2, Insightful)

        by Archtech ( 159117 )

        You know I really don't get what's preventing the UK from rejoining the EU besides pig-headedness.

        As a British citizen, I can tell you: we are saddled with one ghastly bureaucracy run by moronic self-seeking ideologues - we don't need another one layered on top of it.

        No matter how bad things are, more government always makes them worse. As that great American Will Rogers said, "Be thankful we're not getting all the government we're paying for".

        If you Americans think the EU is so great, why don't you join it? Whenever I hear Japanese business leaders saying they wouldn't invest in the UK unless we were "

      • You know I really don't get what's preventing the UK from rejoining

        Well, you see

        the EU besides pig-headedness.

        Oh.

        As far as I can tell the UK is still bringing in just as many if not more immigrants so you didn't get any of that.

        Oddly enough it's harder to deal with such a problem if you aren't cooperating with your neighbours.

        And the shape of your bananas didn't change. I guess you got a different colored passport there is that.

        Funny thing about that. There is a grain of truth in the claim, but a half tru

      • You know I really don't get what's preventing the UK from rejoining the EU besides pig-headedness.

        A desire for independence?

      • UK wont get back in on the sweet deal they had before. And EU isnt interested in letting in them in if they just haul off and leave again when the tories or reform get power.

  • a couple hundred billion pounds.

  • by VeryFluffyBunny ( 5037285 ) on Tuesday October 22, 2024 @01:48PM (#64884551)
    ...with the NHS. The problem is 40+ years of chronic under-funding, mismanagement by non-medical executives, & various attempts at stealth privatisation by both parties whenever they were in power. It's time for all parties to understand that Brits love their NHS & want it restored to it's former glory; it used to be the envy of the world & a model for many other universal healthcare systems.
    • by Bongo ( 13261 )

      ...with the NHS. The problem is 40+ years of chronic under-funding, mismanagement by non-medical executives, & various attempts at stealth privatisation by both parties whenever they were in power. It's time for all parties to understand that Brits love their NHS & want it restored to it's former glory; it used to be the envy of the world & a model for many other universal healthcare systems.

      This.

    • Good luck. Over the next 30 years the ratio of retirees to workers in in the UK will increase by 50%.

      https://cdn.statcdn.com/Infogr... [statcdn.com]

      • So making the system less efficient & more dysfunctional is a way to address that?
      • Good luck. Over the next 30 years the ratio of retirees to workers in in the UK will increase by 50%.

        Funny how even well-informed lay people know such facts, yet governments never see them coming a month in advance.

    • by serviscope_minor ( 664417 ) on Tuesday October 22, 2024 @03:01PM (#64884923) Journal

      It's time for all parties to understand that Brits love their NHS & want it restored to it's former glory

      I think the Tories understand, they just don't give a shit what the public want. If they can win after their media buddies stoke fear of immigrants they will sell off whatever shit they can to their cronies. One fundamental tenet of conservatism is pointing and howling at the other side about something bad that the conservatives are doing. Take Thatchers: "the problem with socialism is eventually you run out of other people's money". Classic conservatism: sell off shit cheap to their cronies then hand over the resulting car crash to Labour to fix, who of course won't be that popular because the economy will keep tanking for a while, then rely on the rigged election system to get back in.

    • Almost like one of the negatives of socialized medicine is that it's subject to the whims and vicissitudes of politics and political funding?

      There's no shortage of medical clinics in the US.

      • No shortage of clinics in the US?? Maybe in Los Angeles or Miami but how about Spearfish South Dakota? or in rural Louisiana? This is a growing problem in the USA, so maybe this comment is incorrect? https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2766043.

  • The last big cpu upgrade for many organizations was from xp to 10, now early Windows 10 machines are not eligible for upgrading to 11 which means that yet another waste of money and hardware to upgrade must be performed.
  • REAL stone-age typewriter about 44 seconds into video [facebook.com].

  • "the world's largest publicly funded health service"

    Is this even remotely true? England isn't even the world's largest speaker of english, their population is a meager 58 million, they're a tiny, tiny island that's economically propped up by london's finance center, which has been significantly impacted by brexit (most everyone picked up and left for frankfurt germany within 3 years, covid helped a lot too with remote work). Without London england's income per capita would rank dead even with missis

    • NHS is astoundingly big. It has 1,499,368 personnel. Wikipedia claims this makes it the second largest non-military public organization in the world, but while it cites an official NHS document for the personnel figure, it does not appear to cite anything for the second-largest claim, nor does it state what the biggest is.

      • by Hadlock ( 143607 )

        Healthcare is often the 2nd or 3rd largest employer in any district, along with primary schools. But england is a tiny tiny island country, they don't even crack the top 20 for population. Presumably any larger country with socialized healthcare will have a larger organization, or, a number of smaller regional orgs that together far eclipse the NHS (and likely share a centralized system as well). Vietnam is 100 million people (so, 72% larger) and probably has a much larger nationalized healthcare system, fo

    • Try again troll, the fastest search shows the UK runs the 'British Commonwealth' (King Charles is the head of the commonwealth):

      "As of 2024, there are 15 Commonwealth realms: Antigua and Barbuda, Australia, The Bahamas, Belize, Canada, Grenada, Jamaica, New Zealand, Papua New Guinea, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Solomon Islands, Tuvalu, and the United Kingdom."

      that's 2.7 billion people or 1/3 of the worlds population.

      • Which country of that group is weighing in at 2.5 billion, population-wise??
      • even if every one of those tiny islands (most of which you can walk across in a day) had a population larger than england, you'd have trouble cracking 900 million people. did you forget India left the failing british empire almost a century ago?

        Australia is physically large but i think they only recently cracked 7 million population, and new zealand famously has more sheep than people it's not especially crowded

        once londons financial industry fully collapses mid century (i don't know any mil

    • Re: (Score:2, Interesting)

      by Archtech ( 159117 )

      You shouldn't confound the UK with England. The population of the UK is officially approaching 70 million, but there are so many uncounted illegal immigrants that it could be as much as 10% higher than that. It's the world's 21st most populous nation, but obviously it's not the largest English-speaking nation: that would be India, the largest nation of all.

      I have no idea why you think the UK is "dependent on the USA", except that you Yanks seem psychologically dependent on feeling that someone, somewhere ne

      • by Hadlock ( 143607 )

        Go tell your PMs to stop crowing about "special relationship" with the US every time they need something, then
         
        https://en.wikipedia.org/wiki/Special_Relationship
         
        I didn't make it up, you did. Or rather, Winston Churchill did.

        • Go tell your PMs to stop crowing about "special relationship" with the US every time they need something, then.

          He's not "my" PM. We don't have a democracy here. Do you stand behind everything "your" President says?

          I didn't make it up, you did. Or rather, Winston Churchill did.

          Make up your mind! Churchill was half American - his English father was literally mad.

      • well we know the US is dependant on the RAF to do all that pinpoint low bombing in all the wars you start.
  • by PPH ( 736903 )

    a ward computer that is not connected to a printer.

    There may be a reason for that. It apparently has patient information on it. In a shitty DBMS (no concurrent user support). Or worse yet, a spreadsheet. So tracking who printed a hard copy of sensitive information could be a problem. So, send it out by e-mail and now you know who received copies (and can be fired for improper use).

  • Umm. So. Ok. Why are they making hardcopies of daily routine tasks? They need more wastepaper to line the parrot cage?

    Can't they just use a fax machine, or have the schedule handcrafted with gold inlay by the local monks?

    Are they out of Hollerith cards and paper tape? HAVE THEY EVEN CONSIDERED 8" FLOPPY DISKS?

    • According to doctors, the interfaces on the systems used in hospitals are really really terrible to the extent that it's actually a vast time saver to use paper.

      HAVE THEY EVEN CONSIDERED 8" FLOPPY DISKS?

      It's going to be delivered some time in the near future, but the testing budget was cut so unfortunately there's a few years delay. Until then please just keep everything in core and use the bootloader that's written up next to the machine if the power cuts and it needs to be restarted.

  • in one place is so they can flog it off to whomever will pay for it,
  • If they cannot operate Stone Age tech, they're not going to be capable of using modern tech. Largely because in either case they just do not know what they are doing.
  • And you get what you pay for.
  • UK gov is too busy trying to blow up Moscow, imprisoning people for telling cops to do their job*, and import the third world onto the Dole to spend money on clinical information systems.

    Guy Fawkes had some ideas.

    * he just died in prison this weekend

  • They didn't have internet or social media.

    However, have you use medical services lately?
    Nobody knows anything, you're just shuffled around to make work for the other specialists.
    In Canada everyone's hands are tied and captive of the hospital enterprise software.
    The software calls the shots, nobody does anything other than look at screens puzzling over which field to fill in.
    They are USELESS.

    if the system is down due to cryptojacking or whatever, you'll die on the operating table, because no one has autonomy
  • I was unfortunate enough to have to spend a significant amount of time in a hospital in New Jersey USA recently. I wasn't the patient, but someone close to me was. I was quite impressed with the technology in use. Many of the computers were on carts so that they could be moved around easily. Codes on drugs were scanned before they were administered to maintain a complete record matched with a patient. All lab tests were done this way also. During rounds the team of doctors would use one or several of the co
  • then log in to another nearby computer to print it off for the team.

    Why exactly does this need to be printed? Why can't it be used on the computer, or on a tablet etc? Printing just wastes paper and creates duplicate copies of the list which is ok if the list remains static but a huge pain if anything needs to be updated.

  • ...they didn't use Boris' 350 millions per week from the Brexit bus for the NHS to buy new computers?

  • Look at what happened at the Post Office when they got shiny new computer systems.....

  • This is the short version of the explanation.

    There are two functions, actual heath care, and health care insurancew. Either can be state provided or private sector provided.

    History and statistics show that the configuration which works the best for a country is government insurance and private sector provision. This is the European and Australian model.

    The reason is government insurance covers everyone and eliminates competition between insurers to avoid bad risks, which costs a fortune. The government i

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