Cross Talk on broken bones and an improving healthcare service

Mike Cross takes a trip to his local hospital for the first time in a decade and finds it improved beyond recognition. As an “NHS IT nerd", he’s pleased to see digital technologies underpinning the transformation.


My bones don't bounce like they used to, so an absurdly trivial tumble means it's back to the X-ray table for me. What a treat, though. My local acute trust, North London's Whittington - unofficial motto "all human life is here" - has improved beyond recognition. 

Brighter, faster, more cheerful

In the bright new foyer, two cheerful volunteer helpers almost fall over each other to direct me to the imaging department. It's a walk-in (limp-in?) centre, so no one's expecting me.

That's fine: the receptionist takes my GP's order sheet, with a bit of prompting calls up my 10-year-old details on the patient-administration system, updates my address and GP's name, hands me a pager and invites me to take a seat. "It is now taken for granted that everyone in the chain knows who I am, and the workflow is impeccable."

Whittington's customer-base hasn't changed much in 10 years - my neighbour is bantering cheerfully with the uniformed prison officer to whom he is handcuffed - but the stress of the wait has gone.

Within 15 minutes, the pager summons me to the X-ray room just as the previous customer is going in. A very few minutes later my own dicky ankle is under the zapper. The radiographer has time to explain what she's doing, to enthuse about the all-digital technology and to assure me that nothing immediately looks broken.

For a full explanation of why I'm hobbling in agony, I'll need to await the radiologist's verdict, via my GP. But thanks to all-digital imaging, I'm reasonably confident that everyone in the chain of care will have the best information to hand, and feel immeasurably better as a result. A visit that I'd expected to take all morning - if not all day - is over in less than an hour.

Boosted by good technology

NHS policy experts will nod knowingly at my gushing report. It's commonplace for people to report positive experiences of their local GP or hospital, while believing them to be atypical of the creaking health service they read about in the papers. "PACS, the classic example of a healthcare technology whose time had come, is a morale booster to patient and professional alike. A lot of healthcare is about morale-boosting."

But it's worth exploring why my local trust is working so well. There's money, of course. And hundreds of staff taking pride in what they do. But IT is making a crucial contribution, too.

As a bit of an NHS IT nerd, I can spot gaps in my local system, especially at the interface between GP and acute unit. Some say that it's ridiculous that imaging orders are communicated on paper. But where it matters, the technology not only works, but can be seen to be working.

It is now taken for granted that everyone in the chain knows who I am, and the workflow is impeccable. Even something as trivial as the waiting-room pager defuses tension and anxiety - it encourages the patient to feel that they have not been forgotten in a corner.

And of course PACS, the classic example of a healthcare technology whose time had come, is a morale booster to patient and professional alike. A lot of healthcare is about morale-boosting.

Now we just need more of it

To go forward with IT in the NHS, we need to identify more technologies like PACS. Just now, some of the best brains in healthcare informatics are now being applied to this very question. But from my own humble recent experience, I'd say NHS IT could benefit from two simpler exercises.

First, measuring the intangible benefits of technology in improving confidence in the system, and second making sure individual patients understand how often their good local experience is underpinned by IT.

And my injury? Well, if you're really interested, I'm still limping - but there's a definite spring in my step.

About the author: Michael Cross is a freelance journalist specialising in healthcare informatics and e-government. He is a member of the British Computer Society.