diamond geezer

 Tuesday, April 22, 2008

"Now off with you, and I'll see you again in six months time."

So ended yesterday's appointment at the Royal London Hospital's Outpatients Department. It's an oppressive cavern of a building, so old that it could have had a starring role in Casualty 1907 (and, indeed, probably did). My consultant handed me a printed out sheet of A4 paper and directed me back to the reception desk outside. I walked briskly through the crowds in the waiting room - some in wheelchairs, some in the morbidly obese category, most from the local Bangladeshi community. I felt very much the odd one out, and wished that I hadn't come straight from work in a nice shirt with a broadsheet tucked under my arm. One lady was still complaining that she'd spent £50 to get here only to discover that her appointment had been cancelled (apparently the computer knew, but it doesn't let on to patients). I quickly escaped.

There was already a long queue at reception. The member of staff behind the desk was doing his best to enter everyone's details and usher them inside, or to direct them back the way they'd come for a blood test (there, that window back there, the one marked 'Blood Tests'). His desk was covered in piled-up folders and sheets of paper, and with a much more modern computer system than I remembered seeing on my previous visit. Last time it looked like the Royal London was still operating using 486s with a flashing DOS prompt. Now at last the technology looked sleeker, more colourful, and potentially more efficient. Or maybe not. The lady in front of me stood clutching a piece of yellow paper which stated "I NEED MY BLOOD TEST RESULTS", or some such linguisticaly undemanding phrase. But the attendant wasn't able to find her blood test results "because you haven't been entered on the system". So she shuffled off, and it was my turn.

I handed over my printed out sheet of paper. There was a sticker at the top with my name on, then underneath that a long list of possible consultation outcomes and tiny ticky boxes. Not one of them was ticked. I was one of the easy patients, no complications, just a next appointment to book. But nothing was easy with the new computer system. First of all I had to be checked out of my previous appointment so that the machine was ready for a new one. The clerk clicked on a series of buttons to bring up my details, then selected the appropriate menu item from an interminable list of drop-down lists. Every time I thought he'd finished I was wrong, there was still another click to be made, and another, and another.

And then to book me a follow-up appointment. Should have been simple. Same place, same consultant, same day of the week, six months time. The calendar on the wall made it pretty obvious that I'd be back on a Monday in mid-October. But not at all obvious to the 2-week-old computer system. "Doctor's not entered you on the system. It only works if the doctors enter you on the system. I mean, they've had the training, and we've told them it's essential, but they still don't do it. Hang on and I'll try and enter you myself." There followed a long struggle while the clerk searched the database for my consultant's name, and an even longer struggle to find the right title for my Monday clinic. Surely one of those hundreds of words beginning with C was the right one. Erm, maybe.

And finally to pick a date. The computer had already suggested a range from mid-October to mid-January but, on clicking, apparently there were no bookings available. Ridiculous, the whole of that period still ought to be mostly free. Try again. Computer says no. A passing nurse tried to assist by restricting the range to Mondays only, which I think was impossible, but still no luck. Ten attempts later, each click resulting in an identical pop-up error message, the booking clerk gave up. "Leave your card with me and we'll stick your appointment in the post." He cast my Outpatients record card into the seething maelstrom of paperwork on his desk, from which I fear it may never resurface, and moved on to service the waiting crowds behind me.

I shall be watching my postbox with anticipation, if more than a little pessimism, in case a follow-up appointment is ever forthcoming. I have my doubts. I have no faith whatsoever in this brand new automated system, complete with ridiculously over-complicated processes for checking in and out. It seems that administrators haven't been trained to use the computers properly and that doctors are busy treating patients rather than completing the "necessary procedures". The whole cretin-designed software infrastructure appears to be another colossal waste of NHS money. In fact a nursing sister with a diary and a pen, sat here in this very corridor 100 years ago, could have done a far more effective and efficient job. But that's progress for you. Let's hope I don't suffer a relapse before the computer finally invites me back.

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