Sunday, 19 August 2012

Medical Hocus Pocus, Goodbye Mark, and Feeding the Digital Mind

Following my return from annual leave last week, by lunch time on Monday all memories of my two week break had been filed in that mind folder labelled ‘Summer Holiday 2012’. It was full on. And Monday night I was to be found at the Double Tree by Hilton Hotel having dinner with colleagues from the the other three Universities in Great Manchester.

It was an interesting evening with creative conversations and a challenging menu. One of the starters was frog’s legs. Thankfully nobody chose this dish as their starter. My Compressed Apple and Ginger Ice Cream desert was a surprising mini feast on its own though. We were there as part of a shared desire to increase the collaboration between the four Universities.

One of the topics of the evening’s discussions was around our input, as educationalists and researchers, to the Greater Manchester Academic Heath Sciences Network (AHSN). We had received feedback from the Department of Health and an invitation to submit by the end of September, a fully costed bid to become an AHSN. AHSN are a new initiative aimed at bringing together providers of health care services, academics and industry in finding new ways of translating research into new approaches to services and in so doing improve the health and well being of the population. It is an exciting opportunity.

The digital revolution is important to how we take this opportunity forward. But Tuesday night I found myself at the Horwich Heritage Centre, and digital technology and health were the furthest things from my mind. I was attending a lecture on Medicine and Magic given by one Peter Watson. Interestingly, when I walked into the room I was mistaken for him, and although I offered to present the lecture, the real speaker arrived. He had longish, silver hair, was at least a foot shorter than me, and wore a shirt that had a definite air of lumberjack about it.

The lecture was mildly amusing in parts and dwelt mainly on stories of quack medicine, discerning the sex of the unborn baby using keys, transferable cures, often involving string, Wise Women (a precursor to the modern day midwife), the use of herbs in treating certain ailments and the universality of Gin as a cure all. There was very little medicine or magic involved and nothing was said about the myth of medicine – I didn’t, however ask for a refund of my £1.50 entrance fee.

He wasn’t a Mark Rapely - and sadly Mark died last week of cancer. Mark was a person I admired. He spent a lifetime challenging the bio-medical view of mental health. He was someone who taught psychology differently! He never ever backed away from saying the really challenging things that many of us think but seldom say. Mark will be missed.

Wednesday evening I was out with the Schools Professors, dining at Abode. The restaurant had an offer for a two course or three course meal, and they certainly had an idiosyncratic way of dealing with this. The waiter brought our first course – which was a mixture of starters and mains, and then our second course which was a mixture of mains and deserts. I found myself eating my desert next to someone who was eating his Hake – not a good situation. When I complained, I was asked ‘what’s the problem you had ordered two courses and that’s what we served’. I won’t be going back there in a hurry. The company was good though!

Thursday night was night in, just thinking about just how hard things get at times. Friday I was at an AHSN stakeholders meeting where we got to present the work undertaken to date. There were 29 CEOs, or their deputies from all the health care providers across the Greater Manchester area. These organisations provide health care to an immediate population of 3 million and a population within an hour’s travel, of some 11 million. It was a great event and I learnt a lot about what had already been achieved in the North West in harnessing digital approaches to health care.

The existing examples were staggering. For example digital dictation, a method of recording and managing natural speech, typically used in the NHS for creating letters and reports and clinical notes, saved Salford Royal NHS Foundation Trust over £500k last year. The former North West Strategic Health Authority estimate savings of £7 million to £18 million per year are currently being achieved across the region.

Tele-health uses equipment to monitor people’s health in their own home. The Department of Health Whole System Demonstrator programme reports significant reductions in emergency admissions (20%) and mortality rates (45%). Whereas telemedicine, used to provide interactive healthcare, is widely used in 6 acute trusts and 7 PCTs across Lancashire and Cumbria who are making savings of £1.8 million annually. NHSmail is the secure email and directory service available to all NHS staff. The system has been accredited for the transfer of patient identifiable data such as referrals and discharge summaries. NHSmail provides a service which sends appointment reminders via text messages. All services using this approach have reduced ‘Did Not Attend’ often as much as a 50% reduction in DNAs at a saving of £31 per appointment.

Online meeting services use technology to enable meetings and consultations to happen without the need for people to be physically in the same location. It includes the use of audio, web and video conferencing. There are potentially huge financial benefits. On average, savings of over £92 per person for each meeting can be achieved. However, I have it from very reliable sources that while NHS colleagues in London DoH offices use this to avoid coming up to Leeds, they do expect all of us to get in the train and travel down to their meetings.

Thankfully, on Friday evening I only had to travel back to the Double Tree by Hilton Hotel to attend my last meeting of the week. Frogs legs, magical doctors and all use of digital technology was banned, and it was good just to have a face to face conversation without any distractions.