IOM DHSC & MANX CARE

[BriT]

9 minutes ago, wrighty said:

So what’s the modern way?

The modern way can’t be letters taking a month to end up in an envelope can it?

[John Wright]

I’ve personal experience.

August last year I was in Norwich. Late, dark, stone cold sober. Hit a pothole, sheared a front bogie wheel, chair tipped over, I fell out. I probably broke my big toe. Swollen, bruised, but not deviated or displaced. 

As I was due on the ferry to Spain the next day I dosed up with painkillers, and cracked on. I’m stupid like that.

Over a couple of weeks swelling went down and settled. By the time I got home in September it seemed OK.

Fast forward to February 2022 and travelling on the ferry from Santander someone, who I thought was holding a heavy sprung door to the outside deck, let go. The door hit my toe.

I Thought I’d wait and see again. Got home. By the time swelling went down there was substantial deviation. And that means it’s painful as it rubs.

13/03 contacted GP for appointment  ( it wasn’t A&E by then )

20/3 X-Ray 

1/7 appointment with ortho consultant in Ramsey. He recommends CT scan 

14/10 CT scan & 2nd X-Ray

Its slow. Not sure that anything can be done. But it’s frustrating. I’m expecting not to hear anything until late January.

[BriT]

7 minutes ago, John Wright said:

Its slow. Not sure that anything can be done. But it’s frustrating. I’m expecting not to hear anything until late January.

I’m sure that’s the case John but go up to Nobles around 8:00AM any morning and there are literally hundreds and hundreds of cars full of admin workers clogging the place up coming to work. It’s the same at 4PM trying to get through Braddan when it’s clogged with hundreds of cars leaving the hospital site. What do these people do if it takes a month to put a letter into an envelope? It’s like Manx Care has become like every other area of the Manx public sector and full of people doing nothing but taking up space in budgets. 

[finlo]

20 minutes ago, John Wright said:

I’ve personal experience.

August last year I was in Norwich. Late, dark, stone cold sober. Hit a pothole, sheared a front bogie wheel, chair tipped over, I fell out. I probably broke my big toe. Swollen, bruised, but not deviated or displaced. 

As I was due on the ferry to Spain the next day I dosed up with painkillers, and cracked on. I’m stupid like that.

Over a couple of weeks swelling went down and settled. By the time I got home in September it seemed OK.

Fast forward to February 2022 and travelling on the ferry from Santander someone, who I thought was holding a heavy sprung door to the outside deck, let go. The door hit my toe.

I Thought I’d wait and see again. Got home. By the time swelling went down there was substantial deviation. And that means it’s painful as it rubs.

13/03 contacted GP for appointment  ( it wasn’t A&E by then )

20/3 X-Ray 

1/7 appointment with ortho consultant in Ramsey. He recommends CT scan 

14/10 CT scan & 2nd X-Ray

Its slow. Not sure that anything can be done. But it’s frustrating. I’m expecting not to hear anything until late January.

That's mental, surely it will have healed by now even if badly?

[John Wright]

4 minutes ago, finlo said:

That's mental, surely it will have healed by now even if badly?

Yes, it’s healed at an angle pointing in. Rubs against the next toe. That’s what causes the pain.

Its mainly my fault for being stupid/brave. I should have gone to A&E in Norwich last year and then in Portsmouth in February.

I just wanted to see if it could be straightened. 

[wrighty]

26 minutes ago, BriT said:

The modern way can’t be letters taking a month to end up in an envelope can it?

I’d love it if we had a proper, integrated electronic patient record, which has facilities to send secure messages to GPs and the patients themselves. Voice recognition for note entry, check, click and send to GP and patient immediately after It’s dictated/typed. 
 

But we don’t, and we’re not going to. I tried. 
 

In any case a majority of our patients don’t do email - it’s alright for you and me, but not the average octogenarian who comes to clinic. 
 

So, any solutions to the current problem @BriT, or just going to keep pointing out that it shouldn’t be like this?

[Sheldon]

3 minutes ago, John Wright said:

Yes, it’s healed at an angle pointing in. Rubs against the next toe. That’s what causes the pain.

Gel toe separators, dirt cheap on Amazon. The nail polish is entirely optional.

[Roger Mexico]

23 minutes ago, wrighty said:

I’d love it if we had a proper, integrated electronic patient record, which has facilities to send secure messages to GPs and the patients themselves. Voice recognition for note entry, check, click and send to GP and patient immediately after It’s dictated/typed. 

Well according to the Written Answer I quoted before: Manx Care are looking to develop the existing dictation system, known as Big Hand, to expand its functionality to include digital dictation and improved digital workflow functions for example electronic secure transfer of documents to GPs. 

I'm not sure how much any of this means except as a flow of buzzwords.  Presumably you're using 'digital dictation' already (please tell me it's not cassette tapes) and I think GPs are sent their copies electronically already.  In the end you're going to need human intervention to deal with Dr A's Scottish accent or Mr B's inability to pronounce 'th' or Mrs C's tendency to omit definitive articles.   AI-type systems will help a bit in getting used to individual peculiarities,  but in the end it needs a human being to communicate with other human beings.

An integrated system is clearly a long way off and the idea that the Isle of Man could develop one on its own, completely insane.  So rather than sitting around, waiting for some magic mega-project to save the day, there needs to be more people recruited locally.  I suspect there will be retired/semi-retired clerical workers willing to go on the Bank/work part time to help out and that's probably the easiest source to go for.  But it will need flexibility from HR and a willingness to devolve personnel issues generally.

[Boo Gay'n]

https://www.bighand.com/en-au/our-solutions/digital-dictation-and-speech-recognition/bighand-for-healthcare/

[360 View]

1 hour ago, Roger Mexico said:

Well according to the Written Answer I quoted before: Manx Care are looking to develop the existing dictation system, known as Big Hand, to expand its functionality to include digital dictation and improved digital workflow functions for example electronic secure transfer of documents to GPs. 

I'm not sure how much any of this means except as a flow of buzzwords.  Presumably you're using 'digital dictation' already (please tell me it's not cassette tapes) and I think GPs are sent their copies electronically already.  In the end you're going to need human intervention to deal with Dr A's Scottish accent or Mr B's inability to pronounce 'th' or Mrs C's tendency to omit definitive articles.   AI-type systems will help a bit in getting used to individual peculiarities,  but in the end it needs a human being to communicate with other human beings.

An integrated system is clearly a long way off and the idea that the Isle of Man could develop one on its own, completely insane.  So rather than sitting around, waiting for some magic mega-project to save the day, there needs to be more people recruited locally.  I suspect there will be retired/semi-retired clerical workers willing to go on the Bank/work part time to help out and that's probably the easiest source to go for.  But it will need flexibility from HR and a willingness to devolve personnel issues generally.

If this works in Scotland, any reason it can’t work here (other than wanting to spend tens of millions on personal pet projects) - EMIS is already used, isn’t it?

https://www.emishealth.com/products/emis-pcs

 

EMIS PCS interfaces with primary, secondary, and community clinical IT systems to help you tie up care across settings. Integration with the national electronic care record databases – such as Key Information Summary (KIS) – means you have vital information available at a touch of a button.

[Apple]

8 hours ago, Roger Mexico said:

Yet again it's a good example of how the NHS/Manx Care is over-managed and under-administered.  No doubt the minutes of all those meetings get typed up more speedily.  But such letters really need to to be turned round quickly, so that the examining doctors can check them when their memories are still fresh.

It's also a splendid example of Ashford unwittingly showing what a mess he left the Department in, but we knew that anyway.

Not a lot to argue with here. It has though been a problem for many years and there is no set standard for informing patients and GPs of outcomes from appointments, surgery etc. In my view there should be, as with a lot of other activities that Ashford pulled back from.

Expecting and waiting for an IT solution is a waste of time ( and money) and merely means the problem is pushed down the road or is regarded as someone else's problem to solve. There are solutions that require different ways of thinking that some are not ready to consider. For example In the past Ophthalmology and ENT experienced similar problems and it took a more flexible approach to how their clinic and surgical sessions were arranged to keep a lid on the paperwork.

Another issue is how medical secretariats are arranged - I am told that isn't helping matters. But staff problems do exist as previously posted.

Solutions - one is that Manx Care needs to rethink the messages it puts out to people and how it communicates with the public of the Isle of Man. We are not the UK and their style of engagement needs to change. 'Just' providing a health and social care service in the way they seem to portray it doesn't come across as genuine or compassionate. It's almost like it is "Just" a project that has to be done, no matter what the consequences or impacts along the way. Maybe that's the way Ashford and Co planned it. But they missed a few stages and  the gaps are now beginning to show.

Changes to the NHS here were desperately needed. It was right to set Manx Care up. I'm still not sure why they had to transfer all the staff over - no doubt that will become obvious later - but essentially its not what is done, but how it is done.   In that respect Manx Care needs to change.

 

[cissolt]

9 hours ago, 360 View said:

If this works in Scotland, any reason it can’t work here (other than wanting to spend tens of millions on personal pet projects) - EMIS is already used, isn’t it?

https://www.emishealth.com/products/emis-pcs

 

EMIS PCS interfaces with primary, secondary, and community clinical IT systems to help you tie up care across settings. Integration with the national electronic care record databases – such as Key Information Summary (KIS) – means you have vital information available at a touch of a button.

They already have emis don't they? Isn't that part of the problem?

As Apple highlights below, moving staff into Manx care is part of the problem.  Looking at the dogs dinner they have made of every foi and inability to secure emails.  These issues are not difficult to solve, but they persist with employing people without the skill to deal with it.

[Apple]

I would dearly like to see a well run health and social care system, with high standards of care and excellent treatment, staffed with well paid, satisfied, committed and highly trained personnel who are determined to meet the health and social care needs of the population, underpinned by sound policies and operational freedoms shared with all. Open and transparent. 

The island will soon have to contend with the threats of strike actions (made in the UK) by paramedic / ambulance personnel, medical and nursing staff and and other essential members of the service. The arguments will flow, back and forth,  the polarisation of so called debate will be evident, the time and money spent on the various issues and the detrimental impacts both real and imagined will be played out in front of an anxious public and fearful patients and families hopping for as little damage as possible. And of course, new funding issues will dominate !!

And like the teachers, and the lawyers in the UK, the younger generation will watch and learn .....

[Jarndyce]

1 hour ago, Apple said:

I would dearly like to see a well run health and social care system, with high standards of care and excellent treatment, staffed with well paid, satisfied, committed and highly trained personnel who are determined to meet the health and social care needs of the population, underpinned by sound policies and operational freedoms shared with all. Open and transparent. 

Who wouldn’t?   As always, the question is how to get there…

My view is that most of this will flow from your comment on personnel.

Swapping one set of bullies for a different set; having a management team that takes the credit when things go well, but pass the blame down the chain when things go badly; appointing people who talk the talk but manifestly do NOT walk the walk - nothing will change until these issues are solved, and giving lip service to “culture change” won’t do it.   How do you get the staff to engage, when they have less than zero confidence that it’s real and that any genuine change for the better will ensue?   Staff at the sharp end have “buzzword” fatigue - and whiplash from the rapid policy changes.

[Apple]

https://www.manxradio.com/news/isle-of-man-news/complaints-system-within-manx-care-needs-to-be-improved/

 

Apart from the obvious issue the tone and style of this says a lot about the attitudes behind and driving Manx Care. See what you think.