The NHS skimped on software and now doctors and nurses are fleeing in frustration

SIR – I took advice from GPs in Canada, Australia and Singapore in the late 1980s before starting the arduous task of computerizing a GP surgery with 8,000 patients in the early 1990s.

We found it was very hard work, summarizing and entering each patient’s full past medical history with their repeat prescription medication and known allergies. The first lesson we learned about software management was: rubbish in, rubbish out.

The NHS has applied software engineering management, which was already obvious by 2000, but instead of investing in a brand new system built from scratch with direct input from the medical professionals who use it daily, it has wasted enormous sums on software consultants trying to patch this now sunk ship.

The problem was perfectly illustrated by the photograph of Dr Gordon Caldwell (“’Pointless form filling’ fueling record delays in hospitals”, report, January 22), with the more than two dozen forms currently required by the NHS for a routine admission to hospital . This partly explains why we get such poor patient outcomes compared with other countries with the same per capita spending. The appalling frustration for medical staff is leading to doctors and nurses retiring and younger ones emigrating, while NHS managers employ agency staff at vast expense as partial replacements.

The answer is to employ the very best software engineers available globally to construct a new fit-for-purpose computer system appropriate for the NHS. They must be instructed by doctors on the agreed medical objectives, including the dovetailing of different specialist departments within economically realistic budgets.

Dr Peter Sander
Hythe, Kent

SIR – I did not write this lightly and am prompted to do so after seeing that hospitals in Wales are planning to send patients home from hospital without a care package. To me, this is reasonable. I speak from the experience of 46 years working in NHS hospitals and most recently in general practice.

It has been the case for many years that families seem to relinquish all responsibility for the care of their relatives as soon as they are in hospital, and hence we end up with thousands of medically fit patients blocking beds for weeks on end. Is it any wonder that A&E departments are unable to find beds for those who need them urgently? Something has to change, and as unpleasant as this may seem, surely a more acute patient is more deserving of a precious bed.

I cared for both of my parents at home until their death in the past two years, as well as working continuously during the pandemic. It was the hardest time of my life, but I owed it to them to keep them out of the hospital. It was also extremely fulfilling to be able to provide them with a dignified death in their own home and bed.

Jan Maclaurin

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