Do you, like me, wonder what all the fuss is about over a paperless NHS by 2020? I did try to find out whether there was a similar drive to eliminate the quill pen in Whitehall: it was the invention of steel nibs in 1822 rather than a lack of geese apparently.
The danger posed by all this attention to paper is that the systems designed to run with it will simply be automated, when the real opportunity lies in working differently. What is the purpose of primary care? To provide immediate local help to those in medical need. What is the purpose of a GP appointment system? To allocate the time of a GP.
If we start from the point of allocating GP time, then automating the process of booking an appointment is the obvious thing to do. It may save a few minutes of receptionist time. The GP is unaffected (thankfully).
If we start with the purpose of improving the efficiency and effectiveness of primary care, then automating appointment booking is a daft idea. It would be wasting GP time, since two thirds of patients don’t need an appointment.
With that purpose in mind we realise that the GP’s time is at least the same if not more valuable when making well informed decisions about how each patient should be helped. Aiding that decision making process is then the obvious top priority.
Only then is it worth turning to technology to enable the change and on that score we are lucky to be living in such excting times. NHS England has a target of 10% of patients to have interacted online with their GP practice this year. In a way it’s hopelessly ambitious given the huge growth that would imply. But when 90% of patients have online access, and most are using it for everything else, I’m inclined to the opposite view that it’s hopelessly unambitions.
I’m currently on what might very loosely be termed a study tour of Korea and Japan. On the Kyoto underground I noticed that fully 50% of passengers spent the journey staring at their smartphones. In Seoul it was 100%.
With the right applications which help both patients and GPs, the NHS won’t have to urge people to change. It won’t be able to stop them. With the current state of NHS finances, it can’t afford to keep missing these trains.