Daily Insight: Not OK Computer

Getting stuck because a computer won’t let you do the simplest task is maddening. We all know this; it is not a controversial concept.

The frustration and sense of impotence must be so much worse therefore if that computer system is, seemingly without reason, preventing you from submitting a bid for a contract potentially worth £144m over nine years.

This is the situation a manager at software and IT services supplier InHealth Intelligence found themselves in July this year.

They were trying to submit their bid paperwork for a significant contract for services covering two NHS regions and Greater Manchester. Yet the procurement portal used by a commissioning support unit for its tenders refused.

Unfortunately, the manager had fallen foul of a function of the software (it would not allow him to upload two documents of the same name) and he could not rectify the problem before the deadline for the tender passed.

After a few weeks mulling over their situation, the firm’s management has decided to bring a claim against NHS England in the London courts. They say excluding them from the process was unlawful; NHSE disagrees.

It will be fascinating to see how this one pans out.

Two strikes and you’re out

Patients face being removed from the NHS waiting list if they decline two dates offered to them for their treatment, according to new internal guidance, as we revealed yesterday.

The guidance, which appears to have gone through little consultation, provoked a mixed and passionate reaction.

Waiting list consultant Rob Findlay was not alone when he said the guidance was an “abuse of national waiting times statistics”, and that “the menacing of patients [proposed in the strategies outlined in the guidance] is appalling”.

But some managers said the guidance was “sensible” and addressing a very real problem the NHS had: the sizeable minority of patients, declining multiple treatment dates which means capacity not being optimised and longer backlogs as a result.

The problem the guidance is trying to address is indeed a genuine one. But, as with many things in life, it’s not always about what you do, but the way that you do it.

Producing the guidance with little in the way of consultation with key stakeholders, such as the Royal College of Surgeons, was an inauspicious start. Then not publishing the guidance on the NHSE website, as is standard for this sort of guidance, was also not a great look: it looks like it was something that system leaders didn’t want much attention drawn to.

Of course, patients should not be turning down multiple treatment dates. But to assume they are all doing through carelessness is equally wrong. There are plenty of patients who have very legitimate reasons for not being able to attend appointments and reasons why they may have missed a phone call or a letter in the post.

A solution is required for this thorny problem, but a more collaborative approach is needed to ensure the guidance is fair to patients as well as trusts.