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The Regional Health Service

It's all very well railing against 'one size fits all', top-down centralisation, says GP For Hire. But it might help get things done...

I have realised that we don't have a National Health Service. We have a regional one. It's only since I've been a locum and worked in three different counties that I've realised this.

What do I mean? Well, let's take admitting a patient into hospital for a start. Each hospital has its own rules for admitting a patient. Some have a GP hotline, some have a switchboard which may or may not answer and when they do they can't find the doctor you are looking for, and some have their own team who negotiate on your behalf with the admitting doctor.

I don't get it. How hard can it be to have a common admission pathway to hospital? Very hard it seems. In the end you get fed up trying to work out what's going on and the patient gets bounced to A&E with a letter.

What about paperwork? Each hospital has its own paperwork to be filled in, different colour schemes and boxes to be ticked. Is it too much to ask to have one set of universal notes? They would look the same for every hospital and could be easily read through, filled in and the relevant section found?

Far too sensible. Each hospital has to have its own identity so someone somewhere in an office can justify their salary. Universal notes would save on stationery costs, improve patient care (as everyone knows where everything is) and you could even audit things more easily if you were so inclined. Hell, if every hospital stuck to this you could even begin to attempt to computerise it. And there could even be a standardised admission letter that GPs could use so the admitting doctor could read our ineligible scrawls.

Mind you, I can't be too critical of different hospital records, seeing as I have had to train in five different electronic record systems to be a GP locum. Some of the systems I've used are truly rubbish. God only knows why the GPs use them.

I could rant about postcode lotteries for healthcare, but everyone knows about those. I'm talking about what goes on behind the scenes. Nurses needing to retrain when they move hospitals, because one hospital's certificate isn't valid in another hospital. New doctors not having the faintest idea how to fill in requests for tests, as every hospital does it differently. TTO forms that vary from place to place with varying information filled in.

Getting everyone to agree on all this would be a nightmare. But then that's where politicians come in, so we can blame them if it all goes wrong.

I read that it's the ambition of Labour and Conservatives that every hospital becomes a foundation trust. (Worked well for Mid Staffordshire, didn't it?). This of course would mean a rebranding of each hospital. New signs, new letterheads, new everything. That will not be cheap, and surely some of that money could be better spent ensuring the smooth running of the hospitals and the staff that work there.

You might even improve patient care, but that's not my main concern.

I just want an easy life.

GP For Hire GP For Hire