'recommended' means 'ignored'. Unless they're going to be punished for not applying the recommendation (in which case it's not a recommendation), management simply aren't going to hire & pay more people than they think they can get away with.

Having worked in hospitals, I can vouch that it's important and routinely ignored too. The best run ward I ever worked on had four nurses for the entire ward (max 28 patients) so 1 nurse per 6-7 patients. But more importantly, they were happy in their jobs, were rarely off sick and worked hard. If I ever had to go back into hospital medicine I'd want to work on the same ward.

The other important thing was the lack of agency staff. The hated ward in the hospital was the one that bleeped us doctors on call (evenings, nights, weekends) most frequently. They would bleep to ask to see a poorly patient and when you got there, there was no one around to chat to ("on a break"), or if there was agency staff, they wouldn't have a clue where the patient was nor anything about them. It meant it took you longer, you had to sift through notes more slowly to build a picture of the patient and then go and see them. Having not seen them before meant you were lost unless you had nurses who had a clue about what was going on.

NHS hit by new tech failure as it scraps patient booking system

http://www.theguardian.com/society/2014 ... m-scrapped

There's so much fail going on in the NHS at the moment.

That Choose and Book (C&B) system is one of the reason why our computers have to have IE6. It cannot run on higher versions. We've managed to avoid using it until about 3-4 months ago where it was finally forced upon us. Up until this point, my consultations were already busy. It would take around 1-2 mins to read notes and document. It would take around 5-6 mins to take a reasonable history, maybe 3-4 mins for an examination. That would generally mean I might take more than 10 mins for a consultation. I would then make a quick note of the patient's name and at the end of the day, I would dictate all the referral letters for that day.

Now I have to squeeze this crap into the 10 mins. When I first did it, it took around 7 mins (timed) to navigate. It's slightly quicker but basically you have to:

- click on the C&B referral option
- select a suitable specialty from a drop down list (eg orthopaedics)
- maybe select a suitable subspecialty (eg knees)
- type in a search area (I normally type 15 miles)
- hit search
- try and work out where the patient wants to go and see which is the quickest
- find that:
--- the hospital/specialty doesn't offer C&B appointments
--- the quickest place to be seen is seven days away in a hospital the patient would never want to attend
--- the available appointments don't suit the patient
--- I can select a suitable appointment
- I then have to select the appropriate appointment, ask it to book (in which time somebody else might have booked it!), print out the appointment, password and reference number
- explain to the patient what the password is for

I have found it to be such a faff that I either resort to the old way of doing things (send a letter to the hospital and let them book the patient in), or give the patient a date/time and if they don't like it they can go online/telephone and change it. Too much faff to do anything else.

When the system works, it's not a bad option - I've had patients with knee problems get seen within two weeks. But at the other end of the scale, either the delay is months or there's no option to book. Not all hospitals and not all clinics offer the system. The bit that pissed me off the most is that the Govt or whoever wanted to implement the system clearly felt GPs aren't working hard enough and moved the admin of booking an appointment from admin staff in a hospital to the GP. I honestly don't see why I should be the one doing the admin work of the hospital - it takes up my time, it reduces the consultation time available, and it leaves me feeling crap.

Because it's the best to operate if you want to chop the NHS into little chunks and then sell them piecemeal to your mates?

Labour pledges GP appointment 'within 48 hours'

http://www.bbc.co.uk/news/uk-politics-27377978

It's easy to promise things when you're not in power.

There are something like 60000 GPs on the register. 3m appointments amounts to 50 apps per GP which is what one extra appt per week?

Getting seen ASAP is gonna be impossible. I recall a study that showed that if patients saw their GP whenever they wanted, GPs would be working 21 hours a day to meet the demand. All this does is incentivise patients to see their GP at the drop of a hat. Sore throat for one hour? Go see your GP. Got a headache but not taken a paracetamol? Go see your GP.

From the bbc website:

which means there's no problem except that conceived by the government.