PART OF A LETTER TO THE CLERK OF THE COMMITTEE
FROM MR ANDREW HAY, CONSULTANT UROLOGICAL SURGEON AND CLINICAL
DIRECTOR FOR INFORMATION, ROYAL SHREWSBURY HOSPITALS (PAC 1999-2000/126)
Would you allow me to add to my letter of 6
March and briefly outline the reasoning that I would have wanted
to put to the committee had I been able to attend.
1. The reason why there are more than 56,000
cancellations of admission each year is because of information
failure.
2. The sheer complexity of the information
problem, how to manage bed allocation efficiently and effectively,
balancing elective and emergency demands with a frequently inadequate
bed resource, demands the use of advanced IT (and the skills to
implement the software solution).
3. Scheduling problems of equivalent complexity
have been solved in the airline, travel, and container docks industries.
It is not a permissible defence for hospitals in the acute sector
to claim, as they generally do, that the scheduling problem is
inherently intractable and that high cancellation rates must be
accepted as a fact of daily life in the NHS.
4. During the past 13 years, a small, dedicated
team at the Royal Shrewsbury Hospital has developed a computer
solution that actually works. Recent experience at the Royal Shrewsbury
Hospital has demonstrated that use of a properly designed computer
model can reduce the cancellation rate to zero.
5. The Shrewsbury solution should now be
deployed in other hospitals (I suggest five separate acute trusts)
within the setting of a research project.
6. A major barrier to wider implementation
of the Shrewsbury solution is in the rules governing the procurement
of computer systems in the NHS. Another barrier is the current
emphasis that trusts are being asked to place on the implementation
of the themes outlined in the government's White Paper Information
for Health (IfH). It is a sad fact that IfH does not make
explicit the need for mature and effective scheduling solutions
as a core component of the information strategy of any acute trust.
7. I would argue that the NHS Executive
should promptly:
— explore how best to set up a research
project, testing the Shrewsbury CALM solution in five other hospitals;
— make explicit the need for proper
scheduling solutions in IfH;
— give consideration to a change in
the procurement rules that make it so difficult for good solutions
to achieve widespread implementation in the NHS.
I hope that these comments are of some value
and are not too late for consideration by your committee.
A M Hay
Consultant Urological Surgeon and Clinical Director for Information
21 March 2000
| 
