Examination of Witnesses (Questions 450-459)
TUESDAY 25 MARCH 2003
MS KAREN
CONNOLLY, DR
TRACY JOHNSTON,
MRS ALEX
SILVERSTONE, MS
ROSEMARY CONNOR,
MR ANTONY
NYSENBAUM AND
MS CLARE
HODGSON
Chairman: We will be going through a similar
format with yourselves. We want to cover as many areas as possible
but also get into other areas. I am particularly conscious that
we did not deal with breast feeding in the last session, so we
have to try and sneak that in at some point. Richard will start
with data collection.
Dr Taylor
450. I am not sure if you were all here for
the first session but we are trying to find out how data is collected
in the various different units, and whether it is still on paper
or whether it is on computers, knowing from previous witnesses
in previous sessions that it varies tremendously across the country.
St Mary's, how do you set about data collection? Is it satisfactory;
is it appalling? Tell us about it.
(Ms Connolly) We have a comprehensive maternity
services information system which was originated in 1987 for one
particular consultant; and then it was implemented across the
maternity unit in 1997. It collects specific data from the outset
of booking, right through to the postnatal period. We do get our
annual statistics from that system, and all deliveries are put
into the computer and outcomes; so we can get annual reports and
monthly statistics. We also have the patient administration system,
which collects the episodes of women who come through the service.
Only in the last 12 months have the two talked to each other,
but only in a minimal way just for the demographic details. We
are still having some teething problems, so we are trying to get
combined data.
451. So they only talk to each other in a limited
way at the moment.
(Ms Connolly) Yes.
452. How old are these two systems, the PAS
and your maternity system?
(Ms Connolly) I could not say how old the PAS system
was because it has been there as long as I have been there, for
the last twenty years; but the updated version of the computer
system for maternity information was updated in 2001, but prior
to that in 1997.
453. You said you have a specific data set.
Have you been involved with work on the national data set? Would
you support what our last witness has said, that that is one of
the strongest needs—a national data set?
(Ms Connolly) Yes. I have not been involved directly
but I would support that because at the moment it is very difficult
to compare data from different units if it has been collected
in different ways. For example, in recording things like a "born
before arrival birth" everybody has different definitions.
When you try and compare them you find that they are slightly
different, so we do need agreed data.
454. How often do your systems crash?
(Ms Connolly) Not very often, I would say. We have
a midwife who is responsible for that overall system, and she
talks with the company that are based in London. If we do have
any problems, we have a help line that staff can ring throughout
the day, and also internal systems at night.
455. Do you keep paper records as well?
(Ms Connolly) We keep birth registers and individual
medical records, but we do not duplicate.
(Mr Nysenbaum) We have paper records of the birth
register that our senior labour ward midwives use to create data—and
that has probably been running for ever. We have a computer system
that was created internally a couple of years ago as a module
of PAS, and it enables us to collect data and to print out maternity
discharge summaries, but as yet it has not allowed us to access
all the data that we are putting in. We have a shortage of people
in the computer department, and prioritisation I am afraid is
very low. The first information we extracted off it successfully
was yesterday, when I waved the sledgehammer of the Commons Select
Committee at the computer department, and they managed to print
off how many inductions we had last year. So there is a wealth
of information, but we have no means at all of accessing it.
456. That was purely and simply because you
do not have somebody with the expertise to know how to find it.
(Mr Nysenbaum) Yes, and the funding to pay for it.
We have the expertise there.
457. Does the fact that it is a module of the
PAS system itself a good thing?
(Mr Nysenbaum) I am not sure whether it is a good
thing or a bad thing, but it certainly has the information on
it, and it appears to be fairly straightforward to access it,
if you know how to use it. Certainly within half an hour of asking
for some information, it was e-mailed to me. It is clearly there,
and it is accessible. I think that every unit must collect the
same data, though. It seems absurd that we have hundreds of different
systems running.
458. Do you have your own specific data set?
(Mr Nysenbaum) Yes, which we created for our own use.
459. So you would agree that that should be
national and it is absolutely obvious that it should have been
years ago.
(Mr Nysenbaum) Yes, absolutely—and it is purely
cost that meant we had to develop our own because we could not
afford to buy other commercial systems.
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