Typing scheme is real concern

I am a medical secretary working at East and North Herts Health Trust. With respect to The Comet article Trust s bid to save £1m about outsourcing the typing of consultants letters: I am amazed at Nick Carver s chutzpah in portraying as advantages, wha

I am a medical secretary working at East and North Herts Health Trust.

With respect to The Comet article 'Trust's bid to save £1m' about outsourcing the typing of consultants' letters: I am amazed at Nick Carver's chutzpah in portraying as advantages, what are actually two of this scheme's greatest drawbacks. No, patient notes will not be sent to India - it would be impractical anyhow. This means that the Indian typist will be working blind, from the spoken word only, rather than with the doctor's handwritten notes as a cross-check. As a secretary I would find my job far more difficult under these conditions, and would myself make far more mistakes, especially if the doctor has a strong accent, as many do.

Secondly the typist will not have the address of the patient. Therefore either somebody back in Britain will have to marry up the letter and the address with the patient and then with the doctor who referred him to the specialist (and who pays for their time?) or else the letters will be computer matched with first the patient and then the registered GP.

Nick Carver does not seem to realise that something like 50% of all referrals are not from the registered GP - usually either a different GP in the same practice or a consultant or other hospital doctor either in the Trust or elsewhere. If computer matching is used, I hope the GPs will enjoy sorting and re-addressing this mail. In the case of mail for hospital specialists, I cannot see how it will get there at all - computers aren't psychic and nor are GPs.

I know that not just secretaries, but hospital consultants have written to appraise Nick Carver of these facts, but he apparently wants to preside over the coming chaos affecting both patients and doctors.


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* I work for two consultants at the Lister Hospital. I keep up with the situation for both my consultants by reading incoming mail and typing (only some) of the outgoing letters to GPs, other consultants etc. I pick up on any anomalies and urgent problems and alert the consultants especially if they are off-site, which happens quite frequently as they have clinics and operating lists in other hospitals too.

Who is going to do this for the consultants when the secretaries are not around? The other big problem is that, in maintaining patient confidentiality by not sending patient names or GPs addresses with the letters, someone is going to have to marry up the typing from wherever with a patient. So how is this going to happen? Automatically? I do not think so. Someone at the Lister Hospital is going to have to copy and paste the text of the letter from the outsource into a letter already addressed to either the GP or whomever and also ensure the letter has the name, date of birth, hospital number and address of the patient. I know from long experience as a medical secretary that it is not the text typing that takes the time, it is the fiddling about with the rest of the letter, folding it and putting it into the envelopes or into the GPs pigeonholes in the post room at Lister.

Do people out there in the real world realise that this could be the thin end of the wedge and typing may be followed by arranging of outpatient appointments? Soon everyone will be phoning a sub-continent call centre to find out about outpatient appointments - it didn't work for the banks and will not work for the NHS.