Caught up in net

THE cost-saving initiative of out-sourcing medical notes to India for typing is facing major problems.

An internet link used to transfer patient information from Lister Hospital to India has failed to meet the needs of East and North Herts NHS Trust, both in terms of speed and capacity.

The Trust had hoped to save as much as £1million by axing 15 medical secretary posts and outsourcing their work.

However, a medical secretary from Lister said: "After the medical secretaries were made redundant it was discovered that the NHS server for the typing to be sent over the internet to India could not cope with this system.

"Medical secretaries are being told that the typing will be kept at the Trust for us to type, as done in the past.

"The problem we have here is that the workforce has been massively reduced and those left are faced with the overwhelming task of doing the work of two or three medical secretaries in addition to their own workload.

"We were already overstretched in the first instance and this has just about bought us to breaking point.

"The Trust has had to resort to bringing in expensive agency staff to try and help with the workload, thus spending the money supposedly saved by making medical secretaries redundant.

"What we worry about now is how long it will be before a major error in patient care happens."

A former medical secretary at Lister, who has recently taken voluntary redundancy, said: "The Lister Hospital has now lost an incredibly knowledgeable and committed group of secretaries.

"I was due to take retirement next year and had fully intended to work up until that time, but I was totally demoralised by the Trust's handling of the outsourcing.

"I understand that in some departments outsourcing has been abandoned as being inherently unworkable and much of the correspondence has had to be returned to the outsourcing companies due to errors in transcribing the letters.

"The East and North Herts NHS Trust should be looking at the huge raft of middle managers who dictate how the money is spent and start giving some of the decisions back to the consultants who are working at the sharp end.

"They have little or no influence now on how these decisions are made and where the money can be best used for the benefit of the patients.

"These are being made by managers who have no medical background or expertise.

"I am now very pessimistic about the future of the NHS and, in particular, the service that will be offered to patients."

Danny Mortimer, the Trust's director of human resources, said: "Like any project of its size, there will always be initial teething problems.

"We are still employing the vast majority of medical secretaries that were in post a year ago. That means we still have a large number of experienced and highly skilled individuals.

"The health service as a whole is connected to the internet through the N3 Link.

"Nationally the NHS is experiencing problems with this link, both in terms of its speed and capacity of transfer of information across the internet.

"This is causing the Trust problems and one of the projects affected is the remote medical transcription service.

"Contingency plans are being considered locally by the Trust, including using a separate, secure link to the internet for the medical transcription service until the problems affecting it are resolved nationally.

"Where one or two of our clinical directorates have been affected, the Trust has approved the very limited use of agency staff to support our staff. The relatively small cost of this short-term measure is far outweighed by the benefits provided to the Trust, GPs and patients.

"The Trust has introduced the medical transcription service because it knows that it will save money, while at the same time providing a consistent, high-quality service. This is proving to be the case already, although more work remains to be done.