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999 Call for the NHS

A grassroots NHS campaign. Not affiliated to any of the political parties.

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By 999 Call for the NHS, Jan 11 2019 10:59PM



Today was my Diabetic half-yearly checkup. A good thing. Blood pressure, weight, draw a bit of blood. I love my diabetic nurse (let’s call her Susan) because she listens, she asks questions about my life, we swap notes on current NHS politics, she is an expert in drawing blood out of my always reluctant hard-to-find veins.


I wonder how Susan is? I’ve not seen her for over a year and a half. I miss her. And I don’t know who I will be seeing today as i pull open the GP Surgery door.


My heart sinks as I tap the digital screen on the wall just inside the GP Surgery door. (Another new software I notice). Receptionists are far too busy doing important stuff to say “good morning” or smile. I know because I can hear them laughing behind the shutters on their windows.


The login screen tells me I am the next patient with (not real name) Julia HCA. How many people here today actually know what an HCA is I wonder? The Nurse’s Room is still next to the waiting room. I know this because the door still has the room plaque “Surgery Nurse” on it - in a nice understated NHS blue.


But beneath it now sits a much larger piece of white plastic with a rather heavy clumsy black font displaying HEALTH CARE ASSISTANT. Being an artistic spirit my heart aches at the complete lack of care and aesthetic sensitivity thats gone into the creation of this overbearing plastic functional sign.


It’s ugly.




My heart sinks further when the door opens and I recognise Julia HCA. My first encounter with Julia HCA was the last time I saw lovely Diabetic Nurse Susan.


That appointment I returned home with four large wads of cotton wool - stuck to both arms, back of both hands (large bruises later) where the needle had been swivelled, twisted and jabbed in an attempt to extract my life-source. On that occasion. after four arduous attempts, Julia HCA had accepted defeat and called Diabetic Nurse Susan away from her very important paper-work (in the next room) to draw my blood.


One sharp, a prick so small I didn’t feel it at all, a smile and a line of friendly genuine chat - two tubes of blood were filled easily. Perhaps my relief at seeing Diabetic Nurse Susan was a factor? I miss Diabetic Nurse Susan.


Anyway... Julia HCA tells me to take a seat by the bed. The chair that is facing away from her. I turn my head so I can see Julia HCA - the other human in the room. Julia HCA is busy reading her screen and tapping her keyboard. She tells me she is going to measure my blood pressure, weigh me and take some blood. Because that is what the screen tells her presumably. When Julia HCA finally looks up I’ve already rolled up my shirt sleeve and placed my arm on the bed.


Without looking at me Julia HCA slips the cuff of the Blood Pressure machine onto my arm. She says firmly “Don’t talk or move while the machine is working.”


She turns away to the counter and gets busy opening the requisite needle pack, card tray and plastic tubes that drawing blood will require.


I don’t move or talk. I’m feeling the pressure. I stare at the PAID FOOT CARE leaflet stuck to the wall...



The blood pressure machine stops whirring and the cuff begins to deflate. Julia HCA scribbles on her pad. She does not offer a comment on her scribbling. I ask what the figures mean. It’s a little over the target. I refrain from suggesting why that might be.


And so the fun bit. Drawing the blood. Today is better. Julia HCA has had 18months more practice. Today only takes three “small prick” attempts and a weary “oh come on” sigh before finally stabbing a vein (in frustration?) and rich dark red fluid flowing forth. I experience a combination of deep relief she does not need to stab me again, gratitude that she has improved, and disappointment that I will not get to see Diabetic Nurse Susan.


So just two large cotton balls taped to my arms this visit. Now...shoes off, pockets emptied and I stand on the scales. Julia HCA tells me my weight in kilos which i have also read from the digital window. Julia HCA goes to the computer. Silence is broken with a “oh 2016 is the last time we weighed you...”.


We both agree that’s bullshit - my words not hers. But Julia HCA cannot tell me how much I have lost since my last visit because its not on the screen. I’m disappointed but resist voicing my internal “for fucks sake”.


Shoes on in silence. Slipping jacket on I thank Julia HCA. Nothing much more to say. Completing her computer screen box-ticking Julia says “Goodbye, see you in 6 months time”. I leave. I realise that throughout this entire clinical process Julia HCA and I have not made eye contact. Not once.


The questions begin as I walk home. (I’m lucky not needing to travel far). Where is Diabetic Nurse Susan? If Julia HCA is replacing her with her skills as the conduit twixt me and computer screen database what is Diabetic Nurse Susan doing? Is she next door doing very important computer work? Is she being a “Martini Nurse” - out and about putting ‘right care in the right place at the right time’ into the community? Or perhaps she’s at a Clinical Commissioning Group or Sustainability & Transformation Partnership meeting offering her valuable clinical expertise towards integrated accounts packages?


This is my experience of the modern NHS GP surgery. I don’t doubt there are good people in them still. But this experience has been faceless with no sense of a relationship, connection or purpose between me and the care professionals - those who once were praised and rewarded for their personal human interaction skills but now are forced to fit the machine of the “health economy” which is one more American idealogical phrase that has crept into our NHS. Scary article warning: PwC New Health Economy in an age of Disruption



Disruption is about right. My relationship with Diabetic Nurse Susan has been disrupted. Ended probably. I have no personal connection now between my sense of looking after myself (Preventative Care - what the NHS claims healthcare is all about) and a healthcare professional who actually gives a shit. Doctors have been warning about the dangers of destroying the doctor/patient relationship since 2012 - the Year of NHS Disruption


Disrupting patients and staff, denying proper human interaction and replacing it with a computer screen or an app only creates an apathy in me that gives rise to me being a patient who doesn't really give a shit either.


Can’t blame Julia HCA. She must know she’s cheaper and not respected in the scheme of things.

Can’t blame my Diabetic Nurse Susan. She’s off somewhere no doubt trying to be integrated and keep her job afloat.


Blame the GP surgery? They’re struggling to find staff on limited funds, under yet more pressure from NHS England to join the new, ultimately faceless, Super Hubs which are supposed to cover 30-50,000 population areas. Even though there is little evidence to prove they will lead to better healthcare.




I can definitely blame NHS England and NHS Improvement along with numerous other business busybodies like the Kings Fund, Nuffield Trust and Health Foundation who with their research studies are “wreckless driving” this inhuman new model of care that will produce better financial outcomes for company shareholders but will not produce better healthcare for patients - not here or anywhere.


It’s been a busy week with new job and campaign admin. I have yet to catch up with all the fuss and nonsense of the new NHS Long Term Plan. Part of me feels there is no point in reading the f**king thing. More of the same as the last bastard 5 Year Forward View plan that has laid the foundations for this “new model of care” we are seeing not so much evolve but explode (disruption don’t forget) inside our NHS.


Why are we allowing Simon Stevens, Chris Ham and others to adopt the Accountable Care Organisation healthcare model following the American model of care when it is universally recognised as being just a bit crap (utter shite) and "based on faulty assumptions, poor economics, and junk science"


This is just one reason why 999 Call for the NHS are continuing our fight in the courts. We have to keep fighting for a healthcare system that is human based, focused and managed. Not a corporate money making machine where patients and doctors are just faceless cogs in the economic machine.


LINK TO OUR LEGAL FIGHT

By 999 Call for the NHS, Aug 7 2018 08:33PM

Steven Carne mulling over the mystery of the URLs

If you have the stomach for it, Roy Lilley's ditty today on his daily "mantra" that goes out every morning to NHS managers and their minions is quite enlightening. It's all about the inevitable journey we are all going to have to take to the ultimate cul-de-sac Rue de Digitech...


Mr Lilley, darling of the NHSWhiteCollars says at one point:


Technology is no respecter of tradition, Royal Colleges or trades unions. Babylon is attracting patients in their hundreds and primary care, in the home counties and commuter belts, will be hollowed out.


It is a deep concern that we have shared for many months now as campaigners in West London have battled with Babylon which licenses it's technology to virtual GP surgery providers like GP at Hand - protestors including GPs gathered in East London recently to oppose the expansion of the virtual service seen as another chisel in the NHS Chipaway toolbox. PROTEST IN EAST LONDON


Not only is the Bablyon App causing havoc in terms of Clinical Commissioning Groups funding (what happens when thousands of extra patients register in your CCG area on a digital app? Well NHS England step in of course...)


The smartphone virtual GP is also creating deep concerns about safe triage and patient welfare given that algorithms and tickboxes are replacing the human skills involved in high quality care. Surprising then to see at the very top of Monsieur Lilley's tosh a big advert for the CEO of Babylon, a certain "proud to be a disruptor" Ali Parsa who is giving a talk at the Royal College of Medicine about - well here's the pic



A sell-out indeed!

I'd be very surprised cos it's not actually AT the Kings Fund.


And here is a taste of Mr Ali Parsa in action. He is a supreme marketing wizard creating PR Editorial that is probably the envy of every clinical PR agency in London. It's easy to do but difficult to make it stick. Parsa is a master. Watch his interview as a panel member on the shipwreck that is BBC Newsnight. The video shows you his tricks very clearly.





There is of course never a mention of Ali Parsa CEO of CIRCLE who failed miserably in taking over Hinchingbrooke Hospital in Cambridgeshire 2013 - not enough money in it! So gave the hospital back to the NHS after just three years of a ten year contract


Anyway I thinks to meself after visiting the events page : Why is Roy Lilley, lover of the NHS, advertising Ali Parsa the man who wants to disrupt it with digitech apps that will totally undermine the idea that is the Art of Caring? Well... turns out the event is organised by something known as UK HealthGateway.



This rings a bell...


this is a little known company UK HEALTHGATEWAY LTD which is a company advising and presumably getting some dosh in return for advice and consultation on how best to peddle your wares in the ever growing competitive market being plonked on the unsuspecting NHS and the public who love it so. Mr Lilley is a Director of this company. But he loves the NHS. Doesnt everyone?


So - back to where we began - this lot also produce something called NHSManagers.net which sends out the daily email Newsletter from Mr Lilley.. this is a supreme example of just one miniscule maze of digital wonder and URL Hide-Behinds.


Bear with me, it is confusing because if you type in the URL NHSManagers.net you actually get taken to something called Institute of HealthCare Management and if you scroll down the ABOUT US page to the last paragraph it is frightening to see some of the names on the Advisory board..


Former Chair of NHS Improvement, Ed Smith,

Sam Jones, recently stepped down as Head of New Models of Care at NHSEngland,

Peter Homa, until January 2018, CEO of Nottingham Universtiy Hosptalsl NHSFT

Fabulous! Oh there is an Academy of Fabulous Stuff apparently! But that's a whole other URL...


So... After seeming to regret the Babylon App in his desktop mantra - turns out he's organising the blessed event at the Royal College of Medicine... ironically where the late Prof. Stephen Hawking gave one of his most powerful speeches about the role of private companies destroying the NHS. I wonder what he would make of Babylon Apps and other piranha fish digi-tech companies?


Suffice to say that whilst Senor Lilley, a Director in the Institute/UK HealthGateway/Fabulous Academy likes to talk about defending the NHS and welfare of manager (mostly) and patients, he can't quite shake the fact that he's really saying "the future is digital so shut up and get on with it". And he of course implies that any pesky campaigners or ne'er-do-wells who dare to question the role of hi-tech, smartphone apps and Artificial Intelligence in the future of healthcare is plainly a moron.


Well we can face it - technical advances are inevitable and should be welcomed into creating a better healthcare service for the future. The NHS before the market years was NEVER afraid of innovation and often led the way in research and new technology.


It's not the tech we're worried about. It's more the worry that the massive glut of entrepreneurial digital start-ups and Community Interest Companies, often partnered with dubious parent companies, are beginning not only to shape the future of healthcare but also manipulating it to meet their needs (profits) and not those of patients. And how accountable are these new digi-techs all hiding behind URLS of gateways, academies, institutes and .nets?


Take the fearful Artificial Intelligence company Alphabet Inc. the mother company of GOOGLE... well their little Artificial Intelligence exercise DeepMind was the subject of an Independent Review which Bloomberg reported as saying:






But guess what? The Independent Review was carried out by a panel of independent Reviewers HIRED BY DEEP MIND. So this review sounds rather hollow... THE PANEL


It's clear now all the moves towards Accountable Care Organisation models of care (call them what you like, quack quack) with all the nasty cuts and reconfigurations being made to fit the template, with more funding flowing directly into IT and Digi-tech Life Science companies, it is clear our NHS healthcare is becoming a feeding frenzy. We used to say the vultures are circling but vulutres only eat dead flesh.


The NHS is being kept alive on a drip and being forced to become the foodsource of the piranhas that are the Life Science and Digi-tech companies so eager to take a large bite.


So Mr Lilley. Chew on that.




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