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back to article Hunt: I'll barcode sick Brits and rip up NHS's paper prescriptions

UK Health Secretary Jeremy Hunt wants to tear up the NHS's clumsy system of printed prescriptions - and instead use "unique barcodes" to dish out medication straight to the poorly. Under the proposals to hopefully reduce human error, paperwork listing medicines and drugs will be sent directly from doctors' surgeries to …

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  1. russthegibbon

    Anti-fraud measure?

    I remember seeing a news report years ago about the large amount of money the NHS was wasting because of people fraudulently ticking the "I don't pay for my prescriptions" box on the back of the slip. Apparently it was only rarely checked that the patient was eligible for this examption. Maybe this measure is really, at least in part, about mimimising that sort of fraud?

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    1. Yet Another Anonymous coward Silver badge
      Reply Icon

      Re: Anti-fraud measure?

      IIRC the reason for the charge was a nominal sum to cover the pharmacists cost of handling the prescription. Since this new computer system will reduce the cost dramatically (all computerised systems do ) the fee can be abolished.

      Alternatively anybody who doesn't have to pay can prove that by registering a 90quid e-passport in the new system on every visit

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      1. graeme leggett Silver badge
        Reply Icon

        Re: Anti-fraud measure?

        The charge was introduced in 1952 to cover part of the drug costs.

        (I note rationing was still in force in '52)

        In some cases, the prescription charge is more than the actual drug cost eg a week course with a common antibiotic, in some cases the charge is less than cost eg a contraceptive hormone implant, and in some cases a lot less eg hormone implant for prostate cancer treatment.

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      2. Midnight
        Reply Icon

        Re: Anti-fraud measure?

        I don't think that "abolished" means what you think it means. The word you are looking for is probably "pocketed".

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    2. Red Bren
      Reply Icon
      Unhappy

      Re: Anti-fraud measure?

      "Maybe this measure is really, at least in part, about mimimising that sort of fraud?"

      I don't see how it would help as my GP doesn't know if I have an exemption or pre-payment certificate. It will still be down to the pharmacy to determine entitlement.

      The easiest way to cut fraud would be to abolish prescription charges altogether. It penalises the long-term sick, it doesn't usually cover the cost of the medication or if it does, your GP will advise you to buy it over the counter.

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      1. JohnMurray
        Reply Icon

        Re: Anti-fraud measure?

        "it doesn't usually cover the cost of the medication"

        The vast majority of drugs prescribed cost less than £7.85.

        A course of Amoxycillin costs less than a pound.

        A Salbutamol inhaler (now generic) costs £2.30.

        28-days supply of Paracetamol/Codeine [500/30] (the maximum a UK doctor can prescribe for an NHS patient) costs, again, less than a quid.

        The cost of those above for a private patient would be much higher than the prescription charge, and that would not include the consultation/prescription charge !

        A lot of medication is not available for purchase without prescription !

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  2. Anonymous Coward
    Anonymous Coward

    Paperless NHS?

    As long as there is one network connected printer in the NHS, people will send their jobs to it, even if it then takes them a week to get theprintouts via post.

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    1. Anonymous Coward
      Reply Icon
      Anonymous Coward

      Re: Paperless NHS?

      And if there is ever a problem with the printer it will be raised as a priority 1 call with the supplier of whichever system they are trying to print from, not whoever can fix the printer.

      Cynical, moi?

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  3. Anonymous Coward
    Anonymous Coward

    NHS patients who refuse to allow their data to be shared across the NHS

    FFS, how do they think that could work?

    Tell them to go private.

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    1. Anonymous Coward
      Reply Icon
      Anonymous Coward

      Re: NHS patients who refuse to allow their data to be shared across the NHS

      3 downvotes, but you don't worry about this shit when it's Google, or Tesco or Amazon or Apple.

      All of whom will quite happily tell you to naff off if you want to control how they use your info such that it becomes harder for them to deliver their services.

      Organisations need to use your info and need to disseminate it across the organisation, anything else is inefficient and pissing money against the wall.

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    2. Anonymous Coward
      Reply Icon
      Anonymous Coward

      Re: NHS patients who refuse to allow their data to be shared across the NHS

      My objection is not the amount of sharing between GP/hospital, but who is given access to the central database.

      And, of course, where that database is.

      At the present the proposal is it is not just medical providers that have access to that data but sundry others such as local taxation, DfWP, DVLA. Some 500,000 plus public servants. Then there is the already-happening proposal to let various others have access to "anonymised" data. By various they mean anyone with a wallet no doubt.

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      1. Anonymous Coward
        Reply Icon
        Anonymous Coward

        Re: NHS patients who refuse to allow their data to be shared across the NHS

        Which part of "NHS patients who refuse to allow their data to be shared across the NHS" isn't clear?

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  4. Anonymous Coward
    Anonymous Coward

    Rhyming Slang

    Makes me wonder how many govt ministers have shares in the IT companies that will try and bring this into existence - besides Alien 3 beat you to it, Jezzwald - make it easy and tattoo bar-codes on everyone's head, I'm betting in your case, they'll spell HUNT wrong....

    Bar codes are so 80s.

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    1. Test Man
      Reply Icon
      Stop

      Re: Rhyming Slang

      I'm assuming when barcodes are mentioned, they're talking about QR bar codes.

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      1. Stuart Abbott
        Reply Icon
        Happy

        Re: Rhyming Slang

        Nope, just simple 2D ones. Unique identifier that then queries a database. Barcode itself has no information beyond a series of numbers and letters.

        Unless you're in Wales in which case, yes it is a QR code :)

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        1. M Gale
          Reply Icon
          Headmaster

          Re: Rhyming Slang

          Barcodes are 1D. QR codes are 2D.

          <- Yes I'm in that kind of a mood.

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  5. plrndl
    FAIL

    Deja Vu

    The IT infrastructure needed to implement this system will cost £25,000,0000,00000,000000... and the project will be cancelled after 5 years.

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  6. Anonymous Coward
    Anonymous Coward

    What it translates to is lots more money from healthcare software providers for all the pharmacists that need to upgrade the systems which interact with the NHS system at a huge cost (or pay massive sums of money -even larger sums of money) to get their own past the QA processes needed for interacting with the NHS system.

    A silent way to further milk the healthcare system of money, only deferring the costs to pharmacies (many smaller ones which will then end up closing)

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    1. JohnMurray
      Reply Icon

      Unless you missed the news: The NATIONAL health service has left the building. With the passage of the Health and Care reform act it, effectively, was killed.

      Now the health dept has no control on funding, or over foundation trust hospitals (except setting standards)

      Control has now passed to the GP commissioning groups (circle health, virgin health, capita et-al)

      Doctors now send patients to private clinics for a large variety of things.

      "you'll need about 12 sessions of physio, you get 5 on the health service and the others will be £50.00 each session. Don't slam the door on your way out. Goodbye"

      The latest idea is a patient gets a set amount, and uses it to buy their treatment.

      Obviously nothing can go wrong with that.

      "I'm sorry sir/madam/ms you have consumed your entire budget. How are you going to pay the additional £25000.00"

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  7. smudge
    WTF?

    HMG is off its face?

    "Or a doctor is prescribing the wrong drugs, because they don’t know what drugs their patient is already on."

    Ehh??? My doctor sure knows what I'm on - he has one of these telebox things with a keyboard, and it tells him.

    Mind you, if Government ministers have doctors who prescribe stuff without knowing what else these people are on, then that explains an awful lot of the last three years' idiocy.

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    1. Stuart Abbott
      Reply Icon
      Thumb Up

      Re: HMG is off its face?

      But your A&E doc might not if you get admitted as an emergency!

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    2. Anonymous Coward
      Reply Icon
      Anonymous Coward

      Re: HMG is off its face?

      My missus is a Pharmacist, and has worked in community and primary care. At least 30% of prescriptions they receive from doctors contain errors, from wrong doses (sometimes dangerously high, sometimes so low as to be a waste of time), to drugs contraindicating or duplicating the effect of existing ones, to some that have been withdrawn for safety reasons.

      The whole system of doctors prescribing is the issue. Pharmacists are the experts on drugs, they spend years studying them, and continually have to prove that they are up to date and knowledgeable. Surely the doctor should be the one identifying the illness / sickness, and then passing that information on to the pharmacist, who will have the more detailed and up to date knowledge on drug regimes?

      P.S. I know the article is about PC and hospitals, but anyone who goes to Boots / supermarket pharmacies and expects good service needs their head checking.

      AC/DC for fear of missus finding out of me taking her name in vain.

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      1. JohnMurray
        Reply Icon

        Re: HMG is off its face?

        But the doctor knows what drugs you have a reaction to, if any.

        And, quite frankly, handing your illness details and medical history to a pharmacist is a data step too far.

        and complete details would be needed, because one drug for an illness may not be practical if the patient has another ailment that may be exacerbated by a new drug. Or maybe you don't read those nice, and quite lengthy, A4 pages of detail that comes within the medication ?

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        1. Anonymous Coward
          Reply Icon
          Anonymous Coward

          Re: HMG is off its face?

          "And, quite frankly, handing your illness details and medical history to a pharmacist is a data step too far."

          This article is about hospitals and Primary care. Weirdly enough, a hospital pharmacist will have both those exact things.

          "because one drug for an illness may not be practical if the patient has another ailment that may be exacerbated by a new drug"

          10 points, which is what contraindications and interactions are (see my previous post), and who are the experts on those? Oh yes that's right - Pharmacists. When it comes to drugs I'd trust a Pharmacist over a Doctor any day.

          Horses for courses, I wouldn't expect a pharmacist to do a surgical consult, I wouldn't expect a surgeon to be writing prescriptions. Instead I'd much prefer to have the best, most knowledgeable person for the job doing it.

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  8. John Moppett

    There is an alternative!

    I carry a USB connector in a card (utagice.com) which allows me to input and check the data and anyone with a PC can read it, but not change it!

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  9. JaitcH
    IT Angle

    Does anyone know where/how to ...

    to opt out of the NHS datasystem?

    Thanks.

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  10. Boris the Cockroach Silver badge
    FAIL

    So let

    me get this straight.

    Your doc can send the chemist an e.copy of your medication for you to pick up, also, in the event of a medical emergency, the hospital can type your number in and see what medication(if any) you are already taking.

    So what he's talking about is a system exactly like the one the out of hours service uses to send a prescription to your local chemist. coupled with an IT system that lets the GP or the hospital see what each other has prescribed to the patient.

    Why not add in the ability for the GP or hospital to see patient notes and test results and we get a system rather like the one my doc and local hospital already uses to see what the patient has been treated with.

    In fact, Take the plastic coated bar code tag that I've got to carry in my wallet and scan it into a NHS terminal and you get to see who I am, how much heart surgery I've had and what medication /latest test results are.

    I wonder if the health minister actually knows what goes on in his department?

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    1. Fatman
      Reply Icon

      Re: So let

      I wonder if the health minister actually knows what goes on in his department?

      Doubt it, after all, he is a politician, and we all know politicians are full of shit.

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  11. Lost in Cyberspace

    Paperless?

    He's obviously never been to our NHS trust

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  12. Tom 13

    This couldn't possibly be any more dangerous than

    juggling 17 vials filled with nitroglycerin.

    Sure, go for it.

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  13. Flakey

    Maybe

    I could tender for the contract, dont know much about computers although i did change a graphics card once. Maybe I could swing it.

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    1. quangotastic
      Reply Icon
      Coat

      Re: Maybe

      If you've changed a graphics card once you are strictly speaking overqualified for the role and would be considered dangerously likely to accidentally achieve an outcome, so I'd remove that off my CV if I were you. Replace it with a moderately smart but not actually threateningly professional-looking suit, perpetually brown nose and Prince2 qualifications (available circa 500 quid off Groupon). It's what all the govt-related IT types are wearing these days.

      Mine's the one with the Prince2 cert in the pocket.

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  14. John Smith 19 Gold badge
    Unhappy

    What is it about NHS IT architectures?

    Flexible -> centralized monster database

    Local -> grossly inflexible.

    Perhaps hospitals might do better attempting to eliminate the 700+ "impossible" operating events.

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  15. Anonymous Coward
    Anonymous Coward

    Not a completely stupid idea...

    ... even if the implementation would turn it into a complete disaster.

    I used to be a BloodRunner, and a common shout was to transport patient notes from one hostpital to another. Usually when Granny had been discharged from one of the "Cottage Hospitals", then had a relapse and was then taken to the ED of the main Hospital.

    Valuable time could (potentially) be saved if said notes were accessible online.

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  16. Adrian Midgley 1

    i saw this in 1999

    But it was store and forward as it needs to be. The US VA separately has it working in their many hospitals and the WorldVista project has been making a product with support of an open source version of it for some years

    In the UK VistA is well known by enough people to put in a Free system known to work over a population in millions.

    I suspect something else had been sold though.

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  17. PaulR79
    Holmes

    Best part of the article

    "Or a doctor is prescribing the wrong drugs, because they don’t know what drugs their patient is already on."

    If the doctor doesn't know what you're on already and doesn't check before giving you new drugs I'd question how they got that position in the first place.

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  18. Dropper

    Another Great Idea

    Government IT project huh? Those never go wrong..

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  19. Arachnoid

    I guess the minister has never talked to someone who works in a warehouse [warehouse I said............!]

    A place where misread bar codes are the bane of existence and invariably lead to delivery issues,which is fine with a case of dried plums but not so good for a dose of mis-prescribed medicine and whos to take the blame for getting it wrong?

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  20. LateNightLarry
    Pint

    I belong to the largest HMO in the US, Kaiser Permanente, that has, with its various branches, about nine million members. A couple of years ago, Kaiser developed an integrated record keeping, prescription ordering, etc., etc. system that has been working well for some time. When I see my doctor, he updates my record on line, places an order for any prescriptions, orders any tests or lab work needed, all while I'm in the examining room. By the time I walk over to the pharmacy, my prescription is ready. I can go to the lab without carrying any paperwork for the ordered tests, and the info is in the computer. I haven't heard any of the staff complaining about problems with the computer system, and the only complain I have is when I need to renew a prescription, and do it on line, it takes up to ten days for the prescription to be mailed from a central mega-pharmacy. But that was the case before they had the computer system for everything...

    That's a WINE glass... since El Reg refuses to provide a real one.

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    1. Anonymous Coward
      Reply Icon
      Anonymous Coward

      If a rhino is a horse designed by committee

      then any IT System designed by the NHS will always be a complete disaster.

      The system used by your HMO would never have worked if designed for/by the NHS as there'd be so many people insisting on their input it would become just another bloated waste of tax payers money.

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  21. Anonymous Coward
    Anonymous Coward

    I live on the Berkshire/Hampshire Border - so my wife, who is often ill, is often treated at, or taken by ambulance to, North Hants (Basingstoke) Hospital, just 15 miles away, much closer at easier to get to than Royal Berks in Reading.

    However, details of my wife's medications don't cross county borders between (Hampshire) hospital and (Berkshire) GP surgery, so if either the consultant at the hospital or the GP changes my wife's medications *WE* need to remember this because both bits of the NHS seem to be working in isolation.

    That's the kind of stuff that needs fixing (before a miss-match in drugs kills somebody)...

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  22. DaddyHoggy

    Of course Hunt the C*nt would quite like us to all have or records digitised and accessible wouldn't he, can't think why, oh hang on: http://www.guardian.co.uk/technology/2013/may/17/private-firms-data-hospital-patients

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