We need to know what’s going on


News and Comment from Roy Lilley.

It was the management guru’s favourite guru, Edwards Deming who said; 

‘In god we trust, 

everyone else brings data…’

Deming was heavily involved in the economic reconstruction of post WWll Japan.  He turned it into a global economic force between the 1960s and ’80s.  

Deming had a fundamental philosophy;

‘… data measurement and analysis are essential to attaining superior performance in every facet a business.’

Let’s have a look at our ‘business’.  

The big problem; ‘winter performance’.  NHSE are very open about how we are doing.  There is a website with loadsa data.  

I downloaded the latest spread sheet for 20th November ’17 to 18th Feb ’18 and had a look at NHS111performance.  I picked one day.  I don’t know why.  Random.  Stuck a proverbial pin into the screen and ended up with the 4th December 2017.  

It was a Monday.  North Koreans were kicking off, Trump was Tweeting.  The driving test included following instructions from a Sat-Nav and the Brexit-Irish-Border issue suddenly became the preoccupation of the front pages.

It was a cloudy but sunny day.  It was also a very busy day for NHS111…

There were

3,865 ambulances despatched.

2,535 people told to make their own way to A&E

15,293 callers told to attend primary care and community care

10,494 recommended to contact primary care

2,838 recommended to speak to primarycare

1,870 told to go and see the dentist

1,104 recommended to go somewhere else

4,077 not told to go anywhere

… and ninety one were advised to go to the pharmacy

Let’s go through the list…

About six and a half thousand clearly had a problem and looks like they ended up in A&E.  Busy or not, if you’ve gotta go, you’ve gotta go…

Twenty eight and a half thousand were directed to primary and community care.  

To be more accurate ‘attend’, ‘contact’ or ‘speak’ to primary care.  If you can figure out the difference… good luck.  All three, presumably, entail phoning a surgery and trying to get through?  Maybe an email?

Cleary, primary care is doing the heavy lifting.

Just over 5,000 were not told to go somewhere, anywhere, presumably a euphemism for go away.  Get a grip!

… and, 91 were advised to go to the pharmacy.

Of 42,076 calls, 39,895 were accommodated somewhere in the health system.  Ninety-one told to go to the pharmacy.

This is a really important set of numbers.  

There is a huge campaign underway to get us to see the pharmacist before we bother the NHS.  Indeed, Helen Stokes-Lampard, boss of the RCGP came up with the tongue-tripping, “Three, before GP” mantra;

‘We’re just asking people to stop and think, when you reach for the phone to book a GP appointment think: ‘Can I do this myself? Do I need some online help? Could a pharmacist help me?’

Pharmacist help?  It looks to me the public don’t seem to think so, hence the campaign, trying to change behaviour.  More importantly, neither do NHS111.  They send vastly more people to nowhere than they do the chemist.

There is a parallel campaign to encourage parents with sick kids to go to the pharmacist, first.  The Patients Association are, shall we say, ‘sceptical’.

These data?  Well, it is true that people who call NHS111 are self-selecting.  They are everything from life threatening, to, by the looks of the numbers, 5,000 sent away, not threatened at all.

I can’t get over the fact that of 42k calls, in only 91 cases did NHS111 call-handlers think pharmacy was a safe, viable option?

Data… you can have it without information but you can’t have information without data and if you don’t like the answers you can always blame the data… but be careful, it sometimes answers back!  

On the other hand data, isn’t information and information isn’t knowledge and knowledge isn’t wisdom.  Data is dumb until you make it talk.

What are these data telling us about pharmacy as a contributor to the healthcare front-line?  Everything?  Maybe nothing…

I always think of data as an MRI scan of an organisation, you can see into its innards.  What can we see here?  A wasted resource, a redundant resource, an overlooked resource.  A resource that isn’t trusted, superfluous or misunderstood…  

It’s important, we need to know what’s going on.  

Have a good weekend.   


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Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.