Discussion:
The most fucked up 2FA ever
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The Natural Philosopher
2025-01-23 00:15:48 UTC
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Is the NHS, using email


From an email header just received...

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4 hours 42 minutes and 18 seconds later...
--
“Progress is precisely that which rules and regulations did not foresee,”

– Ludwig von Mises
Jethro_uk
2025-01-23 09:16:47 UTC
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Permalink
Depends what it's purpose was.

You may have assumed it was to access their services.

They may have designed it so you can't.
The Natural Philosopher
2025-01-23 10:05:51 UTC
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Post by Jethro_uk
Depends what it's purpose was.
You may have assumed it was to access their services.
They may have designed it so you can't.
It gets better. I hit the 'resend code' about 30 times. The last one
arrived delayed by over 10 hours.

Its an NHS service that enables you to view your appointments online.
--
“Ideas are inherently conservative. They yield not to the attack of
other ideas but to the massive onslaught of circumstance"

- John K Galbraith
The Natural Philosopher
2025-01-23 10:26:14 UTC
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Post by The Natural Philosopher
Post by Jethro_uk
Depends what it's purpose was.
You may have assumed it was to access their services.
They may have designed it so you can't.
It gets better. I hit the 'resend code' about 30 times. The last one
arrived delayed by over 10 hours.
Its an NHS service that enables you to view your appointments online.
https://mychart.addenbrookes.nhs.uk/

It gets better

Email says...

Date: 22 Jan 2025 18:39:33 +0000
To verify your MyChart login, please use the code below. This code will
expire today at 18:59 GMT. ...

... Delivery-date: Thu, 23 Jan 2025 00:26:00 +0000
--
The lifetime of any political organisation is about three years before
its been subverted by the people it tried to warn you about.

Anon.
brian
2025-01-24 22:36:00 UTC
Reply
Permalink
Post by The Natural Philosopher
Post by The Natural Philosopher
Post by Jethro_uk
Depends what it's purpose was.
You may have assumed it was to access their services.
They may have designed it so you can't.
It gets better. I hit the 'resend code' about 30 times. The last one
arrived delayed by over 10 hours.
Its an NHS service that enables you to view your appointments online.
https://mychart.addenbrookes.nhs.uk/
It gets better
Email says...
Date: 22 Jan 2025 18:39:33 +0000
To verify your MyChart login, please use the code below. This code will
expire today at 18:59 GMT. ...
... Delivery-date: Thu, 23 Jan 2025 00:26:00 +0000
I find I get out of sync with 2FA validation codes if I do retries and
it takes a while for the code to come. Some go to my mobile phone in a
jacket hanging up somewhere and some go to e-mail on the Mainframe, I do
have one that goes to the landline, Can you opt out of 2FA ?

Brian
--
Brian Howie
The Natural Philosopher
2025-01-25 01:36:50 UTC
Reply
Permalink
Post by brian
Post by The Natural Philosopher
Post by The Natural Philosopher
Post by Jethro_uk
Depends what it's purpose was.
You may have assumed it was to access their services.
They may have designed it so you can't.
It gets better. I hit the 'resend code' about 30 times. The last one
arrived delayed by over 10 hours.
 Its an NHS service that enables you to view your appointments online.
https://mychart.addenbrookes.nhs.uk/
It gets better
Email says...
Date: 22 Jan 2025 18:39:33 +0000
To verify your MyChart login, please use the code below. This code
will expire today at 18:59 GMT. ...
... Delivery-date: Thu, 23 Jan 2025 00:26:00 +0000
I find I get out of sync with 2FA validation codes if I do retries and
it takes a while for the code to come.  Some go to my  mobile phone in a
jacket hanging up somewhere and some go to e-mail on the Mainframe, I do
have one that goes to the landline, Can you opt out of 2FA ?
Brian
They sent me an email asking me if I wanted to and I said 'yes'

May have worked too.
--
Any fool can believe in principles - and most of them do!
David Wade
2025-01-23 11:00:30 UTC
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Permalink
Post by The Natural Philosopher
Post by Jethro_uk
Depends what it's purpose was.
You may have assumed it was to access their services.
They may have designed it so you can't.
It gets better. I hit the 'resend code' about 30 times. The last one
arrived delayed by over 10 hours.
Its an NHS service that enables you to view your appointments online.
It also appears to be geofenced. I can't few from Spain without a VPN....

Dave
The Natural Philosopher
2025-01-23 14:55:40 UTC
Reply
Permalink
Post by David Wade
Post by The Natural Philosopher
Post by Jethro_uk
Depends what it's purpose was.
You may have assumed it was to access their services.
They may have designed it so you can't.
It gets better. I hit the 'resend code' about 30 times. The last one
arrived delayed by over 10 hours.
Its an NHS service that enables you to view your appointments online.
It also appears to be geofenced. I can't few from Spain without a VPN....
Dave
Doesn't surprise me in the slightest. Its the fucking NHS after all.
--
In todays liberal progressive conflict-free education system, everyone
gets full Marx.
Pancho
2025-01-23 21:55:43 UTC
Reply
Permalink
Post by The Natural Philosopher
Post by David Wade
Post by The Natural Philosopher
Post by Jethro_uk
Depends what it's purpose was.
You may have assumed it was to access their services.
They may have designed it so you can't.
It gets better. I hit the 'resend code' about 30 times. The last one
arrived delayed by over 10 hours.
Its an NHS service that enables you to view your appointments online.
It also appears to be geofenced. I can't few from Spain without a VPN....
Dave
Doesn't surprise me in the slightest. Its the fucking NHS after all.
Last few weeks I've been poorly. The NHS is even more fucked than I
remember. They seemed to oscillate between telling me nothing wrong and
you need urgent attention.

The biggest pisser was taking to the trouble to carefully fill out an
eConsult, when I submitted it, it promptly deleted all evidence it had
every existed, and stated it wouldn't deliver my input to the GP because
I need to seek urgent medical assistance, elsewhere. That's is for my
sore throat and ears, a distinctly non terminal problem.

Yesterday, 5 days after the failed eConsult, I finally got an
appointment with GP, after 111 told me I needed to be seen within two
hours. Appointment triage GP was pissed, and said two hours was
nonsense. Well if they had just dealt with the original eConsult...

The only amusing thing was how quickly the physical appointment GP
reached for her mask when I started telling her my symptoms. Anyway to
her credit she appears to have given me an appropriate antibiotic and
I'm feeling much better today.
The Natural Philosopher
2025-01-24 08:42:50 UTC
Reply
Permalink
Post by Pancho
Post by The Natural Philosopher
Post by David Wade
Post by The Natural Philosopher
Post by Jethro_uk
Depends what it's purpose was.
You may have assumed it was to access their services.
They may have designed it so you can't.
It gets better. I hit the 'resend code' about 30 times. The last one
arrived delayed by over 10 hours.
Its an NHS service that enables you to view your appointments online.
It also appears to be geofenced. I can't few from Spain without a VPN....
Dave
Doesn't surprise me in the slightest. Its the fucking NHS after all.
Last few weeks I've been poorly. The NHS is even more fucked than I
remember. They seemed to oscillate between telling me nothing wrong and
you need urgent attention.
The biggest pisser was taking to the trouble to carefully fill out an
eConsult, when I submitted it, it promptly deleted all evidence it had
every existed, and stated it wouldn't deliver my input to the GP because
I need to seek urgent medical assistance, elsewhere. That's is for my
sore throat and ears, a distinctly non terminal problem.
Yesterday, 5 days after the failed eConsult, I finally got an
appointment with GP, after 111 told me I needed to be seen within two
hours. Appointment triage GP was pissed, and said two hours was
nonsense. Well if they had just dealt with the original eConsult...
The only amusing thing was how quickly the physical appointment GP
reached for her mask when I started telling her my symptoms. Anyway to
her credit she appears to have given me an appropriate antibiotic and
I'm feeling much better today.
That is unusually bad.

In the case of the 2FA it is as you would have seen, Addenbrookes, the
biggest hospital in Eastern England.

Medically they are very sound., but the admin is to shit.
My more local hospital (West Suffolk) isnt quite so well appointed
medically, but the staff are better and the organisation is less
'corporate'

My GP is actually pretty good, Although I may have to wait 3-4 weeks for
a routine appointment, if I phone up and ask to see/talk to the 'doctor
of the day' I usually get a phone call back in an hour or so.
--
There is nothing a fleet of dispatchable nuclear power plants cannot do
that cannot be done worse and more expensively and with higher carbon
emissions and more adverse environmental impact by adding intermittent
renewable energy.
Tim Streater
2025-01-24 09:20:36 UTC
Reply
Permalink
On 24 Jan 2025 at 08:42:50 GMT, "The Natural Philosopher"
Post by The Natural Philosopher
Post by Pancho
Post by The Natural Philosopher
Post by David Wade
Post by The Natural Philosopher
Post by Jethro_uk
Depends what it's purpose was.
You may have assumed it was to access their services.
They may have designed it so you can't.
It gets better. I hit the 'resend code' about 30 times. The last one
arrived delayed by over 10 hours.
Its an NHS service that enables you to view your appointments online.
It also appears to be geofenced. I can't few from Spain without a VPN....
Dave
Doesn't surprise me in the slightest. Its the fucking NHS after all.
Last few weeks I've been poorly. The NHS is even more fucked than I
remember. They seemed to oscillate between telling me nothing wrong and
you need urgent attention.
The biggest pisser was taking to the trouble to carefully fill out an
eConsult, when I submitted it, it promptly deleted all evidence it had
every existed, and stated it wouldn't deliver my input to the GP because
I need to seek urgent medical assistance, elsewhere. That's is for my
sore throat and ears, a distinctly non terminal problem.
Yesterday, 5 days after the failed eConsult, I finally got an
appointment with GP, after 111 told me I needed to be seen within two
hours. Appointment triage GP was pissed, and said two hours was
nonsense. Well if they had just dealt with the original eConsult...
The only amusing thing was how quickly the physical appointment GP
reached for her mask when I started telling her my symptoms. Anyway to
her credit she appears to have given me an appropriate antibiotic and
I'm feeling much better today.
That is unusually bad.
In the case of the 2FA it is as you would have seen, Addenbrookes, the
biggest hospital in Eastern England.
Medically they are very sound., but the admin is to shit.
My more local hospital (West Suffolk) isnt quite so well appointed
medically, but the staff are better and the organisation is less
'corporate'
When I was using Addenbrookes services they had the parking well organised, at
least for a whie. If you turned up for an appointment, you waved your
appointment letter at the bloke, who then let you in to park. They also
noticed when I turned up there to A&E with arrhythmia for the fourth time and
arranged for a procedure at Papworth (heart hospital), where I got connected
to the national grid, which sorted it.
--
When I saw how the European Union was developing, it was very obvious what they had in mind was not democratic. In Britain you vote for a government so the government has to listen to you, and if you don't like it you can change it.

Tony Benn
The Natural Philosopher
2025-01-24 11:56:28 UTC
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Permalink
Post by Tim Streater
On 24 Jan 2025 at 08:42:50 GMT, "The Natural Philosopher"
Post by The Natural Philosopher
Post by Pancho
Post by The Natural Philosopher
Post by David Wade
Post by The Natural Philosopher
Post by Jethro_uk
Depends what it's purpose was.
You may have assumed it was to access their services.
They may have designed it so you can't.
It gets better. I hit the 'resend code' about 30 times. The last one
arrived delayed by over 10 hours.
Its an NHS service that enables you to view your appointments online.
It also appears to be geofenced. I can't few from Spain without a VPN....
Dave
Doesn't surprise me in the slightest. Its the fucking NHS after all.
Last few weeks I've been poorly. The NHS is even more fucked than I
remember. They seemed to oscillate between telling me nothing wrong and
you need urgent attention.
The biggest pisser was taking to the trouble to carefully fill out an
eConsult, when I submitted it, it promptly deleted all evidence it had
every existed, and stated it wouldn't deliver my input to the GP because
I need to seek urgent medical assistance, elsewhere. That's is for my
sore throat and ears, a distinctly non terminal problem.
Yesterday, 5 days after the failed eConsult, I finally got an
appointment with GP, after 111 told me I needed to be seen within two
hours. Appointment triage GP was pissed, and said two hours was
nonsense. Well if they had just dealt with the original eConsult...
The only amusing thing was how quickly the physical appointment GP
reached for her mask when I started telling her my symptoms. Anyway to
her credit she appears to have given me an appropriate antibiotic and
I'm feeling much better today.
That is unusually bad.
In the case of the 2FA it is as you would have seen, Addenbrookes, the
biggest hospital in Eastern England.
Medically they are very sound., but the admin is to shit.
My more local hospital (West Suffolk) isnt quite so well appointed
medically, but the staff are better and the organisation is less
'corporate'
When I was using Addenbrookes services they had the parking well organised, at
least for a whie. If you turned up for an appointment, you waved your
appointment letter at the bloke, who then let you in to park. They also
noticed when I turned up there to A&E with arrhythmia for the fourth time and
arranged for a procedure at Papworth (heart hospital), where I got connected
to the national grid, which sorted it.
Addys is good for parking as is the colocated Papworth (and the dear old
Rosie) with two big multistoreys.

West Suffolk hospital parking is shit. I had to go round twice today.
It was worth it though. The anaesthetist interviewing me was um - 'hot'
I believe is the term.

The biggest problem is that they don't share databases. Papworth and
Addenbrookes do, and my GP and West Suffolk to, but Addys can't see what
happens at West Suffolk.

West Suffolk have a perfectly reasonable online way to communicate with
me - they text a link to login and view appointments,. Addenbrookes
email the link and the system is then broken. Because their email system
is shagged basically
--
Religion is regarded by the common people as true, by the wise as
foolish, and by the rulers as useful.

(Seneca the Younger, 65 AD)
Chris Green
2025-01-24 13:02:27 UTC
Reply
Permalink
Post by Tim Streater
On 24 Jan 2025 at 08:42:50 GMT, "The Natural Philosopher"
When I was using Addenbrookes services they had the parking well organised, at
least for a whie. If you turned up for an appointment, you waved your
appointment letter at the bloke, who then let you in to park. They also
noticed when I turned up there to A&E with arrhythmia for the fourth time and
arranged for a procedure at Papworth (heart hospital), where I got connected
to the national grid, which sorted it.
!! The mind boggles....
--
Chris Green
·
Pancho
2025-01-24 13:12:52 UTC
Reply
Permalink
Post by Chris Green
Post by Tim Streater
On 24 Jan 2025 at 08:42:50 GMT, "The Natural Philosopher"
When I was using Addenbrookes services they had the parking well organised, at
least for a whie. If you turned up for an appointment, you waved your
appointment letter at the bloke, who then let you in to park. They also
noticed when I turned up there to A&E with arrhythmia for the fourth time and
arranged for a procedure at Papworth (heart hospital), where I got connected
to the national grid, which sorted it.
!! The mind boggles....
Surely, the heart wobbles..., during Dunkelflaute.
Pancho
2025-01-24 12:49:22 UTC
Reply
Permalink
Post by The Natural Philosopher
Post by Pancho
Post by The Natural Philosopher
Post by David Wade
Post by The Natural Philosopher
Post by Jethro_uk
Depends what it's purpose was.
You may have assumed it was to access their services.
They may have designed it so you can't.
It gets better. I hit the 'resend code' about 30 times. The last
one arrived delayed by over 10 hours.
Its an NHS service that enables you to view your appointments online.
It also appears to be geofenced. I can't few from Spain without a VPN....
Dave
Doesn't surprise me in the slightest. Its the fucking NHS after all.
Last few weeks I've been poorly. The NHS is even more fucked than I
remember. They seemed to oscillate between telling me nothing wrong
and you need urgent attention.
The biggest pisser was taking to the trouble to carefully fill out an
eConsult, when I submitted it, it promptly deleted all evidence it had
every existed, and stated it wouldn't deliver my input to the GP
because I need to seek urgent medical assistance, elsewhere. That's is
for my sore throat and ears, a distinctly non terminal problem.
Yesterday, 5 days after the failed eConsult, I finally got an
appointment with GP, after 111 told me I needed to be seen within two
hours. Appointment triage GP was pissed, and said two hours was
nonsense. Well if they had just dealt with the original eConsult...
The only amusing thing was how quickly the physical appointment GP
reached for her mask when I started telling her my symptoms. Anyway to
her credit she appears to have given me an appropriate antibiotic and
I'm feeling much better today.
That is unusually bad.
In the case of the 2FA it is as you would have seen, Addenbrookes, the
biggest hospital in Eastern England.
Medically they are very sound., but the admin is to shit.
My more local hospital (West Suffolk) isnt quite so well appointed
medically,  but the staff are better and the organisation is less
'corporate'
My GP is actually pretty good, Although I may have to wait 3-4 weeks for
a routine appointment, if I phone up and ask to see/talk to the 'doctor
of the day' I usually get a phone call back in an hour or so.
I don't really buy that GP good argument. At work from time to time I
had to look at how people worked, and figure out how IT automation could
improve efficiency. To a certain extent these people viewed me as a job
thief. This was particularly true of expert practitioners (in any
industry). Most of their expert status came from just a few talents,
which could be abstracted and automated. The problem was that once this
was done their expertise lost status.

There is no reason for the NHS to still be at the Tower of Babel stage,
apart from medical experts refusing to adapt to IT systems, instead of
insisting IT systems adapt to them. There is no reason for an
organisation the size of the NHS to not have effective messaging systems.

The NHS also seems resistant to receiving data, presumably for fear they
might be accused of interpreting it wrongly. So they throttle it to a
rate they can handle. In effect, they prioritise their own good name
above improving patient outcomes. Most industries ask for as much data
as you can give them, and are not concerned if they do not have time to
look at it. They just want to take the win from the occasions they do
have time, but the NHS is a blame culture.
Chris Green
2025-01-24 13:17:52 UTC
Reply
Permalink
Post by Pancho
There is no reason for the NHS to still be at the Tower of Babel stage,
apart from medical experts refusing to adapt to IT systems, instead of
insisting IT systems adapt to them.
Do you **really** mean that? Any good IT prectitioner will build
systems that are adapted to their users, that's what IT is for, it
helps users do their jobs. Forcing users to do things differently or
in ways that don't feel comfortable is an absolutely certain way of
producing IT systems that fail.
--
Chris Green
·
The Nomad
2025-01-24 13:21:54 UTC
Reply
Permalink
Post by Chris Green
Post by Pancho
There is no reason for the NHS to still be at the Tower of Babel stage,
apart from medical experts refusing to adapt to IT systems, instead of
insisting IT systems adapt to them.
Do you **really** mean that? Any good IT prectitioner will build
systems that are adapted to their users, that's what IT is for, it helps
users do their jobs. Forcing users to do things differently or in ways
that don't feel comfortable is an absolutely certain way of producing IT
systems that fail.
+1

Avpx
--
'Never say die, master. That's our motto, eh?' I CAN'T SAY IT'S EVER
REALLY BEEN MINE.
(Hogfather)
Fri 11469 Sep 13:20:01 GMT 1993
13:20:01 up 7 days, 3:56, 1 user, load average: 0.64, 1.13, 1.31
Pancho
2025-01-24 14:16:34 UTC
Reply
Permalink
Post by Chris Green
Post by Pancho
There is no reason for the NHS to still be at the Tower of Babel stage,
apart from medical experts refusing to adapt to IT systems, instead of
insisting IT systems adapt to them.
Do you **really** mean that? Any good IT prectitioner will build
systems that are adapted to their users, that's what IT is for, it
helps users do their jobs. Forcing users to do things differently or
in ways that don't feel comfortable is an absolutely certain way of
producing IT systems that fail.
I said it wrong, I meant individual doctors should adapt to widespread
IT systems. But I think you got my meaning.

The problem for the software developer is that different GP surgeries,
different hospitals do things in different ways. So a software product
can adapt to the working practice of a specific doctor, area etc, but it
will not be adapted to all the other doctors.

The cost of adapting the software to each specific doctor is huge, and
each doctor specific product would then need special adapters so
different doctors could talk to each other. This is why we have
standards, why I made the Tower of Babel analogy.

Another analogy might be a call centre. I guess each employee operative
might like their personal work station to be set up with software they
are familiar with, tuned to their own requirements. However the
management have control and they dictate that each call centre operative
uses a standard set up. The call centre operatives do not have the
political power to stand up to this. The problem with "experts" is they
have more power to resist, and they obstruct automation. This is part of
the reason the NHS, our legal system, etc are so shit.

Or another example would be Stripe, who provide payment systems, back in
the day each company would write it's own, but they were all doing
basically the same stuff, just in different ways. Stripe can invest the
money to do it reliably and spread the cost over a huge customer base.
Companies adapt to Stripe, and get much cheaper better software.

You should not confuse this with the old image of an IT department that
doesn't listen to users, and software developer just do what they like.
This is an argument to the benefits of imposed standardisation.
Andrew
2025-01-24 21:54:06 UTC
Reply
Permalink
Post by Pancho
Post by Pancho
There is no reason for the NHS to still be at the Tower of Babel stage,
apart from medical experts refusing to adapt to IT systems, instead of
insisting IT systems adapt to them.
Do you **really** mean that?  Any good IT prectitioner will build
systems that are adapted to their users, that's what IT is for, it
helps users do their jobs.  Forcing users to do things differently or
in ways that don't feel comfortable is an absolutely certain way of
producing IT systems that fail.
I said it wrong, I meant individual doctors should adapt to widespread
IT systems. But I think you got my meaning.
The problem for the software developer is that different GP surgeries,
different hospitals do things in different ways. So a software product
can adapt to the working practice of a specific doctor, area etc, but it
will not be adapted to all the other doctors.
Err, I take it you have no actual working knowledge of NHS
systems like Patient Admin, Waiting Lists, Booking Lists,
Clinical data handling, Radiology and Radiography reporting
and plenty more ?.

Every NHS hospital functions along the same basic lines, so
a national standard Hospital system would be quite possible
and that is mostly there and has been for over 15 years. What has
held it back are the usual suspects who were given gargantuan
amounts of money to run the truly even more gargantuan database
required and are only interested in gouging as much money as
possible and not genuinely helping the NHS implement the most
effective systems. Not helped by endless committees who have to
make decisions for the 1.3 million staff and ultimately train
all the end-users (with high staff turnover) to actually use the
systems properly.

The NHS intranet allows doctors and other NHS users to
interact via secure email. Patient data flows from Pathology
labs and other sources back to GP surgeries electronically
and has been for ages. If everyone had a broadband connection
and a tablet or PC and went paperless then the NHS could
become far more efficient but the NHS' bread and butter are the
12 million pensioners, notable the over 75's and this group
are mostly internet refuseniks and insist on paper appointments
send by mail, and using the bloody phone to make changes or
ask for things like test results.

The problems arise when a patient has multiple ongoing treatment
episodes at different clinics/firms within one hospital and
frequently across more than one hospital. These different
specialty's don't talk to each other. They frequently
prescribe medication that interferes with what another
specialty has instructed the patient GP to prescribe.

It's no good expecting an eye surgeon to understand what
is wrong the old biddy's colon because the expertise stops
at the neck and vice versa.
Jeff Layman
2025-01-24 22:44:24 UTC
Reply
Permalink
Post by Andrew
Err, I take it you have no actual working knowledge of NHS
systems like Patient Admin, Waiting Lists, Booking Lists,
Clinical data handling, Radiology and Radiography reporting
and plenty more ?.
Every NHS hospital functions along the same basic lines, so
a national standard Hospital system would be quite possible
and that is mostly there and has been for over 15 years. What has
held it back are the usual suspects who were given gargantuan
amounts of money to run the truly even more gargantuan database
required and are only interested in gouging as much money as
possible and not genuinely helping the NHS implement the most
effective systems. Not helped by endless committees who have to
make decisions for the 1.3 million staff and ultimately train
all the end-users (with high staff turnover) to actually use the
systems properly.
The NHS intranet allows doctors and other NHS users to
interact via secure email. Patient data flows from Pathology
labs and other sources back to GP surgeries electronically
and has been for ages. If everyone had a broadband connection
and a tablet or PC and went paperless then the NHS could
become far more efficient but the NHS' bread and butter are the
12 million pensioners, notable the over 75's and this group
are mostly internet refuseniks and insist on paper appointments
send by mail, and using the bloody phone to make changes or
ask for things like test results.
Of course it's the patient's fault! Why on earth should it be anything
else? It's obvious as the buggers won't use electronic methods of
communication - after all, they can barely use a telephone.

Let me take you back 40, or even 60, years when there wasn't an internet
and all communications with a patient were by "snail" mail. That didn't
seem to be a problem then; patients turned up at hospital at the right
time. If they wanted an appointment with the GP they phoned up in the
morning, and were told to come that day at nn o'clock and wait in the
waiting room. They saw the GP within 30 minutes of nn, and went away
with a prescription which was filled within a few minutes of being
handed in at the chemist's shop. Nowadays? If only...

Currently there's very little chance of getting a phone appointment; at
my surgery they are "released" at 1100 on Wednesdays and 1600 on
Thursdays. A few minutes before these times the line is engaged. Quelle
surprise! Other than that it's eConsult. A rigmarole which annoys me the
thankfully rare times I have to use it. And if it works, I might get a
phone call from a doctor (or more usually a nurse practitioner these
days) any time in the morning or afternoon. So I have to hang around
waiting for a call.

And if they have to communicate with me to arrange an appointment or do
something else, I get a text from a no-reply number with a link to a
website. I won't do *anything* on an Android phone which involves
health, so I have to copy the link to my laptop and deal with it there.
It might be a crap website which is poorly designed, but I can't do
anything about it. I can't even email the surgery as they don't accept
emails from patients. So don't blame me as I'm hardly an "internet
refusenik", even though I passed 75 some years ago.
--
Jeff
Andrew
2025-01-25 20:39:08 UTC
Reply
Permalink
Post by Jeff Layman
Post by Andrew
Err, I take it you have no actual working knowledge of NHS
systems like Patient Admin, Waiting Lists, Booking Lists,
Clinical data handling, Radiology and Radiography reporting
and plenty more ?.
Every NHS hospital functions along the same basic lines, so
a national standard Hospital system would be quite possible
and that is mostly there and has been for over 15 years. What has
held it back are the usual suspects who were given gargantuan
amounts of money to run the truly even more gargantuan database
required and are only interested in gouging as much money as
possible and not genuinely helping the NHS implement the most
effective systems. Not helped by endless committees who have to
make decisions for the 1.3 million staff and ultimately train
all the end-users (with high staff turnover) to actually use the
systems properly.
The NHS intranet allows doctors and other NHS users to
interact via secure email. Patient data flows from Pathology
labs and other sources back to GP surgeries electronically
and has been for ages. If everyone had a broadband connection
and a tablet or PC and went paperless then the NHS could
become far more efficient but the NHS' bread and butter are the
12 million pensioners, notable the over 75's and this group
are mostly internet refuseniks and insist on paper appointments
send by mail, and using the bloody phone to make changes or
ask for things like test results.
Of course it's the patient's fault! Why on earth should it be anything
else? It's obvious as the buggers won't use electronic methods of
communication - after all, they can barely use a telephone.
60 years ago, men retired at 65 and most were dead by 73 while women
'retired' at 60 and chattered on to 78. Now there are 1.6 million over
age 85 and 15,000 over 100 and cost the taxpayer an *average* of £30,000
each for their 'free' NHS, which now includes amazing (and eye-
wateringly expensive) treatments which did *not* exist 60 years ago and
the taxes this 85+ group have paid is peanuts compared to the staggering
cost that they are imposing on todays workers.
Post by Jeff Layman
Let me take you back 40, or even 60, years when there wasn't an internet
and all communications with a patient were by "snail" mail. That didn't
seem to be a problem then; patients turned up at hospital at the right
time.
Or not at all !!, just like they don't turn up for their GP appointment.
Ask your practice for their DNA stats.

60 years ago stamps were peanuts even after discounting inflation.
What is the NHS' annual bill for sending pointless bits of paper
via Royal Mail when they could be sent electronically ?.

50 years ago people ended up crippled by the nerve damage caused by
un-diagnosed (or too-late diagnosed) Pernicious Anaemia because very
few hospitals had Coulter Counter Model 'S' blood cell counters which
measured all the vital parameters. If you had any sort of cancer or
leukaemia then your *only* chance of any sort of cutting edge treatment
was in just a handful of teaching hospitals. So many other diagnoses
back then that was a death sentence. If you want to go back to those
halcyon days, good luck.
Post by Jeff Layman
If they wanted an appointment with the GP they phoned up in the
morning, and were told to come that day at nn o'clock and wait in the
waiting room. They saw the GP within 30 minutes of nn, and went away
with a prescription which was filled within a few minutes of being
handed in at the chemist's shop. Nowadays? If only...
Err, wrong. Even 30 years ago I could just turn up at my GP surgery,
morning or evening and wait to be seen. No appointment needed.

There were >10 million FEWER people fifty years ago and believe me, as
someone who worked in NHS path labs for 11 years between 1971 and
1984, things went wrong all the time, but the patient never knew.
Specimens were received from GP's unlabled or late (unusable), the
same specimen gave wildly different biochemistry results at different
hospitals because there was no national quality control scheme, test
results were lost, sent to the wrong address, blah blah. If you had
different treatment episodes at different hospitals, neither hospital
knew what the other hospital was doing (and prescribing). Now every
NHS GP and Hospital can see all your treatments instantly because it
is all computerised. 50 years ago ASTMS, Clive Jenkins union regularly
caused mayhem in Path Labs, Radiology depts and all the other non-
medical and non-nursing parts of a hospital.
Post by Jeff Layman
Currently there's very little chance of getting a phone appointment; at
my surgery they are "released" at 1100 on Wednesdays and 1600 on
Thursdays. A few minutes before these times the line is engaged. Quelle
surprise! Other than that it's eConsult. A rigmarole which annoys me the
thankfully rare times I have to use it. And if it works, I might get a
phone call from a doctor (or more usually a nurse practitioner these
days) any time in the morning or afternoon. So I have to hang around
waiting for a call.
And since 50% of people insisting on seeing a Doctor are time-wasters
this is the way to go. A significant number of people request
appointments just to get a sick note and then get abusive if the GP
says it isn't necessary.
Post by Jeff Layman
And if they have to communicate with me to arrange an appointment or do
something else, I get a text from a no-reply number with a link to a
website. I won't do *anything* on an Android phone which involves
health,
Why, are you paranoid ?. All your GP data has been uploaded to massive
databases anyway, supposedly in anonymised form.
Post by Jeff Layman
so I have to copy the link to my laptop and deal with it there.
It might be a crap website which is poorly designed, but I can't do
anything about it. I can't even email the surgery as they don't accept
emails from patients.
Yes it will, they will use the same email system as my GP does -
https://www.pmgdoctors.co.uk/contact1.aspx
Post by Jeff Layman
So don't blame me as I'm hardly an "internet
refusenik", even though I passed 75 some years ago.
And you are part of the cohort that is pushing the NHS to its limits.
If you think things are bad now, wait until all the baby boomers are in
their 80's, 10 years from now. As far back as 2017 it was predicted that
debt/GDP would hit 200% by 2035 because of the financial implications
they will impose on the NHS.
Tim Streater
2025-01-25 21:03:35 UTC
Reply
Permalink
There were >10 million FEWER people fifty years ago ...
More like 20 million. %0 million when I was a kid, 70 million now.
--
Labour - a bunch of rich people convincing poor people to vote for rich people by telling poor people that "other" rich people are the reason they are poor.

Peter Thompson
Tim Streater
2025-01-25 21:05:11 UTC
Reply
Permalink
On 25 Jan 2025 at 20:39:08 GMT, "Andrew" <***@btinternet.com> wrote:

[snip enormous rant]

You are Eric Idle in the Travel Agent sketch AICMFP.
--
"The idea that Bill Gates has appeared like a knight in shining armour to lead all customers out of a mire of technological chaos neatly ignores the fact that it was he who, by peddling second-rate technology, led them into it in the first place." - Douglas Adams
Jethro_uk
2025-01-26 11:36:23 UTC
Reply
Permalink
TL;DR is we either export our old folk or import some young ones.
Pancho
2025-01-26 13:50:45 UTC
Reply
Permalink
Post by Jethro_uk
TL;DR is we either export our old folk or import some young ones.
Only if you follow the eternal growth Ponzi scheme. If the far east also
needs to import youngsters, they will become harder to find. I guess
Japan is the country to watch, how they handle it.

We could also have improved efficiency, and target extending productive
life, as opposed to extending years of old age infirmity.
Jethro_uk
2025-01-26 13:57:52 UTC
Reply
Permalink
Post by Pancho
[quoted text muted]
Only if you follow the eternal growth Ponzi scheme.
Problem is that *is* capitalism.

Much as I detest Nigel Farage, he is the only mainstream politician I
have ever heard who has openly question why we need to fetishish growth
so much. Admittedly he was coming from an anti-immigration line of
thought. But it was - and still is - a valid question.

Historically *all* empires have fallen at some point when they run out of
resources. Either directly (literally running out of stuff) or indirectly
(being unable to manage the stuff you have).
Handsome Jack
2025-01-26 14:19:13 UTC
Reply
Permalink
Post by Jethro_uk
Post by Pancho
[quoted text muted]
Only if you follow the eternal growth Ponzi scheme.
Problem is that *is* capitalism.
Much as I detest Nigel Farage, he is the only mainstream politician I
have ever heard who has openly question why we need to fetishish growth
so much. Admittedly he was coming from an anti-immigration line of
thought. But it was - and still is - a valid question.
Because there are still lots of people who are not very well off, and the
only ways of making them better off are by growing the economy or sharing
it out more equally. Since the latter is implacably resisted by those who
have the most, the former is politically preferable.
Post by Jethro_uk
Historically *all* empires have fallen at some point when they run out
of resources. Either directly (literally running out of stuff) or
indirectly (being unable to manage the stuff you have).
No they haven't. The Roman empire didn't fall for that reason, it fell
(essentially) because it was attacked from without. The British empire
didn't fall for that reason either, it fell because its rulers decided it
was unethical to keep hold of it. The Second French Empire fell for the
same reason (accompanied by a revolution.)

In fact I can't think of a *single* empire that fell because it ran out of
resources. Mostly it's because they are conquered by enemies.
Jethro_uk
2025-01-26 15:10:51 UTC
Reply
Permalink
Post by Handsome Jack
In fact I can't think of a *single* empire that fell because it ran out
of resources. Mostly it's because they are conquered by enemies.
You missed out the second part of my statement. Maybe because it
disproves your reply ?

I said they either run out of resources or are *unable to manage them*.
(With a combination of both being possible).

The Roman Empire fell because ultimately it was too unwieldy to respond
to multiple threats all at once - that is pure resource management. If it
could have managed itself across it's expanse, it would have continued.

The British Empire fell because it was unable to develop a political
system that could manage such a diverse estate. Conversely this far the
US has become what it is because it can manage an entire continent as a
country. Or at least could once upon a time.

We live under a practically infinite supply of energy. Yet still
regularly run out of it. If that isn't piss poor resource management,
what is ?
Tim Streater
2025-01-26 16:17:17 UTC
Reply
Permalink
We live under a practically infinite supply of energy. Yet still regularly
run out of it. If that isn't piss poor resource management, what is ?
If you're referring to the Sun, we don't have access to any meaningful amount
of it. Neither do we have any technology that can capture a significant
fraction of it. And if we could, we wouldn't dare use it on Earth. That really
*would* fuck up the climate.
--
"A committee is a cul-de-sac down which ideas are lured and then quietly strangled." - Sir Barnett Cocks (1907-1989)
The Natural Philosopher
2025-01-26 20:43:15 UTC
Reply
Permalink
Post by Handsome Jack
Post by Jethro_uk
Historically *all* empires have fallen at some point when they run out
of resources. Either directly (literally running out of stuff) or
indirectly (being unable to manage the stuff you have).
No they haven't. The Roman empire didn't fall for that reason, it fell
(essentially) because it was attacked from without.
No, It doidnt.

What happened was that the geographical limits of communication were
reached. Instead of the cheap and quick import fro,m egypt, they used
overland routes from Gaul, but by te time the horse drawn carts got to
Rome., they had eaten all the grain to get there.

Then the local warlords came along and said 'we can do protection at 20%
off what Rome is charging you' and the tribes said 'DEAL!' and that was
the end of that.,

The British empire
Post by Handsome Jack
didn't fall for that reason either, it fell because its rulers decided it
was unethical to keep hold of it. The Second French Empire fell for the
same reason (accompanied by a revolution.)
Bolloxs. It was simply uneconomic to hold on to countries that were no
longer supplying the wealth they used to
Post by Handsome Jack
In fact I can't think of a *single* empire that fell because it ran out of
resources. Mostly it's because they are conquered by enemies.
The reason they are conquered by enemies is because they ran out of
resources.
Duh!
--
"Fanaticism consists in redoubling your effort when you have
forgotten your aim."

George Santayana
Joe
2025-01-26 14:57:39 UTC
Reply
Permalink
On Sun, 26 Jan 2025 13:57:52 -0000 (UTC)
Post by Jethro_uk
Post by Pancho
[quoted text muted]
Only if you follow the eternal growth Ponzi scheme.
Problem is that *is* capitalism.
Don't forget that it also *is* government.
--
Joe
The Natural Philosopher
2025-01-26 20:38:04 UTC
Reply
Permalink
Post by Jethro_uk
Post by Pancho
[quoted text muted]
Only if you follow the eternal growth Ponzi scheme.
Problem is that *is* capitalism.
No it isn't.
Its expansionsist economics, borrow now , invest in production, have
more goods next tear, future generations pay back.


WE have top invent steady state economies such as existed in the middle
ages.
Post by Jethro_uk
Much as I detest Nigel Farage, he is the only mainstream politician I
have ever heard who has openly question why we need to fetishish growth
so much. Admittedly he was coming from an anti-immigration line of
thought. But it was - and still is - a valid question.
Because it is the only way to pay off the debts that previous
governments since Blair incurred when instead of investing in
production and infrastructure, they simply gave it to people to spend on
imports = 'investing in people'

This is all Blair's legacy. The lying cunt.,
Post by Jethro_uk
Historically *all* empires have fallen at some point when they run out of
resources. Either directly (literally running out of stuff) or indirectly
(being unable to manage the stuff you have).
Yup.
Especially when they refused to use the resources they actually had,
like gas and plutonium
--
“But what a weak barrier is truth when it stands in the way of an
hypothesis!”

Mary Wollstonecraft
The Natural Philosopher
2025-01-26 20:32:29 UTC
Reply
Permalink
Post by Pancho
Post by Jethro_uk
TL;DR is we either export our old folk or import some young ones.
Only if you follow the eternal growth Ponzi scheme.
That is the real issue. Since WWII affluence has been achieved by
increasing populations and assuming infinite resources.

No one has developed a model for a stable state economy and populations.
The Japanese are close, but there are technically bankrupt.

Rachel Reeves desnt even understand the question.
Post by Pancho
If the far east also
needs to import youngsters, they will become harder to find. I guess
Japan is the country to watch, how they handle it.
Yup. Biggest racists in the world really. We dont want no stinkin
immigrants!
Post by Pancho
We could also have improved efficiency, and target extending productive
life, as opposed to extending years of old age infirmity.
I think that is already happening. I certainly never expected to be
alive, active and rational at this age.
--
"In our post-modern world, climate science is not powerful because it is
true: it is true because it is powerful."

Lucas Bergkamp
Tim Streater
2025-01-26 21:29:03 UTC
Reply
Permalink
On 26 Jan 2025 at 20:32:29 GMT, "The Natural Philosopher"
Yup. Biggest racists in the world really. We dont want no stinkin immigrants!
As my nephew, who is married to a Japanese woman and lives in Japan, will
confirm.
--
I was brought up to believe that you should never give offence if you can avoid it; the new culture tells us you should always take offence if you can. There are now experts in the art of taking offence, indeed whole academic subjects, such as 'gender studies', devoted to it.

Roger Scruton
Jeff Layman
2025-01-26 16:28:33 UTC
Reply
Permalink
Post by Andrew
Post by Jeff Layman
Post by Andrew
Err, I take it you have no actual working knowledge of NHS
systems like Patient Admin, Waiting Lists, Booking Lists,
Clinical data handling, Radiology and Radiography reporting
and plenty more ?.
Every NHS hospital functions along the same basic lines, so
a national standard Hospital system would be quite possible
and that is mostly there and has been for over 15 years. What has
held it back are the usual suspects who were given gargantuan
amounts of money to run the truly even more gargantuan database
required and are only interested in gouging as much money as
possible and not genuinely helping the NHS implement the most
effective systems. Not helped by endless committees who have to
make decisions for the 1.3 million staff and ultimately train
all the end-users (with high staff turnover) to actually use the
systems properly.
The NHS intranet allows doctors and other NHS users to
interact via secure email. Patient data flows from Pathology
labs and other sources back to GP surgeries electronically
and has been for ages. If everyone had a broadband connection
and a tablet or PC and went paperless then the NHS could
become far more efficient but the NHS' bread and butter are the
12 million pensioners, notable the over 75's and this group
are mostly internet refuseniks and insist on paper appointments
send by mail, and using the bloody phone to make changes or
ask for things like test results.
Of course it's the patient's fault! Why on earth should it be anything
else? It's obvious as the buggers won't use electronic methods of
communication - after all, they can barely use a telephone.
60 years ago, men retired at 65 and most were dead by 73 while women
'retired' at 60 and chattered on to 78. Now there are 1.6 million over
age 85 and 15,000 over 100 and cost the taxpayer an *average* of £30,000
each for their 'free' NHS, which now includes amazing (and eye-
wateringly expensive) treatments which did *not* exist 60 years ago and
the taxes this 85+ group have paid is peanuts compared to the staggering
cost that they are imposing on todays workers.
Aren't you jumping the gun a bit here? All we're discussing is the ease
or difficulty in getting an appointment with a GP - what treatment might
cost is another matter and further down the line.

I assume your conclusions were drawn from studies such as
<https://bmjopen.bmj.com/content/11/12/e054666>. The problem is that
even if 4/10 appointments are taken up by "frequent attenders" (mainly
elderly women, as they are more likely to get to an older age than
males), the number of GPs have increased proportionally above the growth
in population. From
<https://www.nuffieldtrust.org.uk/news-item/is-the-number-of-gps-falling-across-the-uk>
the number of GPs per 100000 population (UK) was about 43 in 1964, then
it dropped a little for six years, but then rose steadily to a peak of
67 in 2009. It dropped again to 60 in 2018. I didn't look for later
figures, but the total number of GPs in the UK increased from 49500 in
2018, to 54600 in 2022. That's about an 11% increase, while the UK
population increased from 66.4M to 67.5M over the same time - only 1.7%.

Add to that the number of "paramedics" in practices such as nurse
practitioners and clinical pharmacists who deal with an increasing
number of patients. Also add the pharmacists in shops who are being
asked to deal with minor ailments instead of GPs.

There's an interesting, if somewhat old (1988) paper at
<https://www.nuffieldtrust.org.uk/sites/default/files/2017-01/general-practice-web-final.pdf>.
There are good historical figures in the tables in Chapter 5. I wonder
how the figures in table 10 would compare with those today. On average
there were 26 consults a day, 4 home visits on one round, plus night
visits, and weekend out-of-hours calls!
Post by Andrew
Post by Jeff Layman
Let me take you back 40, or even 60, years when there wasn't an internet
and all communications with a patient were by "snail" mail. That didn't
seem to be a problem then; patients turned up at hospital at the right
time.
Or not at all !!, just like they don't turn up for their GP appointment.
Ask your practice for their DNA stats.
I know the stats. I am on our practice "Patient Participation Group",
where a number of patients meets with the practice manager around 3
times a year to discuss various points.
Post by Andrew
60 years ago stamps were peanuts even after discounting inflation.
What is the NHS' annual bill for sending pointless bits of paper
via Royal Mail when they could be sent electronically ?.
I don't disagree; all I was trying to point out was that a much slower
system seemed to work.
Post by Andrew
50 years ago people ended up crippled by the nerve damage caused by
un-diagnosed (or too-late diagnosed) Pernicious Anaemia because very
few hospitals had Coulter Counter Model 'S' blood cell counters which
measured all the vital parameters. If you had any sort of cancer or
leukaemia then your *only* chance of any sort of cutting edge treatment
was in just a handful of teaching hospitals. So many other diagnoses
back then that was a death sentence. If you want to go back to those
halcyon days, good luck.
There's nothing there that hasn't occurred since medicine became a
science rather than an art, and will continue to occur. And it's off
track - as I pointed out above that this is about getting an appointment
with a GP, not the latest monoclonal antibody treatment at umpteen £K a
year.
Post by Andrew
Post by Jeff Layman
If they wanted an appointment with the GP they phoned up in the
morning, and were told to come that day at nn o'clock and wait in the
waiting room. They saw the GP within 30 minutes of nn, and went away
with a prescription which was filled within a few minutes of being
handed in at the chemist's shop. Nowadays? If only...
Err, wrong. Even 30 years ago I could just turn up at my GP surgery,
morning or evening and wait to be seen. No appointment needed.
Quite possibly, but 30 years ago the internet had been around for
several years. I was using a pre-internet time as the example.
Post by Andrew
There were >10 million FEWER people fifty years ago and believe me, as
someone who worked in NHS path labs for 11 years between 1971 and
1984, things went wrong all the time, but the patient never knew.
What makes you think they know now? A few years ago I had some test
results showing I was in end-stage renal failure and required immediate
dialysis. I pointed out to my practice that all my other blood chemistry
results were normal, I had never had any kidney problems, and it looked
like a serious error had been made. A repeat test was negative, of
course. How much did that mistake cost the NHS? Fortunately I have a
detailed knowledge of medicine, and know when to question what GPs tell
patients.
Post by Andrew
Post by Jeff Layman
Currently there's very little chance of getting a phone appointment; at
my surgery they are "released" at 1100 on Wednesdays and 1600 on
Thursdays. A few minutes before these times the line is engaged. Quelle
surprise! Other than that it's eConsult. A rigmarole which annoys me the
thankfully rare times I have to use it. And if it works, I might get a
phone call from a doctor (or more usually a nurse practitioner these
days) any time in the morning or afternoon. So I have to hang around
waiting for a call.
And since 50% of people insisting on seeing a Doctor are time-wasters
this is the way to go. A significant number of people request
appointments just to get a sick note and then get abusive if the GP
says it isn't necessary.
Reference please, for 50% being time-wasters.
Post by Andrew
Post by Jeff Layman
And if they have to communicate with me to arrange an appointment or do
something else, I get a text from a no-reply number with a link to a
website. I won't do *anything* on an Android phone which involves
health,
Why, are you paranoid ?. All your GP data has been uploaded to massive
databases anyway, supposedly in anonymised form.
I think you mean pseudo-anonymised form. That has been shown to be
susceptible to "reverse engineering". I'll bet you didn't even pay
attention when the "care.data" system was proposed. Fortunately that was
killed before birth despite various attempts at reincarnation since.

As to privacy on an Android phone, this was from less than a minute with
an internet search:
<https://www.bmj.com/content/373/bmj.n1248>
<https://pmc.ncbi.nlm.nih.gov/articles/PMC9237761/>
<https://campaignsoftheworld.com/news/the-dark-side-of-google/>
Post by Andrew
Post by Jeff Layman
so I have to copy the link to my laptop and deal with it there.
It might be a crap website which is poorly designed, but I can't do
anything about it. I can't even email the surgery as they don't accept
emails from patients.
Yes it will, they will use the same email system as my GP does -
https://www.pmgdoctors.co.uk/contact1.aspx
Actually, my practice has just started including an email address on
their "contact" page. I'll ask them what it should be used for at my
next PPG meeting.
Post by Andrew
Post by Jeff Layman
So don't blame me as I'm hardly an "internet
refusenik", even though I passed 75 some years ago.
And you are part of the cohort that is pushing the NHS to its limits.
If you think things are bad now, wait until all the baby boomers are in
their 80's, 10 years from now. As far back as 2017 it was predicted that
debt/GDP would hit 200% by 2035 because of the financial implications
they will impose on the NHS.
Welcome to Soylent Green...
--
Jeff
Pancho
2025-01-24 22:55:38 UTC
Reply
Permalink
Post by Andrew
Post by Pancho
Post by Pancho
There is no reason for the NHS to still be at the Tower of Babel stage,
apart from medical experts refusing to adapt to IT systems, instead of
insisting IT systems adapt to them.
Do you **really** mean that?  Any good IT prectitioner will build
systems that are adapted to their users, that's what IT is for, it
helps users do their jobs.  Forcing users to do things differently or
in ways that don't feel comfortable is an absolutely certain way of
producing IT systems that fail.
I said it wrong, I meant individual doctors should adapt to widespread
IT systems. But I think you got my meaning.
The problem for the software developer is that different GP surgeries,
different hospitals do things in different ways. So a software product
can adapt to the working practice of a specific doctor, area etc, but
it will not be adapted to all the other doctors.
Err, I take it you have no actual working knowledge of NHS
systems like Patient Admin, Waiting Lists, Booking Lists,
Clinical data handling, Radiology and Radiography reporting
and plenty more ?.
I'm a patient. I have observed them working. I see obvious flaws in the
system. I understand. The problem is that many people in the NHS don't
seem to understand. Don't understand how to automate services, Don't
understand have information can be integrated.
Post by Andrew
Every NHS hospital functions along the same basic lines, so
a national standard Hospital system would be quite possible
and that is mostly there and has been for over 15 years. What has
held it back are the usual suspects who were given gargantuan
amounts of money to run the truly even more gargantuan database
required and are only interested in gouging as much money as
possible and not genuinely helping the NHS implement the most
effective systems. Not helped by endless committees who have to
make decisions for the 1.3 million staff and ultimately train
all the end-users (with high staff turnover) to actually use the
systems properly.
The NHS intranet allows doctors and other NHS users to
interact via secure email.
Erm? They can talk with email? Is that an achievement in 2025. It is a
pretty meagre achievement, and, as TNP notes their email, doesn't even
work. I was writing industry wide, electronic mail system for insurance
companies in the 1980s. Today I'd contract it out to someone like Google.
Post by Andrew
Patient data flows from Pathology
labs and other sources back to GP surgeries electronically
and has been for ages.
Does it? Not in my experience all the tests I have had recently required
me to pick up a paper form from the GP surgery and take it to the
testing centre. Some of the results then got lost. AIUI, this getting
lost is quite normal.


If everyone had a broadband connection
Post by Andrew
and a tablet or PC and went paperless then the NHS could
become far more efficient but the NHS' bread and butter are the
12 million pensioners, notable the over 75's and this group
are mostly internet refuseniks and insist on paper appointments
send by mail, and using the bloody phone to make changes or
ask for things like test results.
Ah right, blame the patients. I accept email, my surgery chooses not to
use it. My GP surgery messed up my access to the NHS APP and then spent
ages blaming everyone else. Blaming other people seems to be a core
skill in the NHS.
Post by Andrew
The problems arise when a patient has multiple ongoing treatment
episodes at different clinics/firms within one hospital and
frequently across more than one hospital.
Do you understand what an integrated system should do, because it seems
that you don't?
Post by Andrew
These different
specialty's don't talk to each other. They frequently
prescribe medication that interferes with what another
specialty has instructed the patient GP to prescribe.
Yes, that is something an integrated IT system could warn people about.
Compatibility checks are an obvious thing to automate, no reason for a
doctor to have to remember all that stuff.
Post by Andrew
It's no good expecting an eye surgeon to understand what
is wrong the old biddy's colon because the expertise stops
at the neck and vice versa.
It is certainly a good idea for an eye surgeon to record the drugs they
have prescribed so that the colon surgeon can read them.

I know I had drugs prescribed on Saturday, which my GP could not see on
Wednesday. Luckily I took the packet. The Doctor then proceeded to blame
the pharmacist for giving me the wrong drug. The pharmacy they advised
me to see.

The IT systems are just absolute rubbish. It takes just a few minutes to
understand that.
The Natural Philosopher
2025-01-25 01:36:06 UTC
Reply
Permalink
Post by Pancho
The IT systems are just absolute rubbish. It takes just a few minutes to
understand that.
IME they are not bad and getting better.

The GP and the local hospital are fully joined up.

Its only the Cambridge hospitals that dont talk to the suffolk hospitals
that are the problem.
--
“Ideas are inherently conservative. They yield not to the attack of
other ideas but to the massive onslaught of circumstance"

- John K Galbraith
Tim Streater
2025-01-25 09:24:51 UTC
Reply
Permalink
On 25 Jan 2025 at 01:36:06 GMT, "The Natural Philosopher"
Post by The Natural Philosopher
Post by Pancho
The IT systems are just absolute rubbish. It takes just a few minutes to
understand that.
IME they are not bad and getting better.
The GP and the local hospital are fully joined up.
Its only the Cambridge hospitals that dont talk to the suffolk hospitals
that are the problem.
Trust boundaries ?
--
"The idea that Bill Gates has appeared like a knight in shining armour to lead all customers out of a mire of technological chaos neatly ignores the fact that it was he who, by peddling second-rate technology, led them into it in the first place." - Douglas Adams
The Natural Philosopher
2025-01-25 10:43:46 UTC
Reply
Permalink
Post by Tim Streater
On 25 Jan 2025 at 01:36:06 GMT, "The Natural Philosopher"
Post by The Natural Philosopher
Post by Pancho
The IT systems are just absolute rubbish. It takes just a few minutes to
understand that.
IME they are not bad and getting better.
The GP and the local hospital are fully joined up.
Its only the Cambridge hospitals that dont talk to the suffolk hospitals
that are the problem.
Trust boundaries ?
I really don't know to be honest
--
Truth welcomes investigation because truth knows investigation will lead
to converts. It is deception that uses all the other techniques.
Andrew
2025-01-25 20:53:51 UTC
Reply
Permalink
Post by Pancho
Post by Andrew
Post by Pancho
Post by Pancho
There is no reason for the NHS to still be at the Tower of Babel stage,
apart from medical experts refusing to adapt to IT systems, instead of
insisting IT systems adapt to them.
Do you **really** mean that?  Any good IT prectitioner will build
systems that are adapted to their users, that's what IT is for, it
helps users do their jobs.  Forcing users to do things differently or
in ways that don't feel comfortable is an absolutely certain way of
producing IT systems that fail.
I said it wrong, I meant individual doctors should adapt to
widespread IT systems. But I think you got my meaning.
The problem for the software developer is that different GP
surgeries, different hospitals do things in different ways. So a
software product can adapt to the working practice of a specific
doctor, area etc, but it will not be adapted to all the other doctors.
Err, I take it you have no actual working knowledge of NHS
systems like Patient Admin, Waiting Lists, Booking Lists,
Clinical data handling, Radiology and Radiography reporting
and plenty more ?.
I'm a patient. I have observed them working. I see obvious flaws in the
system. I understand. The problem is that many people in the NHS don't
seem to understand. Don't understand how to automate services, Don't
understand have information can be integrated.
Post by Andrew
Every NHS hospital functions along the same basic lines, so
a national standard Hospital system would be quite possible
and that is mostly there and has been for over 15 years. What has
held it back are the usual suspects who were given gargantuan
amounts of money to run the truly even more gargantuan database
required and are only interested in gouging as much money as
possible and not genuinely helping the NHS implement the most
effective systems. Not helped by endless committees who have to
make decisions for the 1.3 million staff and ultimately train
all the end-users (with high staff turnover) to actually use the
systems properly.
The NHS intranet allows doctors and other NHS users to
interact via secure email.
Erm? They can talk with email? Is that an achievement in 2025. It is a
pretty meagre achievement, and, as TNP notes their email, doesn't even
work. I was writing industry wide, electronic mail system for insurance
companies in the 1980s. Today I'd contract it out to someone like Google.
Post by Andrew
Patient data flows from Pathology
labs and other sources back to GP surgeries electronically
and has been for ages.
Does it? Not in my experience all the tests I have had recently required
me to pick up a paper form from the GP surgery and take it to the
testing centre. Some of the results then got lost. AIUI, this getting
lost is quite normal.
Not for me. No test results have ever been lost. Worthing hospital
used the NHS Intranet to send the results electronically back to
the GP practice.

If your GP uses SystmOnline then you can log in and see all your
medical history and test results online. You can make appointments,
and request regular prescriptions online -

https://systmonline.tpp-uk.com/2/Login?Date=20250125204132
Post by Pancho
If everyone had a broadband connection
Post by Andrew
and a tablet or PC and went paperless then the NHS could
become far more efficient but the NHS' bread and butter are the
12 million pensioners, notable the over 75's and this group
are mostly internet refuseniks and insist on paper appointments
send by mail, and using the bloody phone to make changes or
ask for things like test results.
Ah right, blame the patients. I accept email, my surgery chooses not to
use it. My GP surgery messed up my access to the NHS APP and then spent
ages blaming everyone else. Blaming other people seems to be a core
skill in the NHS.
Post by Andrew
The problems arise when a patient has multiple ongoing treatment
episodes at different clinics/firms within one hospital and
frequently across more than one hospital.
Do you understand what an integrated system should do, because it seems
that you don't?
Have you *any* working knowledge of the NHS and *really* big IT systems
like for example the ones run by clearing banks ?. If not, you have no
idea what an 'integrated system' even means.
Post by Pancho
Post by Andrew
These different
specialty's don't talk to each other. They frequently
prescribe medication that interferes with what another
specialty has instructed the patient GP to prescribe.
Yes, that is something an integrated IT system could warn people about.
Compatibility checks are an obvious thing to automate, no reason for a
doctor to have to remember all that stuff.
There you go again, using a word that you have plucked out a
dictionary without any understanding of how massive the NHS and its
data handling (and storage) requirements are.
Post by Pancho
Post by Andrew
It's no good expecting an eye surgeon to understand what
is wrong the old biddy's colon because the expertise stops
at the neck and vice versa.
It is certainly a good idea for an eye surgeon to record the drugs they
have prescribed so that the colon surgeon can read them.
I know I had drugs prescribed on Saturday, which my GP could not see on
Wednesday. Luckily I took the packet. The Doctor then proceeded to blame
the pharmacist for giving me the wrong drug. The pharmacy they advised
me to see.
The IT systems are just absolute rubbish. It takes just a few minutes to
understand that.
Says someone who has only ever worked on mickey-mouse commercial systems
that are utterly dwarfed by the size and complexity of the NHS.
Pancho
2025-01-25 23:51:27 UTC
Reply
Permalink
Post by Andrew
Post by Pancho
Post by Andrew
Post by Pancho
Post by Pancho
There is no reason for the NHS to still be at the Tower of Babel stage,
apart from medical experts refusing to adapt to IT systems, instead of
insisting IT systems adapt to them.
Do you **really** mean that?  Any good IT prectitioner will build
systems that are adapted to their users, that's what IT is for, it
helps users do their jobs.  Forcing users to do things differently or
in ways that don't feel comfortable is an absolutely certain way of
producing IT systems that fail.
I said it wrong, I meant individual doctors should adapt to
widespread IT systems. But I think you got my meaning.
The problem for the software developer is that different GP
surgeries, different hospitals do things in different ways. So a
software product can adapt to the working practice of a specific
doctor, area etc, but it will not be adapted to all the other doctors.
Err, I take it you have no actual working knowledge of NHS
systems like Patient Admin, Waiting Lists, Booking Lists,
Clinical data handling, Radiology and Radiography reporting
and plenty more ?.
I'm a patient. I have observed them working. I see obvious flaws in
the system. I understand. The problem is that many people in the NHS
don't seem to understand. Don't understand how to automate services,
Don't understand have information can be integrated.
Post by Andrew
Every NHS hospital functions along the same basic lines, so
a national standard Hospital system would be quite possible
and that is mostly there and has been for over 15 years. What has
held it back are the usual suspects who were given gargantuan
amounts of money to run the truly even more gargantuan database
required and are only interested in gouging as much money as
possible and not genuinely helping the NHS implement the most
effective systems. Not helped by endless committees who have to
make decisions for the 1.3 million staff and ultimately train
all the end-users (with high staff turnover) to actually use the
systems properly.
The NHS intranet allows doctors and other NHS users to
interact via secure email.
Erm? They can talk with email? Is that an achievement in 2025. It is a
pretty meagre achievement, and, as TNP notes their email, doesn't even
work. I was writing industry wide, electronic mail system for
insurance companies in the 1980s. Today I'd contract it out to someone
like Google.
Post by Andrew
Patient data flows from Pathology
labs and other sources back to GP surgeries electronically
and has been for ages.
Does it? Not in my experience all the tests I have had recently
required me to pick up a paper form from the GP surgery and take it to
the testing centre. Some of the results then got lost. AIUI, this
getting lost is quite normal.
Not for me. No test results have ever been lost. Worthing hospital
used the NHS Intranet to send the results electronically back to
the GP practice.
If your GP uses SystmOnline then you can log in and see all your
medical history and test results online. You can make appointments,
and request regular prescriptions online -
https://systmonline.tpp-uk.com/2/Login?Date=20250125204132
MY GP doesn't use system online. I've already mentioned, I used the NHS
App (which is similar). My GP no longer allows online appointment
booking. I've already mentioned trying to get an appointment via
eConsult and the disgraceful way it failed to help, destroying any kind
of audit trail.

Online repeat prescriptions are another prime example of a crap system.
Are you entitled to free prescriptions? You'd think a reasonable IT
system would give the patient the ability to register for free
prescriptions online, on the NHS App, or System Online. Instead, when
you pick up the prescriptions from the pharmacy, a paper form with
extremely small print, in a funny colour, is shoved at you, for you to
sign. No time to read it is given, even if you could read it, you don't
want to hold up the queue. You are just expected to sign. No evidence of
what you have signed is provided, no receipt. The NHS are then known to
issue millions of faulty penalty notices charging people with falsely
claiming free prescriptions.

I now routinely photo all NHS consent forms. More often than not, NHS
staff act offended, like I'm a troublemaker for doing so.
Post by Andrew
Post by Pancho
If everyone had a broadband connection
Post by Andrew
and a tablet or PC and went paperless then the NHS could
become far more efficient but the NHS' bread and butter are the
12 million pensioners, notable the over 75's and this group
are mostly internet refuseniks and insist on paper appointments
send by mail, and using the bloody phone to make changes or
ask for things like test results.
Ah right, blame the patients. I accept email, my surgery chooses not
to use it. My GP surgery messed up my access to the NHS APP and then
spent ages blaming everyone else. Blaming other people seems to be a
core skill in the NHS.
Post by Andrew
The problems arise when a patient has multiple ongoing treatment
episodes at different clinics/firms within one hospital and
frequently across more than one hospital.
Do you understand what an integrated system should do, because it
seems that you don't?
Have you *any* working knowledge of the NHS and *really* big IT systems
like for example the ones run by clearing banks ?. If not, you have no
idea what an 'integrated system' even means.
Ah, that old canard, again. You don't need to be a rocket scientist to
know that rockets that explode on launch have problems.

FWIW, I have worked for banks, I know the issues storing and aggregating
data from different sources. (I have no idea what you think is
significant about clearing banks)
Post by Andrew
Post by Pancho
Post by Andrew
These different
specialty's don't talk to each other. They frequently
prescribe medication that interferes with what another
specialty has instructed the patient GP to prescribe.
Yes, that is something an integrated IT system could warn people
about. Compatibility checks are an obvious thing to automate, no
reason for a doctor to have to remember all that stuff.
There you go again, using a word that you have plucked out a
dictionary without any understanding of how massive the NHS and its
data handling (and storage) requirements are.
An integrated system should be able to query a patient's medication
history and check new meds using a compatibility service. That isn't
hard. It isn't massive data. It can be distributed, data records don't
need to be held centrally.
Jethro_uk
2025-01-26 11:35:33 UTC
Reply
Permalink
If your GP uses SystmOnline then you can log in and see all your medical
history and test results online. You can make appointments,
and request regular prescriptions online -
Ours uses SO and you can't make appointments (you used to be able to).

Now the only online booking is for a "vConsult".

Also not all correspondence seems to be logged. I'm under a neighbouring
health authority and their letters don't show up.

If this was the first, not the forty first year, I'd be forgiving. But
they can't get fucking basics right. Basics that were bottomed out last
century.

Folk need to remember that the primary objective of any system is to
shovel money to the shareholders as efficiently as possible. Anything
else is moot. And if it works, well, you got lucky.
Joe
2025-01-25 15:37:07 UTC
Reply
Permalink
On Fri, 24 Jan 2025 21:54:06 +0000
Post by Andrew
Post by Pancho
Post by Pancho
There is no reason for the NHS to still be at the Tower of Babel
stage, apart from medical experts refusing to adapt to IT
systems, instead of insisting IT systems adapt to them.
Do you **really** mean that?  Any good IT prectitioner will build
systems that are adapted to their users, that's what IT is for, it
helps users do their jobs.  Forcing users to do things differently
or in ways that don't feel comfortable is an absolutely certain
way of producing IT systems that fail.
I said it wrong, I meant individual doctors should adapt to
widespread IT systems. But I think you got my meaning.
The problem for the software developer is that different GP
surgeries, different hospitals do things in different ways. So a
software product can adapt to the working practice of a specific
doctor, area etc, but it will not be adapted to all the other
doctors.
Err, I take it you have no actual working knowledge of NHS
systems like Patient Admin, Waiting Lists, Booking Lists,
Clinical data handling, Radiology and Radiography reporting
and plenty more ?.
Every NHS hospital functions along the same basic lines, so
a national standard Hospital system would be quite possible
and that is mostly there and has been for over 15 years. What has
held it back are the usual suspects who were given gargantuan
amounts of money to run the truly even more gargantuan database
required and are only interested in gouging as much money as
possible and not genuinely helping the NHS implement the most
effective systems. Not helped by endless committees who have to
make decisions for the 1.3 million staff and ultimately train
all the end-users (with high staff turnover) to actually use the
systems properly.
It isn't just IT. I had an operation in a well-known London hospital
about seven years ago. On admittance on the day of the operation, I sat
at a desk with a nurse and we filled out about a square yard of
paperwork. Paper. It was assembled into a folder.

The folder stayed with me, and after a couple of hours in recovery to
check that there were no leaks, I was trundled up a few floors to a
general ward for a couple of days. On arrival, a nurse said there was
some information that they needed. I handed her the folder and she said
that they didn't use that system, and we then covered another square
yard of paper. This was on a different floor of the *same* hospital.
Post by Andrew
The NHS intranet allows doctors and other NHS users to
interact via secure email. Patient data flows from Pathology
labs and other sources back to GP surgeries electronically
and has been for ages. If everyone had a broadband connection
and a tablet or PC and went paperless then the NHS could
become far more efficient but the NHS' bread and butter are the
12 million pensioners, notable the over 75's and this group
are mostly internet refuseniks and insist on paper appointments
send by mail, and using the bloody phone to make changes or
ask for things like test results.
Yes, I'm subscribed to such a system. It notifies me of appointments,
telling me the time and date and the clinical speciality involved. What
it doesn't tell me is *where* it is, not even which hospital. I have to
wait for a letter for that, which may arrive up to ten days after the
appointment is created.

Note that the bloody phone is the *only* real-time communication
method, and if the letter hasn't arrived by the day before the
appointment, and that has happened, my only way to find out where I'm
supposed to be is by phone.

The ten days, by the way, seems to be evenly split between the hospital
not getting the letter posted promptly, and the good old Post Office in
taking up to five days to delivery a letter franked 'first class'.
Post by Andrew
The problems arise when a patient has multiple ongoing treatment
episodes at different clinics/firms within one hospital and
frequently across more than one hospital. These different
specialty's don't talk to each other. They frequently
prescribe medication that interferes with what another
specialty has instructed the patient GP to prescribe.
It's no good expecting an eye surgeon to understand what
is wrong the old biddy's colon because the expertise stops
at the neck and vice versa.
Generally there is a 'most important' discipline that applies to a
patient, and other consultants are aware of this and generally check
with that department. On a couple of occasions, this may not have
happened, and I have myself raised the matter with the 'most important'
people. They do insist that any blood test be done in their London
hospital and not in my local hospital, citing delays and communication
difficulties, but I suspect they just don't trust anyone else.

I might add that most clinical and technical staff are extremely
competent, and it is administration which really lets the NHS down. I'm
not the first to have observed that.
--
Joe
The Natural Philosopher
2025-01-24 13:31:44 UTC
Reply
Permalink
Post by Pancho
There is no reason for the NHS to still be at the Tower of Babel stage,
apart from medical experts refusing to adapt to IT systems, instead of
insisting IT systems adapt to them. There is no reason for an
organisation the size of the NHS to not have effective messaging systems.
The NHS also seems resistant to receiving data, presumably for fear they
might be accused of interpreting it wrongly. So they throttle it to a
rate they can handle. In effect, they prioritise their own good name
above improving patient outcomes. Most industries ask for as much data
as you can give them, and are not concerned if they do not have time to
look at it. They just want to take the win from the occasions they do
have time, but the NHS is a blame culture.
I think I may have identified their problem.

It looks like they (MuChart) have a server that sends email via the
internal NHS email system where it gets sanitised and spat out to us
mere mortals.
It looks like the server they have, is not registered for SPF or DMARC
in the NHS.NET SPF record as a valid sender of email from 'nhs.net'. And
that a policy of 'well if its spam we will simply delay it rather than
reject it' policy is in use.

I have emailed a reply to their support stating what I had observed.

Maybe it will get fixed before next winter
--
It’s easier to fool people than to convince them that they have been fooled.
Mark Twain
Andrew
2025-01-23 22:54:30 UTC
Reply
Permalink
Post by The Natural Philosopher
Post by David Wade
Post by The Natural Philosopher
Post by Jethro_uk
Depends what it's purpose was.
You may have assumed it was to access their services.
They may have designed it so you can't.
It gets better. I hit the 'resend code' about 30 times. The last one
arrived delayed by over 10 hours.
Its an NHS service that enables you to view your appointments online.
It also appears to be geofenced. I can't few from Spain without a VPN....
Dave
Doesn't surprise me in the slightest. Its the fucking NHS after all.
And he is in *Spain*, not the UK
David Wade
2025-01-24 21:05:40 UTC
Reply
Permalink
Post by Andrew
Post by The Natural Philosopher
Post by David Wade
Post by The Natural Philosopher
Post by Jethro_uk
Depends what it's purpose was.
You may have assumed it was to access their services.
They may have designed it so you can't.
It gets better. I hit the 'resend code' about 30 times. The last one
arrived delayed by over 10 hours.
Its an NHS service that enables you to view your appointments online.
It also appears to be geofenced. I can't few from Spain without a VPN....
Dave
Doesn't surprise me in the slightest. Its the fucking NHS after all.
And he is in *Spain*, not the UK
Yes but they have arranged an appointment for me before I return, and I
was hoping to re-arrange it...

Dave
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