Repetition « A Midwife’s Muse

Repetition

June 3, 2008 at 8:09 pm | In Midwifery, Paperwork, Pregnancy, Winds me up, Work | 16 Comments
Tags: pregnancy notes

Booking paperwork or, why I don’t have enough time for my women -

Complete a Registration form. Name, Address, Phone numbers, DOB, NHS number, LMP, EDD, G.P, Practice number, Named midwife, Hospital booking at, Lead professional, Obstetric history, Medical history, BMI.
Fill out green notes. Name (on every page), Address, Phone numbers, DOB, NHS number, LMP & EDD (on 3 pages), Next of kin, Emergency contact, Lead professional, Hospital booking at, G.P, Named midwife, Contact numbers for hospital (Switchboard, antenatal clinic, labour ward, community midwives office). That’s the 1st page completed! Personal details, Partners details, Ethnicity, Full medical history, Family medical details, Previous pregnancies, parity, Blood and screening tests checklist and consent obtained, Summary of timings of scheduled antenatal appointments, blood tests, ultrasounds. Height, weight, BMI, record of booking blood pressure, special features. Name of booking midwife & signature x 3.
Complete NHS Family origin questionnaire form (triplicate, copies to be attached to notes & blood forms). Name, address, DOB, NHS number, G.P, EDD, Hospital.
Complete blood request forms x 5. Name, address, DOB, NHS number, Phone number, G.P, Practice number, Hospital booked at, EDD, parity, gestation.
Complete maternity exemption certificate. EDD, Midwives PIN number & name. Signature.
Complete scan request forms x 2. Name, Address, DOB, NHS number, Phone number, G.P, Practice number, Hospital booked at, EDD, Date of previous scans.
Record in caseload register. Name, Address, DOB, NHS number, Phone number, G.P, Practice number, Hospital booked at, Lead professional, EDD, intended feeding method
Fill out front page of hospital notes Name, Address, DOB, NHS number, Phone number, G.P, Practice number, Lead professional, EDD.

Can anyone see the real frustration about this?

In today’s computer age, where a one off entry could print off everything required, I spend precious time writing out the same information over and over again. What is truly gauling is that one of the sections I have to complete involves an explanation of data protection and how the provided information may be used – “ to monitor health trends, strive towards the highest standards, increase our understanding of adverse outcomes, make recommendations for improving maternity care “. Hang on, what was that last item? “To make recommendations for improving maternity care”. Well I’ve got a really easy suggestion for them, free up the midwives to practice midwifery by cutting down on the paperwork repetition.

Want to see the green pregnancy notes, which are now supposed to be used nationally? Here’s the link.

16 Comments »

RSS feed for comments on this post. TrackBack URI

I have exactly the same form as that for new girlfriends; which is why I live alone.

Comment by punctuation — June 4, 2008 #

Reply
Will a system like RiO sort this out? I work for a Trust (mental health) that is in the process of going live with RiO, and it certainly sounds good.

Comment by Anne — June 4, 2008 #

Reply
punctuation – I can see that asking them about their partner and requiring an emergency contact number may make them think twice about your intentions!

Comment by midwifemuse — June 4, 2008 #

Reply
Anne – I had never heard of RiO, so web-trawled. The info I could get was rather scant but it would seem that if all the systems were compliant then it would save a lot of duplication. Since we have not even been issued with SMART cards though I would doubt that reducing our paperwork by investing in a computer programme would been seen as the way forward. The whole way that the health service operates, or doesn’t, regarding computers is absolutely ridiculous, every hospital, every G.P’s surgery using different systems and now this fiasco with Fujitsu just shows how absolutely useless those in charge really are.

Comment by midwifemuse — June 4, 2008 #

Reply
But you can see how a “maternity exemption certificate” could be a very useful thing to a feckless soul like myself.

Comment by punctuation — June 4, 2008 #

Reply
It looks like what you need to reduce all that duplication is a decent database. Oh yep, you already mentioned that computer systems are rubbish. But honestly, that would solve the problem – with a decent database you shouldn’t have to complete the same data twice, that’s what they’re for. It would also save trees (hugs the nearest tree). I looove the green paper, would keep me entertained for hours (chuckle).

Comment by cartside — June 4, 2008 #

Reply
cartside – Perhaps the ’saving the planet’ approach would be the way to encourage the powers that be to invest in a decent computer system.

Comment by midwifemuse — June 5, 2008 #

Reply
What happens is a patient refuses consent for data sharing? Legally this is a patients right? If a health professional unduly infleuces/pressurises a patient etc over this that could be a complaint to the NMC.

I really need to look at this now. Feeel free to email me in complete and total confidence.

As well as Campaigning we also provide an advice/information line on medical confidentiality are happy for people to contact us anonymously.

I founded The Big Opt Out because as a patient I could not opt out of having my medical information shared. My MP Paul Goodman obtained an debate in Parliament and spent several years working on my case. I was very concerned if I could not opt out with over 20 years experience in the NHS what about everyone else? I also discovered that there was no voluntary organisation offering specialist advice on medical confidentiality. Its a vast and complicated area of medical ethics.Hence I joined forced with some doctors,NO2ID and a Prof of Security and Engineering The Big Opt Out was born. We have all been working together on medical confidentiality for about 4 years and The Big Opt Out started Nov 2006. I also discovered that there was no voluntary organisation offering specialist advice on medical confidentiality. Its a vast and complicated area of medical ethics.

All patient/health professional queries are in strict confidence and are answered by NHS Managers or Nurses.

I really do need to look at this. Feel free to contact me anonymously in complete and total confidence.

The Big Opt Out
http://www.thebigoptout.com

Comment by tboo — June 6, 2008 #

Reply
tboo – As you can see on page 2 of the green notes we are compelled to inform patients of their rights re. data protection. I have never had a woman refuse to allow her information to be used or entered on to a computer. I’m not sure what you mean by pressurising or influencing, I can’t imagine how I could do this, or why to be honest. If I do come across anyone who expresses concerns I shall give them the details of your organisation.

Comment by midwifemuse — June 6, 2008 #

Reply
The problem is that when a patient wants to opt out in our experience they are put under a lot of pressure to allow the information to be shared especially from PCT’s. One PCT has refused a patient treatment unless they can talk to her GP,about her refusal to share info! We have had several cases of this nature. Even Dr Foster gets a copy of all the info you collect, in identifiable format including Mother and Baby discharges. Its really frightening.

The Big Opt Out

Comment by tboo — June 6, 2008 #

Reply
tboo – Who releases the info to Dr Foster, and why does it need to be in identifiable format? I shall check this with my manager ASAP as I find it totally unnecessary. I’ll let you know her response.

Comment by midwifemuse — June 6, 2008 #

Reply
The Hospital Trust will send the Mother and Baby database to a database called SUS Secondary User Service at BT (THE PHONE COMPANY). BT send the identifiable patient info to Dr Foster, the PCT, Strategic Health Authroity and the DH. Anyone can apply for access to the data if the purpose is good enough. They have to apply to the PIAG Patient Information Advisory Group at the DH. It also applies to ALL hospital outpatient and inpatient admissions. When the NHS Care Records go live it will apply to GP records too! ALL the data is fully searchable and identifiable. The DH know its unlawful and admit this in DH Minutes and they do not want a patient to legally challenge it! Its in their MInutes!!! It breaches the DPA, Common Law of Confidentiality and Human Rights Act. Dr Fleur Fisher (former Head of the BMA Ethics Dept) and Prof Ross Anderson from Cambridge University have been fighting this since the mid/late 90’s. We all joined forces and The BIg Opt Out was born. We have been working together for about 4 years now on this.

Its unlawful, there is no opt out and it applies to absolutely all hospital outpatient and inpatient treatments/attendences. All Mother and Baby discharges are sent to the database. There is a dataset for Mother and Baby discharges for the datbases which includes proposed contraception, if I remember correctly.

Your own recent hospital treatment will have been sent to. That is how I was mistaking labeled as an Alcholic Paul Goodman had to get a parliamentary debate to get all data removed. Even then it was still resent to the datbase and Caroline Flint former Health MInister had to make a formal apology to the House of Commons.

There is absolutely no confidentiality in the NHS. I am bringing a GMC Case the Director of Public Health at my PCT as she is failing to provide with health care unless I agree to go back on the database. My case is very complex.

I am completely deregistered from the NHS and my GP see me free of charge.

Last Sunday Radio 5 did a programme to try to expose this, especially Dr Foster.

Its why I left the NHS as when I researched this I was horrified I doubt your Manager will know about it. If your PCT is the same as mine I have kept their Solicitor busy for the last year with this. I dread to think of what their legal bill is.

TBOO

Comment by helen — June 7, 2008 #

Reply
tboo – I’m gob-smacked! I’m also furious about this and feel that I have been put in an appauling position where I am, unwittingly, betraying my women’s, and their families trust. I am horrified about the underhand way in which it appears that patient confidentiality is being betrayed.

Comment by midwifemuse — June 7, 2008 #

Reply
If a switched on women who saw YOU found about this then yes there is the potential for a complaint to the NMC. No I not having a go at you at all just purely trying to raise awareness. It also puts you at professional risk.

I very much doubt your Manager knows anything about this. I did n’t as an NHS Manager. Its only because I worked in the NHS for over 20 years and put all the jargon together when trying to opt out of the NHS Care Records. This is why Paul Goodman pursued my case and secured a parliamentary debate. I then found that Ross and Fleur had been actively working this- we have been working together for about 4 years now. GP’s etc started contacting Paul Goodman about my case when it came into the Press I wasn’t your average patient. Hence how we all joined forces.

UCLH where I have worked and was a long term patient got so worried they gave me complete original paper records and removed me from their PAS system.

What is frightening the DH admit its unlawful yet refuse to allow patients to opt out. The latest DH document we have recived last week says if patients don’t like it they can refuse treatment!

No at TBOO we are not against computerised medical records or medical research but it should be with a patients fully informed consent.

This why I set up TBOO as there is not another patient organistaion that can offer detailed advice/info to patients on medical confidentiality.

I can back this all up with DH documents etc if you need them. Just email me in COMPLETE CONFIDENCE admin ATthebigoptout.com

I think your PCT is the same mine that I am having the legal battle with over this. Do let me know what happens?

TBOO

Comment by helen — June 8, 2008 #

Reply
Helen – Thank you for your input. I’m putting together an entry on this topic now, and the more I look the more uneasy I feel.

Comment by midwifemuse — June 8, 2008 #

Reply
[...] @ 8:42 pm Tags: NHS Spine, opt-out, patient confidentiality Last week I wrote an entry entitled Repetition bemoaning the number of times of that I had to enter exactly the same information, on different [...]

Pingback by NHS Confidential? « A Midwife’s Muse — June 8, 2008 #

Reply