NHS Waiting times.

Its not often I get to blog from actual experience and while I cannot claim to work for the NHS department responsible for dishing out statistics, its fair to say - from my desk situated at the throbbing heart of Scotland's National Health Service - I can offer something of an insight into How Things Really Work.

This post might be a bit dull, so I'm including The Seven Wonders of the World to keep you interested. The Great Pyramid of Giza is first. Impress friends at dinner parties by referring to it by its lesser known names; The Pyramid of Khufu or Cheops.

First of all, I and the people who sit around me are the NHS staff most folk want to see the back of. It's in this building (among one or two others) where all the managers and bureaucrats so reviled by the taxpaying public work. However, people who work here do things like make sure lead gonad shields and aprons in x-ray departments aren't riddled with holes, negotiate contracts to make savings worth millions, plan new hospitals & health centres so they are fit for purpose - like checking doors are wide enough to allow ordinary or bariatric hospital beds (that we buy) to pass through or that new over-bed tables will actually go over the beds or (somewhat more critically) making sure women's bits aren't overly irradiated during mammography scans plus a heck of a lot more besides.

The bit that I work in concerns itself with hospital equipping; its where the people who know about things like electro-medical or lab equipment sit. You can't just go out and buy a blood analyzer, pharmacy robot or a PACS imaging system for medical imaging (be that x-ray, CT or CAT scanning.) These things are often part of the fabric of the building so require a fair bit of forward planning.

The Hanging Gardens of Babylon. Babylonian Priest Berossus attributed their existence to Neo-Babylonian king Nebuchadnezer II - he was so cool; in The Matrix, Morpheus named his ship after him.

The next time you're in a hospital or health centre, look out for bins - why? because bins are a pain in the arse. Every room must have at least one and it needs to be the right kind. If its a treatment area it'll need to have a domestic bin and a clinical waste bin - they'll also need to be the right size. I haven't even mentioned user preference - I mean to say - you'd think a bin was a fucking bin, but its not. You get solid walled bins, bins without walls, plastic bins, metal bins, bins of different colours (white for domestic waste yellow for clinical waste and red for body parts (joking) the entire bin can be coloured or just the lid.) You get soft closing bins (the standard these days) and waste paper bins also of different colours and capacities. Where I work, we make sure every room that needs a bin gets a damn bin. Take a project like Aberdeen's Emergency Care Centre; across seven floors we distributed 693 sack holders, 329 small pedal bins and 429 sanitary disposal bins. And its not just that, its everything from plug sockets to bog roll holders and paper towel dispensers, laboratory equipment to gamma cameras and CT scanners.

Zeus at Olympia; made famous by Laurence Olivier in the original (and much better) film Clash of the Titans.

Over and above all of this, for clinical areas we also have HAI compliance - which stands for Healthcare Associated Infection - this is the reason nurses get all frowny when you sit on hospital beds or patient chairs, its why there are bottles of hand wash every five metres and its why buying hospital equipment isn't straight forward. For example, in examination areas you won't see any fabric covered furniture, it'll be vinyl; there will be blinds instead of curtains and there shouldn't be any untreated wood visible - even floors in new builds curve as they join walls so germs can't congregate in hard-to-clean corners.

But I digress.

This is also where the people who punt out all those statistics on waiting times, cancellations and attendances sit - its called Information Services Division. I say that, the name might have changed, we've just been through a reorganisation and if I'm being honest, I'm no longer sure what division I work in, never mind ISD.

Temple of Artemis at Ephesus. Sometimes (although less accurately) known as the Temple of Diana - what ever you do, don't let The Daily Express know. 

In the 'news,' you'll never guess; we have Jenny Marra from Scottish Labour claiming credit for an SNP government U turn which didn't happen on a policy which up until that point Labour MSP's didn't give a shit about.

Its been a while since 'Scottish' Labour had the reins of government in their grubby little mitts, but when they did - they didn't report NHS statistics with any regularity - which leads us to my point.

As you would imagine, its a lot more complicated than you might think - to go from quarterly to weekly reporting is no mean feat, in fact, I imagine it'll present significant challenges. There are fourteen NHS boards in Scotland who collect & own the data required. Sitting to one side is National Services Scotland which is essentially thought of as another board but is mostly not patient facing - its where all those pesky managers and bureaucrats are - all that data coming from the boards needs to be shared with ISD (which is a division of NSS) then crunched.

The Mausoleum at Halicarnassus. Well this is awkward, A.K.A The Tomb of Mausolus, who was interred there with his wife Artemisia II of Caria... Who was also his sister... (As you do...)

Except the word 'crunched' doesn't do it justice - its massive undertaking in terms of computing time. Also some of the data is patient identifiable - a huge no-no - so needs to be anonymised. After that it needs to be checked and checked again.

Take Orkney, home to the smallest NHS board serving just under 20,000 people. In Dec 2014, 419 A&E attendances were recorded. Hospital in-patient activity to September 2014 saw 1457 (Quarterly figure) patients treated across all specialties. At the other end of the spectrum you have Greater Glasgow & Clyde who's A&E departments saw 36,118 patients in December 2014 and saw 423,926 in-patients treated to the end of September 2014.

The Colossus of Rhodes. Accounts differ, I like to think he stood astride the entrance to Mandraki harbour as drawn above. It was a statue of Helios; the Greek Titan-God of the sun. Some say Colossus referred to its height (some 30m.) There are scholars who believe it is what seafarers thought when they looked up and saw his 'package' as they entered the harbour. (I made that up.)

I know I'm being a bore, even finding the information in the previous paragraph took monumental patience and while I didn't contemplate suicide as such, I never ruled out self harm.

Suffice to say, those figures represent the two boards at either end of the range in terms of population and represent a fraction of the patient facing activity all boards take part in. We haven't even mentioned the number of GP appointments or home visits, or talked about referral waiting times across all the various services the NHS in Scotland provide - not limited to cancer care, child health, drugs & alcohol misuse, dental care, health & social community care, heart disease, maternity & child birth, mental health (adult and child), sexual health, strokes and a good bit more besides.

The Lighthouse at Alexandria.Finished in 247 BC, it was finally abandoned in 1323 AD after earthquake damage. During that time, it was the tallest structure (120 to 137m tall) in the ancient world - which is impressive, but not as impressive as Helios' balls as you entered Mandraki harbour.

To get stats in all, or even some of those areas published on a weekly basis is going to be tough. I'm told the relevant departments are enthusiastically recruiting statisticians and analysts - bearing in mind, a large number saw their jobs evaporate during a previously severe workforce contraction - to get the figures out on a monthly basis. 

No doubt the clueless (and slopey shouldered) Jenny Marra will be on hand to bemoan the number of so-called backroom staff employed by the NHS in Scotland.