The ambulance IT system

I read this article and was shocked.

"Urgent talks are underway to save a computerised capacity and activity monitoring system (CAMS) used to direct ambulances to hospitals best placed to deal with patients after PCTs in the East of England SHA withdrew their funding.

The East Anglian Ambulance Trust and acute trusts across Norfolk, Suffolk and Cambridgeshire are in last minute talks with East of England (EoE) SHA to prevent the screens going blank on 7 March 2007."

Instead of just withdrawing the funding (£175,000 per year), why can't the PCTs actively find ways to make it financially worthwhile. There are clear technical and productivity benefits - so it would definitely be worth saving.

Apparently there has been a massive overspend of £175m. What happened to proper financial planning and project management? I learned that sort of thing at A-Level and this is a government project - so they should know this stuff. It's just plain ridiculous.

Nurses update the system's information on a two-hourly basis and it contains details of the number of empty beds and waiting times. That sort of thing can be essential as there are many cases where patients need to get to hospitals as soon as possible and if they arrive at one that's full, they could die.

Recent evaluations of the system show that it can save a lot of money and it tends to divert around 5% of patients. That might not seem much, but when you consider the number of busy A&Es across the country, it can add up to quite a few people.

The reporter for E-Health Insider mentioned:

"Losing CAMS is unlikely to endanger patients, sources told EHI, as hospitals have a duty to treat patients in an emergency. But it will mean the ambulances and trusts revert to pen and paper."

Considering that the NHS is implementing the National Programme for IT, which supposedly revolutionises the way hospitals work, this goes against the objectives of the government project.

In the FrontPoint Systems blog, they call it "short-termism" in this entry. It's certainly that. There have been many cases where businesses have initially made losses, but then gone on to make a profit. Why can't the PCTs see that the savings will eventually cancel out the epxense (ok, it might be a long time given the overspend, but it will happen eventually).

The key objectives in the strategic action plan for the Welsh version of this system are:

• Provide and coordinate an increasing range of mobile healthcare for patients who need urgent or unscheduled care
• Provide an increasing range of other services and alternative care pathways, e.g. in primary care, diagnostics and health promotion
• Improve the speed and quality of service provided to patients with emergency care needs
• Improve the speed and quality of call handling, provide significantly more clinical advice to callers, and work in a more integrated way with partner organisations to ensure consistent telephone services for patients who need urgent care
• Improve overall efficiency, effectiveness, consistency and quality of care provision
• Ensure Trust compliance with the Civil Contingencies Act 2004
• Provide strong leadership, both clinical and managerial, so that organisation structure, culture and style match new models of care

Those objectives will be the same as the English version, and they are worthwhile objectives. Why not do something to keep the system going?

So, what do you think?

Technorati tags: Ambulances, IT, Healthcare

The war on terror

Ever since September 11th, 2001, there's been one thing that's dominated the news - the war on terror. There's been so many sub-plots and it's near impossible to tell when it will end. Despite the fact that I find terrorism abhorrent, I disagree with the war.

It all started with an Al-Qaeda attack on the World Trade Center. For a while, the United States concentrated on trying to find Osama Bin Laden, but for some reason the objective suddenly changed from that to wrestling power from Saddam Hussein in Iraq. There are no proven links between the two people. There is no evidence to suggest Osama was hiding out in Iraq. There was no reason for the primary target to change.

Ok, so the focus switched to Iraq. Weapons inspectors were sent in to see if Weapons of Mass Destruction (WMDs) existed in that country. The inspectors weren't able to complete the inspection and no proof was found - yet the war still took place. Sure, a guy responsible for the deaths of many innocent people was brought to justice, but was he brought to justice in the right way?

To figure out the answer to that, we need to sidestep for a second and look at the Charter of the United Nations. All member countries must obey the contents to stay as members of the organisation.

Article 2, point 3:

"All Members shall settle their international disputes by peaceful means in such a manner that international peace and security, and justice, are not endangered."

Article 2, point 4:

"All Members shall refrain in their international relations from the threat or use of force against the territorial integrity or political independence of any state, or in any other manner inconsistent with the Purposes of the United Nations."

Article 24, point 1:

"In order to ensure prompt and effective action by the United Nations,its Members confer on the Security Council primary responsibility for the maintenance of international peace and security, and agree that in carrying out its duties under this responsibility the Security Council acts on their behalf."

What the US did wasn't exactly peaceful, so that's the first of the above broken. The US were also using force against Iraq's territorial integrity - that's the second one broken. The third one is also broken because the United Nations Security Council never agreed to the US starting a war. It was also pre-emptive, yet we have a legal system which says innocent until proven guilty.

Anyway, enough about Iraq for now. Since Saddam was taken out of the equation the US switched to focus to Iran and the country's president, Mahmoud Ahmadinejad. He says that the US is "the great satan". Since that was said, people assume that he is going to launch an attack on the US. However, people have threatened others in normal life and it's just been words. There is nothing to prove (at the moment) that it's not the same thing with Ahmadinejad.

The following quote is from this article:

"The US and its Western allies suspect Iran of using its nuclear energy programme as a cover to produce atomic weapons. Tehran denies this claim."

The key word here is "suspect". There is no proof that Iran's nuclear programme has the objective of making weapons. It could just be something to power homes - like Britain's nuclear programme. Also, it's a bit hypocritical for the US and UK to say that a country should be prevented from creating nuclear weapons when they have a stockpile of their own already!

My next point is about all the soldiers that have been to the Middle East. They have done their job to the best of their ability - many sacrificing their lives in the process. For that, I have a massive amount of respect for them. It wasn't their fault that they were sent there.

To conclude, I would say that the United States broke the rules of the UN Charter and initiated a pre-emptive war against Iraq without any proof they had WMDs. They may have removed Saddam Hussein - which is a good thing - but they went about it in the wrong way. Too many soldiers have lost their lives and now the focus has been put on Iran, when there's no proof that they are producing WMDs either. On top of that, the original objective of finding Osama Bin Laden has not been achieved. Hopefully, you can see why I disagree with the war on terror.

So, what do you think?

Technorati tags: War, Terrorism, Politics, Iraq, Iran, Afghanistan

Why would you want to work for someone?

I found this story after reading something about the huge bonuses offered to the executives at Google (exec bonuses is a rant for another day). It's about the top 100 companies to work for in the United States. At the top is Google, which isn't entirely surprising if you look at the percentage of people they recruited in one year. Although staff turnover wasn't mentioned - that would have been an interesting figure to see.

Microsoft is way down at 50. As the two corporations compete against each other, this could be seen as a big blow. MS is a much bigger company too, so you would think it could afford a better environment. However, you have to think of what makes a good environment. Is it facilities? Is it the atmosphere created by the team you work with? Is it the knowledge that you will be well paid for your hard work? Is it basic job security? (I say basic because it's low down on Maslow's hierarchy of needs.)

There's no single answer for everyone. It's likely that it's more than one thing that makes the ideal environment for someone too. As this is such a complicated issue, there have been many theories about how to make employees happy.

Apart from Abraham Maslow, there was also Elton Mayo and Frederick Herzberg who had popular theories.

The image below is a diagram of Herzberg's Two Factor Theory:

You'll notice two things - Hygiene factors and Motivation factors. Here are some examples:

Hygiene

• Working conditions
• Quality of supervision
• Salary
• Status

Motivation

• Achievement
• Recognition for achievement
• Advancement to higher level tasks
• Growth

This page shows the results of the different combinations of hygiene and motivation. It's clear that high amounts of both equals a happy worker. However, does a company invest money and time in all of the examples, or just some of them. If it doesn't get it right, then staff turnover increases and productivity goes down (I should mention at this point that staff turnover can be deceptive if you have a large amount of employees on short term contracts). Also, smaller companies might not be able to invest enough to get the balance.

Mayo's theory was the Human Relations Theory. He stated that:

"One friend, one person who is truly understanding, who takes the trouble to listen to us as we consider our problems, can change our whole outlook on the work."

What this means is that he believes that working relationships (especially with management) is the most important thing. If you make friends at work, they can make the day go quicker and they may even improve the way you do work because of their different background and possibly greater experience. If you work well with the management, it's likely that they'll be more receptive to what you say and you could get further in whatever business you're in. However, this is a two-way thing. The management have to be open to the ideas of others. Without that, people leave and profit takes a dive. For a full list of points from Mayo's theory, click here. The problem with this theory is that even if the workforce gets along with each other and can easily talk to the management, the business won't be a success if the facilities aren't appropriate/up-to-date/of a certain quality.

What a business should do is ask the existing employees what they want. If it's possible, then they should invest in it. Note the word possible though. If management says yes to everything, they may make promises they can't keep or get into financial trouble if they way to get a thing is to spend money. As well as ask, they should observe. Observation can get different and/or more information that can be useful.

So, what do you think?

Technorati tags: Employment, Jobs