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NHS Toolkit takedown will inconvenience docs, not patients

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Analysis Patient care will not be affected by an NHS decision to pull a doctors' appraisal website offline to improve its security, but the life of UK doctors will be complicated.

The return of the NHS Appraisal Toolkit, which provides an online database that allows NHS doctors to prepare for their annual appraisals, is not due until 3 March. The removal of the resource means the assessment of the performance of 27,000 hospital doctors and GPs who use it will almost certainly be delayed, the GP who was the first to tell us that the site had been laid low explained.

"There is no back-up for those doctors using the system," the family doctor, who asked not to be named, explained. "They have been told they can phone the helpline and have their forms emailed to them (but not to their appraisers). Some but not many may have local copies on their desktops. Otherwise, it's a question of trying to get the info and keeping your fingers crossed."

The timing of the closure coincides with the run-up to appraisal deadlines for many doctors, so it could hardly have come at a worse time for many medics.

"Deadlines are technically fluid, but there is a contractual obligation for GPs to engage in a Primary Care Trust's appraisal process, which would normally run from April to March," the doctor explained.

"Hopefully PCTs will be amenable to date changes, I understand that there is a message from the Dept Health for them to be flexible. Otherwise the appraisals this year could be a bit of a waste of time as the info won't be available to either party. If they are rescheduled, that is all well and good, but many people will be at best significantly inconvenienced."

He added that some doctors may be forced to pay for locum cover to cover rescheduled assessment meetings. Despite the inconvenience and potential expense to doctors, patient care ought not to be affected.

"An important point though is that if appraisals don't happen, no one will be suspended or have to stop working, so patient services should be unaffected," the doctor explained. "In fact I would stress that, patients should be unaffected by this problem."

The doctor described the unscheduled suspension of the site as another example of an "NHS IT mess-up" and speculated on the reason for the suspension, which may be related to a move to upgrade the site to support more modern browsers.

"Whether it is related to the NHS mostly (almost exclusively) using IE6, I don't know. I hope there hasn't been an actual security breach because I suspect many doctors have potentially sensitive information in their appraisal documentation," he concluded.

The Department of Health said on Tuesday that the site was suspended as a precaution after an audit highlighted possible security shortcomings. It stressed that no breach had taken place, which is just as well because the site is a treasure trove of highly sensitive medical data containing information on doctors' performances alongside named patient data including near diagnosis mistakes, critical incidents and the like.

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Test the Managers not the GP's!

Its not the GP's that need assessing regularly, but the dictators who run practices now and treat patients as an unimportant inconvenience rather than the reason for the existence of the practice.

Id wish for an appraisal of the way practices are run, mine has taken a complete nosedive since merging with the other 2 in this area leaving ZERO patient choice. The most attentive and thorough GP has left the practice after continual complaints about him taking long than the standard "4 mins per patient" (or thereabouts) for consultation leaving many of us feeling that there isn't a doctor left there that we can trust - or actually has the time to get to the issue at hand, and yet there seems to be no government initiative to test the quality of management imposed on us by these faceless individuals, and its that issue that impacts on patients as much as any other

Everything is don't through an 08444 number and at the peak of chaos was resulting in queues of upto 20 mins, and a 3 week wait for a routine appointment. The changes needed in the NHS is to get rid of the bullsh*t practice managers who seem to have forgotten that the "kingdom" they rule is in fact a PUBLIC service paid for with PUBLIC money!

Fail because thats what the super practices do in terms of patient friendliness and accessibility!

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Back to the effects of taking down the site..

The NHS Appraisal Toolkit is the *only* place I, as a GP, would normally store most of the information I need for my annual Appraisal and keep for Revalidation (coming to all doctors sometime soon).

The GPs - and hospital doctors - affected are those who *have* to have an Appraisal before the end of the 2009/10 NHS year - i.e. 31.3.10.

If the site is unobtainable for any reason, there will be consequences for both the individual doctors *and* their Appraisers - both sets having to run to tight schedules at the end of the year.

As the GP interviewed said, this is stressful for all the doctors concerned, both appraisers and appraisees, but no risk to patients: the major complaint among GPs on different lists seems to be the failure to email the documentation needed when they request it.

After all, the numbers affected are relatively low - no more than 4/52ths of the doctors in the country (I am adding two weeks to allow for the doctors needing appraisal in the two weeks after 3.3.10: appraisers usually need two weeks to read through all the Appraisee's evidence).

Surely there must be a Disaster Plan covering this contingency?

Finally, this taking down of the site affects all doctors coming up for appraisal, not just GPs, and will no doubt be causing as much stress in hospitals as in General Practice - maybe more....

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Oh Go On

I know for a fact that the NHS and whoever they want to pay money to get the job not done run third party Google Analytics scripts on their HTTPS pages.

Like I don't know for shit but that strikes me as being totally fucking branedead with no available excuse.

Go on... Apply for an NHS job and see if Google is sniffing your panties.

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It would appear

that you are conflating the job of a relatively unqualified receptionist with that of someone who has spent five years in medical school, followed by up to eight years of hospital-based further medical training and continuous assessment before being allowed to work as a GP.

Since the whole Shipman thing, GPs are generally not allowed to work in a practice on their own; the knock-on effect of this being that GP practices have grown larger, with the associated need to employ a tier of practice management staff. I would suggest that this is down to the political interference in the NHS of MPs, rather than a lack of willingness of hard working medical staff to answer your phone call for a sick note.

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Anonymous Coward

It would appear....

You are wiling to be disingenuous.

There are thousands of single-handed GPs still practising. Shipman hasn't made a blind bit of difference (but the QIPP agenda will).

One thing that almost all GP practices have in common, large or small, is a tier of practice management staff -- with small practices employing one or two receptionists, and large ones employing many more. It's got sod all to do with political interference.

And the ability to provide patients with decent access to GPs (and nurses et al) is not correlated with the size of a practice. However, your chippy defensive response makes me suspect it's pretty shite at your practice, and that your default position is to blame the PCT for all your woes. If that's the case, then it's time for you to remember that you're supposed to be looking after your patients, that the PCT is your sole customer and it might be prudent to start behaving as though their opinions actually mattered, and finally that British GPs are the best-remunerated in the world, for all the moaning about what a dreadful deal they get.

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