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Haven't they heard of email? The NHS may be undertaking the largest civilian IT project ever, but the managers sure seem fond of paper.

Boards of NHS Trusts created at least 22 million paper documents in the past two years, generated for communications to senior managers, and to each other. The number is probably higher, since only 258 of the 430 Trusts have so far complied with Freedom of Information requests.

The South West Essex Trust was the worst culprit, generating 333,000 documents, but four of the five worst offenders were in Teesside: Hartlepool, Middlesbrough, Redcar and Cleveland and Stockton on Tees teaching Trust. Why Teesside? It must be the Parmos.

The paper trail was unearthed by researcher Kirsty Skinn.

The NHS has over 42,000 managers and the Department of Health burned through almost half a billion pounds in fees to external consultants in the year 2009-2010, we learned from the release of the Coins database last week.

Health watchdog the King's Fund reports that while the number of staff rose 35 per cent from 1999 to 2009 (to 1,117,000), the number of managers rose by 85 per cent.

Someone should hold a meeting. ®

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