DID you read in yesterday’s Adver about the boss of IMH apologising over its appointments fiasco at five GP surgeries?

A senior figure from Swindon Care Commissioning Group also said they were sorry for the situation which has seen, among other things, patients left on hold for well over an hour and appointments cancelled by text at a half-hour’s notice.

The CCG, which turned the five surgeries over to the tender mercies of IMH, says it’s holding a learning event to find out what has gone wrong and how the situation might be improved.

I have no idea what a learning event is, but it sounds as though it might be quite expensive and time-consuming, perhaps involving lots of meetings, focus groups, and buzzword-laden proceedings in which people talk about paradigms, stakeholders and suchlike.

As I care deeply for the NHS and know it needs every spare penny, I offer the following thoughts to the CCG in the hope of speeding the learning process somewhat:

1.) Engaging the services of private companies to help with NHS duties can save money - but only if the whole affair doesn’t turn out to be an unmitigated disaster.

2.) Definitions of unmitigated disaster in the case of booking systems at GP surgeries include, but are not limited to, patients having to wait ridiculous amounts of time and having appointments arbitrarily cancelled.

3.) Possible outcomes of the problems listed in point (2) include patients with very serious illnesses giving up trying to secure appointments, with potentially lethal consequences. Other possible outcomes are patients not securing treatment before minor ailments become major, and panicking patients unnecessarily burdening A&E units and walk-in centres.

4.) These negative possible outcomes, quite apart from being outrageous and disgusting, might end up costing the NHS so much in unnecessary pressure on other resources, not to mention the potential costs of settling entirely justified compensation claims, that the added expense might wipe out any savings accrued from hiving off a vital service to a private company in the first place.

5.) Just in case anybody needs a reminder, patients are not statistics. They are not numbers to be switched from column to column on a balance sheet. They are not abstract concepts. They are living, breathing human beings who deserve to be treated with dignity and respect - not least because the taxes gouged out of their pockets every month or every week pay for the NHS in its entirety.

6.) When deciding how to run an appointments system for a GP surgery or several of them, calculating how many workers are likely to be needed at the call centre at any given time is not especially difficult. Start with the number of people who staffed the phones before the new organisation was brought in and ask yourself whether there were any horrendous, wretched delays. If there were not, the chances are that you have hit on the appropriate number.

7.) If the organisation you are thinking of bringing in claims it can do the job with fewer people, ask yourself whether there are likely to be fewer patients or fewer illnesses. If the answer is in the negative, you might wish to query the claim.

8.) A great way of regaining the confidence of the public after a catastrophe such as the one involving IMH is to apologise, to admit the situation is unacceptable - and then to set out a clear and binding schedule for change. If there is no such schedule, you might as well not bother. Patients are not naive or stupid.

9.) Another great way of regaining public confidence is to tell your hireling that unless it can completely change its dismal performance within weeks, it must sling its hook.


WELL done to Pets at Home, the pet supplies chain, for inviting parents to take their children to free pet care workshops during the February half term.

The workshops will focus on caring for smaller animals such as hamsters, gerbils and rabbits, but I hope they prove such a success that larger animals with more complex ways can be included in future sessions.

Cats, for example. Friendly workshop leaders might even bring in their own cats to help the children learn.

“Look at the expression on this cat’s face, everybody. See how it’s looking all starving and pitiful, like one of those animals you see in adverts for charities such as Cats’ Protection and the RSPCA.

“Can anybody remember what to do now? Should we feed the cat straight away?

“That’s right, we shouldn’t feed the cat straight away. We should check first with everybody else in the house and ask them whether they’ve fed the cat. We’ll probably discover that the cat has been fed half a dozen times in the last hour alone.

“And can anybody remember the best way of telling which person from a group of 20 or 30 of our friends or relatives is allergic to cats, even if they don’t know themselves?

“Correct! The allergic one among the 20 or 30 is the one our cat zeroes in on like a guided missile and insists on sitting on their lap.Or their head.

“Finally for today’s session, does anybody remember why it’s important to buy your cat a scratching post?

“Well done!It’s important to buy the cat a scratching post because charity shops do great work and a scratching post is a fine thing to donate after your cat takes one look at it, turns its back and carries on shredding your sofa. But remember not to throw the box away, as your cat will want to sit in it, looking vaguely contemptuous.”