Yeah see I've been round this buoy professionally, so please bear with me.B0ll0cks.
I cant not reveal the source but there are 220 (ish) NHS Trusts in NHS England and many Trusts have multiple hospitals. A request went out for data for the centre to analyse - specifically they wanted chest x-rays of Covid patients.
Care to guess how many of the NHS England hospitals responded - not Trusts (with multiple hospitals) - hospitals. Go on. Have a guess.
18. Fcuking 18 hospitals.
NHS my arrse. the hospitals are empty.
220 people made redundant last week in one of the Clinical Support Units. There are 136 Clinical Commissioning Groups in NHS England. A CCG is basically a collection of GP practices and the CSUs provide support services to them GP practices. The reason for the redundancies is because the GPs are not making any referrals to hospitals for operations, scans etc, so they have laid off the support team because the have fcuk all to do.
Do you know how the NHS economy works?
GPs get paid for referrals. The hospitals get paid by the DoH for carrying out the treatment/operations.
One of the largest suppliers to the NHS has seen a 70% collapse in revenues because there are no operations being performed. They are currently sat on $50m of inventory in their supply chain that has not moved for 6 months.
Come back when you know what you are talking about.
Just off to clap for the NHS and stick my flag up.
Enjoy the pay rise. I took a 30% pay cut and my mrs took 15%.
I did something very similar in March/April time, albeit with a different dataset and at a slightly smaller scale so I do know something of the challenge. I won't say anymore than that as I'm bound by confidentiality.
The first thing is there is no 'centre' really with the NHS. Sure PHE or the DHSC can request any data they want of the clinical trusts but they are under no obligation to actually provide it. The nearest thing to a chain of command that could would be the NHS regions but chest x-rays may simply not be their priority.
But let's say the regions get on board with request and pass it on to the Trusts. This is where it gets really interesting. Firstly, there may be no mechanism for transferring the data that's been demanded. Do you want electronic files or physical images? Let's assume electronic, what format and what's your transfer mechanism? E-mail? Via a portal? FTP? Upload to a database?
Where do you send them? Who's collating them? How should files be labelled? What data retention policies are in place and do they align with the sending Trusts?
All of that's called Data Governance and every Trust has different policies in place. Equally they all have their own data management systems which usually don't talk to one another. So if you're the Trumpton NHS Trust it may be physically impossible to send clinical data to Camberwick Green next door. Let alone that there London.
Lastly, and this is from personal experience, there's what happens when a new request for which there is no process in place actually lands with the Trust. Usually it gets passed around a few different e-mail recipients before ending up in a Group Inbox in the ICU. That usually means it's with the senior nurse to deal with. Sure she could spend a shift finding out that she doesn't know any of the answers to the questions above but she's got patients to manage so it ends up in File 13. Whoever sent the request in the first place moves on and here we are.
The NHS is great at some things, less so at others.