Every doctor has a list of patients that they look after. It tells them:

1. Where the patient is.
2. Their hosp no, date of birth,
3. Current problems,
4. Diagnoses,
5. Active problems’,
6. Important test results,
7. ‘Jobs/Tasks to be done’: Tests to chase/ order, results to chase, medications to prescribe, referrals to make.
1. Jobs/ Tasks gets checked off (on the piece of paper).

The patient list is the lifeblood of doctors. Different specialities have different requirements for the patient list. It is NEVER one size fits all.

A printed sheet of A4 either from a MS Word/ Excel file.

1. Every morning, a doctor sits next to a computer and manually updates ALL of the above.
2. A sheet (over several) gets printed and this is used to documents changes to ALL of the above throughout the working day.
3. At the end of the day (5-6pm), the Word file gets manually updated.

1. Important patients gets handed over to the on call team.
2. They then create ANOTHER patient list. This is often handwritten!! or typed into another word/excel file

You’ve guessed it, another patient list gets created!! In the morning, the whole process starts again.

Handover software only addresses a point in time where patients get handed over to the night shift from the day shift. It does not support everything else. It does not link with blood results systems, ordering systems etc. And it does not address the management of the bulk of the work that happens during the day.

Hospitals up and down the country are investing in handover systems because poor handover causes people to die in hospital.

But that’s completely missing the point. Handover is about handing over responsibility of the care of the patient, the patient’s problems, tasks, jobs, location etc. does not change. Handover is only one part of the larger ‘Patient List’ problem.

1. It does not affect the lives of IT directors, Medical Directors or Finance managers who hold the purse strings.
2. Junior doctors create these lists and are most heavily dependent on them. They have very little to no say in the running of hospitals.
3. NHS trusts does not care about the process of care delivery or coordination within a hospital as long as government and payment targets are met. Junior doctors just compensate for the inefficiency by working longer hours and gritting our teeth.
4. A effective electronic intelligent patient list requires integration of various IT systems, PAS, Order Comms, Results and Radiology. IT vendors make this task next to impossible.