How text messages can eradicate waiting times

A text messaging services can engage the difficult younger demographic who make up the vast majority of ‘do not attends’, writes Tom Whicher. Photograph: Sebastian Pfuetze/Getty Pictures

Has there ever been a much more explosive problem in the NHS than waiting instances?

Progress has been manufactured in much more latest times, but figures published by the government in March for the January time period show a reversal of these hard-won enhancements. About 2.9 million men and women had been waiting for remedy in the first month of 2014, up by 362,000 from January 2013.

Figures also show a rise in the quantity of patients in England who had not been treated within the NHS target of 18 weeks between referral to remedy, from 143,741 in January 2013, to 189,179 in 2014.

As one particular of the most substantial-profile targets in the NHS, managers are underneath pressure to throw sources at attempts to carry down breaches, this kind of as employing additional employees to chase patients to make sure they attend, and frequently putting on extra clinics at a expense of around £600 a throw. Offered that the typical hospital runs about 200 additional clinics, this bill could finish up at an additional £100,000 a year. Even if person hospitals are in a position to meet targets in this way, it really is clear that these techniques are unsustainable given the unrelenting squeeze on NHS finances.

It is towards this backdrop that some hospitals are commencing to recognise methods that simple daily engineering can assist. DrDoctor has been operating with a variety of hospitals and clinical commissioning groups across the United kingdom to introduce an automated text messaging method that saves time for staff and tends to make access to appointments easier for individuals.

For instance, providing individuals the choice to adjust, accept or acquire option dates by a 1-word text message has pushed down ‘do not attend’ (DNA) charges at Heatherwood and Wexham Park Hospitals NHS basis trust by twenty%.

We are now embarking on a trial at the trust that will text offers of cancelled appointments to patients on the waiting listing. The believe in was hit by twelve,700 late cancellations inside of two days of the appointment time at Heatherwood outpatients in the final year.

We proposed the move soon after our survey at the believe in found that sufferers needed updates on reserving modifications by way of technology that they are familiar with. The huge majority – 91% – of patients would accept last-minute appointments if a cancellation freed up time, even with much less than a couple of days notice.

Early pilots indicate that we can refill greater than 50% of cancelled appointments by means of the DrDoctor method. We are confident that figure will increase when we roll out to include more substantial numbers of individuals and appointments.

Often referred to as “slot utilisation”, the smart use of hospital appointment data and the technological potential to flag up totally free time can ensure generating good on targets isn’t a costly venture. Employing SMS, smartphone and eventually on the internet portals which patients can accessibility as effectively as professionals, is a far far more efficient way than manually sorting by way of patient information and instances, and frees up time to concentrate on improving the quality of care sufferers receive in other techniques too.

This ease of communication is transformative for patient experience text messages and automation perform for most sufferers. Mixed with on the internet solutions, for individuals with smartphones or PCSs we can engage the hard younger demographic who make up the bulk of DNAs. With the vast majority of administration automated, reserving teams can now target on the frail or at danger sufferers who need to have an additional human assisting hand.

We are forever getting told that the NHS is lacking in innovation. Imaginative use of existing technologies and giving individuals greater details will go a lengthy way to minimize the consistent dilemma of missed appointments, late cancellations, and the failure of some trusts to meet 18 week limits on waiting times. It won’t fix all difficulties, but it would be a effectively-required start off.

Tom Whicher is co-founder of DrDoctor

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How text messages can eradicate waiting times

Messages about lowering sugar intake unclear, say campaigners

A Starbucks caramel frappuccino is made up of a lot more than 44g of sugar – 11 teaspooons

One particular Starbucks caramel frappuccino with skimmed milk and whipped cream contains virtually twice as considerably sugar as the Planet Wellness Organisation says is the advisable daily intake, and a can of Coca-Cola or Pepsi has one and a half times the quantity, but campaigners fear that the message about cutting down on sugar is insufficiently clear.

In a draft updated guideline on sugar consumption, WHO recommended on Wednesday that no more than ten% of our calories ought to come from sugar, but advised much less than 5% would be preferable.

For an regular grownup consuming 2,000 calories a day, that equates to 50g of sugar – or twelve teaspoons – at the greater limit and 25g – six teaspoons – at the decrease restrict.

A kid, whose calorie intake is much decrease, would reach the limit even faster.

The Starbucks caramel frappuccino contains much more than 44g of sugar – eleven teaspoons – which is significantly above the lower limit and nearly at the upper limit, suggesting that it could be unwise to drink one particular at all.

Coca-Cola and Pepsi in 330ml cans have nine teaspoons of sugar, a 51g Mars bar has eight teaspoons and a Muller Crunch Corner strawberry shortcake yoghurt six teaspoons. There is additional sugar in numerous savoury dishes, like pasta sauce and soup, to improve taste and texture.

Aseem Malhotra, cardiologist and science director of the pressure group Action on Sugar, which developed the table of food items with added sugars at its launch in January, stated most men and women would find it difficult to determine how much sugar they are consuming, and are not assisted by labels.

Malhotra points out that several producers add with each other the WHO recommendation of 10% of additional sugars and a more ten% of intrinsic sugars – individuals from fruit and greens, which had been the subject of a separate nutritional recommendation by the WHO in 2003 to try out to persuade individuals to eat far more of them. As a outcome, Coca-Cola can say that the 35g of sugar in a 330ml can is 39% of an adult’s guideline daily advisable sum of total sugars, even although it is made up of only additional sugar.

“This is very misleading,” stated Malhotra. “I agree with the WHO recommendation, but it has to be translated into one thing meaningful for the client.”

Public Wellness England responded to the WHO announcement by accepting the 10% limit recommendation. It went even more, incorporating that it “will meticulously consider the suggestion that a additional reduction of sugar to under 5% of total energy intake per day would have further positive aspects.” The United kingdom currently has a ten% limit guideline. Surveys recommend that adults in England consume 11.six% of their calories as sugar and young children 15.two%.

The WHO recommendation is a response to the growing obesity epidemic, which is a result in of improved heart condition, strokes, type 2 diabetes and some cancers, and also tooth decay.

But the food and drink market appeared to be relaxed in excess of the guidelines. Barbara Gallani, director of regulation, science and health at the Meals and Drink Federation, said: “The primary recommendation in the draft guidance … supports the present United kingdom policy on sugars, that intake of cost-free sugars must not exceed 10% of complete vitality. Exactly where bodyweight achieve is referenced in the draft guidance, this as well supports existing United kingdom government policy and market action to lessen calories in the diet plan.

“Excess calories, no matter whether from fat, sugars or other nutrients, can result in bodyweight acquire, which is why United kingdom meals and drink producers are working to lessen calories in their items, numerous performing so underneath the United kingdom government’s Duty Deal calorie reduction pledge.” The federation pointed out that the WHO said there was greater uncertainty about the science underpinning a 5% limit.

Messages about lowering sugar intake unclear, say campaigners

I make an awful discovery in R"s text messages

It is wrong, it is incorrect, it is wrong to be looking at his texts I say, by means of tears. But I can not stop.

At 3am, a tiny drunk, exhausted and previously feeling the early results of a hangover, I discover that R is seeing an individual. I’m not purposefully nosing around for clues of his extramarital shenanigans I’m buzzing with joy soon after a friend’s celebration and have neither the vitality nor wish to rifle by way of R’s coat pockets for indications of deceit and desperation. I arrive property singing with enjoy for my buddy Emma, the party host, who was still dancing when I crept out of her residence and into my taxi. I want to say goodnight and thank her for a great evening. I look in my bag for my phone but realise I have left it charging in her kitchen.

This is why I creep into the bedroom in which R is sleeping (he has been babysitting) to use his mobile phone to message Emma. I scroll down his mobile phone contacts for her amount and see the get in touch with historical past – they have been speaking just lately and regularly. I seem at a latest text message that suggests she is far far better acquainted with R than I had imagined.

Emma, my close good friend, flirting with my husband? It appears bizarre that she is calling him “mon amour” and sending him strings of kisses to sign off. When I study a couple much more messages, I realise that the Emma I think it is, is not that Emma at all. She is an additional Emma, a girl I’ve in no way met.

Trembling, I consider the mobile phone downstairs to the kitchen and sit at the table. The dancing fairy lights around the mirror bathe the space in hostile blue, flashing frantically in sequence. They look to mimic my feverish compulsion to stab the mobile phone screen with my finger, as I open message soon after message from Emma to R, and R to Emma. There is so much to study and I am amazed, simply because R is usually so scrupulous about deleting outdated things.

It is incorrect, it is incorrect, it is wrong to be carrying out this, I say, by way of tears.

But I cannot stop. There is something rather exhilarating about currently being faced with all of this information, the truth and the tricks, the stuff I had absolutely no thought about – a seductive desire to learn what has been going on. And nevertheless I know what the ending will be for me: when I study the final message the entire physical exercise will truly feel nihilistic and sad.

There are sexy texts, caring texts, scheming emails that speak of R and Emma’s specific comprehending of each and every other messages that say they would like to run away with each other. “Aren’t we negative doing this behind our partner’s back?” kind conversations.

There are complete paragraphs focused to extreme flattery – all the sentences sting my soul. And when I read a couple of beautiful issues that R writes about Emma, I think of the times he has explained equivalent things to me. In one particular message I am the subject. They mention a time when they held hands in the back room of a pub and talked about me.

“Me!” I cry with disbelief, in my echoey kitchen. A woman holding my husband’s wedding ringless finger, talking about me? I actually do start massaging my eyelids tough because if you’ve ever accomplished this, you will know that the discomfort is distracting.

The once satisfied night is swallowed up complete and replaced with an aching sense of reduction and powerlessness. I want to bang my head towards the wall, but I will not. I put the cellphone down and stroll upstairs. I enter the area the place R is and touch him on the shoulder. My thoughts is already complete of cliches: “We need to have to speak.”

“Tomorrow,” he says, crossly. “I need to get up early for work.”

Then I say, “I know about you and Emma.”

Moments later, he follows me downstairs to the living area.

“How significantly have you had to drink? Never do this to oneself now,” he says.

“Why? Why didn’t you inform me about this when I asked you all those occasions if you have been seeing any person else? Does Emma know that you tell me you enjoy me and that you don’t want anybody else?”

I can’t perform out whether I want to throw something heavy at his head, or crawl into his arms.

“I am just so, so sad,” is all I can say.

R turns to leave the room almost as rapidly as he’d come in, saying: “We are separated and this has completely practically nothing to do with you. Just get some rest.”

I make an awful discovery in R"s text messages