30th September 2016

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Matthew Syed - author of 'Black Box Thinking'
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In conversation with Roy Lilley
25th October 2016 - King's Fund - tickets here.
Good enough for the diamonds
News and Comment from Roy Lilley
The BBC are running an interesting story:
"Police body cameras can dramatically reduce the number of complaints against officers...  
The Cambridge University study showed complaints by members of the public against officers fell by 93% over 12 months compared with the year before."
There is more to it and it is worth a quick read.
This takes us full circle to something I was writing about almost three years ago.  CCVT, cameras in care homes and the role of monitoring in the NHS.
Inspection cannot make care safer.  If care is poor the man with the clipboard arrives too late.  If it is good, the woman with the clip board has wasted her time and our money.
What we want to know it what is happening in real-time.  

I want the answer to the question 'how did we do today'?  
When we can answer that, I want to know 'how are we doing, now'?
You know, I know, ministers know, the regulators know... we can answer those questions if we want to.  We can.  With the help of technology.  There is almost a conspiracy preventing it from happening.
Privacy, confidentiality and discretion are the usual reasons trumped up.  They are false reasons.
The simple answer to the dissembling is in the hands of the technologies we eschew.  

The images produced by a nurse-cam in a nursing home, can be Bluetoothed to a secure server, password protected and only the relatives or the individuals have access.
It is their care that is being monitored and the images are their images.  If the experience of the police is anything to go by, complains drop to near zero and poor policing, or in our case 'care', identified immediately.
It is the same for GPs.  Consultations in the surgery are about as transparent as a bin liner.  This puts the GP at risk and the patient at a disadvantage.
Allowing a patient to plug a stick into the GP's desk-top and use the web-cam to record what is said and done creates a security record and a reference point for the patient who may well leave a consultation not really remembering what the GP said.

Ring the surgery - why not record all the conversations?  The bank does.
Operations, hospital proceedures?  The same applies.  If we can have CCTV in the corridors and car-parks, I can't see why we can't have it in the operating theatre.  The images become the sole property of the patient.
Once a record has been created we could make a simple rule.  You can't complain about the NHS unless you provide the record.  We get rid of all the 'he said, she said' nonsense.
I know, you are probably choking on your cornflakes, or have missed your bus-stop at the very thought of this... sorry.  But, let's take a breath, a pace back and have a think.
Let me ask you a question; have you ever tried to make a complaint about the NHS?  It's easier to make a complaint about the Pope.  The system is designed to be impenetrable and is so loaded with liability consequences for the care provider and the staff; it collapses under its own weight.
Got the evidence on the screen - get the picture?  All the bureaucracy disappears.  It either happened or it didn't.
There are something like 500 complaints about the NHS every day.  The NHS sees 1m people every 36hrs so you might think that is not a bad score-rate.  Nevertheless, the 500 occupy hours of time, hack people off and either end up in a plastic, corporate apology or in court; making the lawyers rich and everyone else grey.
The number of complaints increases by nearly 6% a year and £illions are held in reserve for liabilities and pay-outs.
Cameras could change the balance of care, put the patients in charge and provide an assurance for staff that they cannot be falsely accused.
It will be an entirely different NHS... I get that and I know there will be those of you reading this that will fight the idea to the last bed-side.
However, if the images are owned by the patient, if they are only accessed by them but must accompany any complaint, I don't see why we shouldn't give it a go, trial it.
There will have to be codes of practice and all the usual malarkey but if it's good enough for the Coppers it's good enough for the diamonds in the NHS.
Have a good weekend.  
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Matthew Syed
Former Commonwealth Table Tennis Champion and author of Black Box Thinking

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