> We can’t have Matt Hancock calling a hospital and hearing: baa-ruhr-reee-uh-reeee-uh-reee
Especially when they then go BOING BOING Tshhhhhhh <click>
The NHS has been told to stop clinging onto the past, after it was revealed trusts have more than 8,000 fax machines still in use. According to Freedom of Information requests submitted by the Royal College of Surgeons, Newcastle Upon Tyne Hospitals NHS Foundation Trust is the worst offender – with a whopping 603 machines. …
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I'll hazzard a guess that given the pager tech works, it'll be a cautious replacement program.
First hand experience over a few years regularly proved mobile phones were pretty much useless in the deeper parts of the Hospital.
Happily for us the NHS Pager's didn't suffer the same fate.
As fot Fax Machines. Outdated, yes. Still functional, yes.
The myriad of Staff I've had the pleasure to deal with are highly trained in their particular fields. PC skills are seconday to Life saving skills in my book.
Given the huge range of staff ages and IT abilities, landing everyone with a Fax replacement would cause more trouble than its worth in the short term. Again, baby steps toward phasing them out both from a tech and staff training angle.
Just my 2p worth and to anyone from the NHS who may be reading this, keep up the good work and ignore the naysayers. Unsing heroes.
Ahh yes , the Casualty view of a hospital, or whatever merkin drama.
Very little healthcare is provided under a blue flashing light, with a nurse holding onto an artery.
The majority is treating chronic conditions where you need to track progress over a very long time, sloging away.
This is where the fuckwit buffoonery that is accepted for the NHS fails all the time.
The NHS stats are great ..... apart from one - Improving peopkes health outcomes
They use them to make patients life difficult whilst avoiding doing any work. Personal experience, Hospital needed GP to fax hospital some info. GP would not send fax unless they were first recieved fax from hospital. Hospital refused to be the first faxer as there was not reason to. GP reception refused to fire up the fax until the hospital had demonstrated enough fax respect by sending them one first. . End results, lots of everyones time wasted while I (the sick guy) have to phone round trying to get people to do their jobs. And of course the admins and receptionists were all an absolute delight to work with.
Don't UK solicitors still use Fax machines still ?
What do the NHS use them for ? I am certain they have e-mail, telephones etc.
Up until not that long ago, email was not a legally-allowed method of delivering information (for use in a court of law anyway - it's too easy to forge).
Fax on the other hand was legally-allowed in a court of law. Which is why solicitors still have them since they deal (a lot) with other solicitors and they are, by nature, a slow-moving bunch..
I understand that email is now a legal method (despite still being ridiculously easy to forge).
"You want to hazard a guess how much clinging to those fax machines and pagers is costing the NHS? I bet the maintenance and service contracts are eye-wateringly expensive with them being basically obsolete and with so few suppliers."
I wonder just how many fax machines are actual stand-alone fax machines (with thermal paper that fades in sunlight) and how many are big, expensive multi-function printer/copiers with the fax add-on pre-installed and so used by default as the lowest common denominator for comms to the multifarious parts of the NHS all running on different vintages of systems that won't always inter-operate reliably?
"Fund the NHS properly"
What is properly? Under 13 years of labour, through one of the greatest booms, after selling gold and racking up debts money wad pissed all over them. We are giving them more now than Brown and his spending.
This is not a low tax country so I would be happy for the gov to throw away less and give it to our services, or even back to the people they rob. But chances are it would come from the budget of defence or education or something else. And the NHS will always want more.
"And the NHS will always want more."
let me correct that for you....
.... And the NHS will always NEED more
you could fund the NHS to the tune of £250M a week, but then you could always find a department wanting an extra few million a year to cover the cost of the latest prosthetics technology that's needed because of some war on another we have been dragged into on a lie is creating a back log of people needing replacement limbs.....
@ pÉ¹ÉÊoÉ snoÉ¯ÊuouÉ
".... And the NHS will always NEED more "
Then it cannot possibly survive. If it always needs more then it can never have enough and must collapse. I hope there is a way around that. Delivering healthcare is more important than pleasing an insatiable maw.
"Then it cannot possibly survive. If it always needs more then it can never have enough and must collapse. I hope there is a way around that. Delivering healthcare is more important than pleasing an insatiable maw."
there are things that can be done, NHS funding of "alternative" treatments should be stopped for a start. Fixing peoples cosmetic surgery screw-ups should come with a bill....
But the thing with healthcare is that no matter how much it is funded, it could be running like a well oiled machine, every department working within budget, targets on waiting times met.... but until you reach a point where a GP refers you to a specialist in the morning and you can see that specialist the same day, and go into surgery that afternoon, or as many rounds of IVF as needed, then it will always need more money.
A health service is like an R&D department. It will burn through every penny in its budget no matter how much it has.
there are things that can be done, NHS funding of "alternative" treatments should be stopped for a start. Fixing peoples cosmetic surgery screw-ups should come with a bill....
I notice you list "alternative" treatments and cosmetic surgery as things that should be stopped...
...yet consider IVF to be "needed"....do you know how mind-bendingly expensive IVF is?
...yet consider IVF to be "needed"....do you know how mind-bendingly expensive IVF is?
Yes, that is an interesting one. Taken to the extreme, if one person of a couple can't produce the necessary to create a child, maybe there's a biologic "fault" telling them something important. I've also heard IVF campaigners claim that it's every womans right to have a child if they wish. Well, actually, no, it isn't a right of any kind. No mention of the men either. But I could imagine it being a very, very difficult decision as to where to draw the line at when to offer or refuse IVF treatment on the NHS. As I understand it, different NHS trusts set the bar at different levels and it's usually set by people well removed from the process, ie bean counters.
It only needs more until we can actually find cures for conditions which really weigh down the NHS finances, a easily administered cure for type 2 diabetes on it own would save the NHS 10% of it entire budget, about 12 billion pounds. That for one single disease. cystic fibrosis patient, they cost about 500 million a year. Dementia that something like 4 billion a year in costs alone could saved if we found a cure, plus billions more on the social care side of things.
There are other areas such as spinal cord damage which if we could repair them would no doubt save a large amount of money in both health and social care cost. Same with brain damage from strokes, luckily at least for one type of stroke brain damage from them should be extremely rare events in the 10 years or so.
This is where the real savings in the NHS and all health services can be made, of cause we have no clue when cures might arrive. Hemophilia for example it look like both A and B form will be curable in the next 5 years if current success of trials continues.
The problem with the "find a cure" approach is the other side of the business. A pill that cures diabetes is something you can only sell to a customer once, a pill that treats diabetes without curing it, you have a lifetime subscription you can keep selling. The pill selling people would rather the later than the former, so that's what they spend their rather large R&D budgets on.
but most blue sky research is done by charities or government funded universities, they will be the ones to find the cure, it will either be take up by pharmaceuticals or other source of funds will fund clinical trials. Or the NHS will do it itself. An it has shown increasing willingness to actually fund clinical trials itself over the years, the recent successful hemophilia trials was partially funded by the NHS.
>Then it cannot possibly survive.
What can? The NHS is the cheapest possible health system. Any other would cost more - just in administration. And that's before you start treating people.
Those who attack the NHS must imagine that they will always be able to afford any health costs that might hit them, as they begin to fall apart, with age.
I wasnt attacking the NHS, I was just pointing out how the argument of always 'needing' more would remove its possibility of surviving. I disagreed with his choice of wording.
"Those who attack the NHS must imagine that they will always be able to afford any health costs that might hit them, as they begin to fall apart, with age."
That depends. The NHS is such an amazing and wonderful system that nobody in the world copies it. As health services go it could be much worse but it could also be much better.
"I'm young, fit and healthy. I never need to go to the doctor! Why should I pay for obese geezers to get their DIABEEETUS medicine when they won't stop drinking sugary syrup-water by the bucketload?!" ~Basically every 'MURICAN who's never had to face a sudden and unexpected healthcare bill.
Source: Am 'Murican. Have had to face sudden unexpected healthcare bills. Would quite happily bend knee to HM the Queen in exchange for healthcare alone, let alone all the other good reasons to want out at the moment.
because of some war on another we have been dragged into on a lie is creating a back log of people needing replacement limbs.....
It's just not "wars".. it's old age also and accidents.
extra few million a year to cover the cost of the latest prosthetics technology
The latest prosthetic tech isn't cheap. A dumb knee or arm is a mere pittance compared to the latest bells and whistles tech prosthetics. Yes, they do more and are worth it, IMO. However, to give them to some old gaffer in a wheelchair who won't walk or use the limb is ridiculous in the least. I don't know how the NHS handles this but here in the States, a mere prescription entitles anyone to get one if they are an amputee.
My wife is a leg amputee and to get a good leg and knee is outrageously expensive. We both know too many people who consider the high tech limbs a "status symbol" only. It's just one of the problems with medicine and cost.
Then there's the cost of the "latest and greatest" medications... again, some are considered status symbols.
The NHS will always need more because it's a victim of its own success. Every life it prolongs now becomes a future patient needing treatment for the degenerative diseases of old age. So what is the solution, is there one?
Do we assess a treatment not only on its cost and effectiveness, but also on its utility? A costly, but life-saving treatment could be considered "worth it" for a thirty-something, but not for a sixty-something, based on tax contributions they are likely to make. It's the thin end of a rather nasty wedge; what other variables do you factor in? Do you prioritise treatment based on income, as that will offer a higher "return"? Speaking as someone who has spent most of his adult life taking medication, which has allowed me to be a well-paid, productive member of society, I don't like the idea of a system that might prioritise my treatment while I'm working, but when I hit retirement, no longer deems me worth it.
A costly, but life-saving treatment could be considered "worth it" for a thirty-something, but not for a sixty-something, based on tax contributions they are likely to make.
The sixty-something will point out that they've made enough tax contributions to cover it already. False logic, it's true, but if the sixty-something lives until the next election they still have a vote and hence a say in how things are done.
"13 yrs of labour? WHEN?
Hint, Blair was conservative"
I am not sure which alternative universe you are from but he lead the labour party. And he had pretty impressive backing to actually get labour seen as a serious contender since before the 80's. With large support from the population particularly labour supporters.
I understand he is ridiculously toxic and an embarrassment to the country but before him labour were unelectable since before the 80's. Corbyn is willing to give us a demonstration why (and is demonstrating it already). Your claim that Blair was a tory implies labour has been unelectable for nearly 40 yrs and counting!
And, as noted today and other times recently (passim as Private Eye might say) the Blair government removed much of the restriction on the gambling industry, making it an open market industry, leading to the curse of the high speed gambling machines in all these betting shops (of which there are now far more, so that they can get around one of the few limitations; number of machines per den of vice) and the increased number of rather disingenuous, if not downright objectionable, gambling adverts on TV, particularly during the world cup when there were plenty of kids watching i.e. describing throwing money away by the bucket load as "more fun". hardly supporting traditional Labour principles.
Oh. And don't forget PFI.
>Oh. And don't forget PFI.
First implemented under the Major govt.
I'll warrant you have a hospital/school/clinic/pool/community centre, within easy reach of your gaff - which wouldn't exist but for PFI. Some PFI deals were badly negotiated, by inexperienced managers. That doesn't make PFI a bad idea.
The UK has very little tax compared to out European peers with decent healthcare. In Germany the idea of putting away 20k tax free in an ISA forever is a fairy tail dream. €800 of interest and dividends and that's your lot. The public healthcare is comparible with private healthcare in the UK in my experience.
I think above average earners in the UK get away with paying very little tax. Council tax is the only local tax and it tops out at what 2k a year for a mansion?
It's quite obvious that it's probably the old guard types of physicians who insist on this as they have no idea about some of this new fangled equipment. I've seen it in the States, one doc uses smartphones and computers to the max, another insists on paper for everything and fax machines. The paper guy is the department boss....
If the processes they have constructed work with Fax machines, what is the problem? just because they aren't shiny new tech doesn't make it bad. If the process works, then be very careful when replacing it with shiny new bollocks because as we all know quite often it can end up as a retrograde step...
If the process is faulty, then replacing the fax machines won't necessarily fix the process.
You have three options:
1. Place document on fax machine, type in extension number, send. ... Get receipt.
2. Place document on scanner, type in email address, send. ... Phone to check they got document (and confirm that pea-soup pdf filename from scanner's pea-soup email address is not Wannacry18).
3. Place document on scanner, scan. Walk to PC, open email, write "here's attached docs you asked for", remember not to click send, browse to network, attempt to find correct document with pea-soup filename on today's random network folder, now send. Delete file on network drive so not everyone can read it.
Yes, I'd pick #1 any day of the week, or night of the weekend for that matter.
That there is the problem, however the solution is to have the scanners that behave like fax machines where you can just press the email button and type in the email address and message. The only problem with that is either everyone has a scanner or you have a shared machine you log into to send a fax, again adding steps and leaving the problem of people forgetting to log out into the mix.
A scanner can behave like a fax machine now? How does it prove receipt?
The reasons why fax is still used is:
1. Sending and recieving happen live, in REAL TIME. Mail is not real time. The two endpoints are in constant comms back and forth during scanning, sending and printing. If the fax machine at the other end breaks, the sending fax knows this. Email has some way to alert of delivery failure but its not able to tell you the email never got to the users inbox because the disk failed after the smtap server accepted the message.
2. You get a status report printed by the sending machine that will let you cover your arse when the other side claim you never sent it.
In basic terms the fax machine is the digital (i doubt many analogue ones are left about) version of a live phone call, only with images. Email is what it allways have been, the electronic version of paper post.
There however is something the NHS can use to replace fax. EDI. Electronic Document Interchange is a well defined standard for doing this sort of thing over almost any link from morse code to email or direct as2 connections. However, it is typically used for ordering and invoicing of products so im not sure if it is fully suitable.
To replace fax, you must replace fax. Not squeeze something that does half a job into the same hole because its more modern. You need a direct replacement.
4, Form committee to agree a document transfer requirement that meets health-data-2000 principles and ISO-FOO and health data standard BAR and Eu standard WIBBLE
5, Get quote from approved suppliers
6, Discover only Crapita is willing to tender - consider shooting self
7, Wait 5-10 years for solution to be delivered
8, Consider just emailing the document - consider what would happen to you, your team, your hospital if the Daily Mail find out.
9, Fax it
You forgot to mention Print document first, as these should be on the PC already. If you're dealing with paper forms, you have other issues to fix as well.
4. Use a Service management type tool. i.e. a web site.
Launch browser, log in, click upload, select document done.
No need to scan in, as document should already be in electronic form, and process should be fully traceable (no paper receipt needed).
You forgot to mention Print document first, as these should be on the PC already. If you're dealing with paper forms, you have other issues to fix as well.
There's likely loads of paper forms. When the ED overflows into corridors, junior doctors can walk up and down assessing patients. A clipboard and a well designed form is much more efficient than a laptop (likely with a dying battery). Now you could probably replace it with a tablet computer but you still have battery life issues, and you're going to spend a fortune on the conversion for what gain?
"Print document first, as these should be on the PC already."
If the document starts life as a written note on ward rounds are you saying that the Dr should type it up so it can be emailed? Or wait until a secretary should type them up?
Different situations give rise to different use cases. Different use cases have different optimal solutions.
How about option 4 - set things up properly so users can easily email scanned documents?
4. Place document on scanner, select your name on the touch-screen, press scan. Go back to your PC and find the reasonably named document under the folder "Scanner" in your "My Documents" folder, right-click, then send as attachment. Done.
With modern VOIP phone systems, supporting FAX machines is an absolute nightmare. Yeas, I know T.38 and all that, but just try to make it completely reliable. We tried for about a year, and about the fifth time some executive comes in on a rampage about their FAX not going through, you give up and order an analog line. We run a consumer call center on VOIP, and yet our one analog FAX line costs about 1/2 of our total monthly phone costs!
And that's the main problem with FAX, it's the all too often needed analog line. A modern equivalent would allow one to hit a FAX app on your mobile, take a picture of the document you want, and send it to the person in your contact list. How they choose to receive such communications is of no concern to you whether it be on their mobile, desktop, or some digital FAX-like machine. FAX machines either need to catch up and go digital or be shoved aside.
You forgot to mention Print document first, as these should be on the PC already. If you're dealing with paper forms, you have other issues to fix as well. Fax over digital lines has been possible for years.
Also, for many of these folk they're likely using fax servers. So, with something like RightFax, they can fax a doctor and it will come in to their outlook mailbox as a PDF. The doctor can fax back from their computer if necessary.
You have three options:"
I suggest a fourth.
4, Place document on scanner, Select your email address from list. Walk to PC, open email in forward mode, write "here's attached docs you asked for". You can check first that you did of course put them in the correct way round, haven't been screwed up or lost in the in tray. Not only that but you can add a read receipt, send to multiple people at once. lots of other benefits as well.
About 2-3 years ago I had a little problem with HMRC (UK Inland Revenue). I had to fill in and sign a form and send it back to them. As I'd left it rather tight for time post-wise I phoned and said I could scan it and email it. I was told very firmly that they could only accept a fax. I said I hadn't owned a fax machine for years and asked what was wrong with email, she said, rather frostily, 'because of security...'
I hadn't the heart to tell her how many documents I'd seen faked on fax machines...
she said, rather frostily, 'because of security...'
Well, congratulations to someone at HMRC who understands that sending an email is like sending a post card - which can be read by anyone who handles it. I have been asked a large number of times , and refused, to email sensitive information; I ask what encryption they use ... generally they not understanding.
I have been using PGP/GPG (encryption for email) for years but most people do not support it. I suspect that the likes of GCHQ discourage it where they can - they like postcard-like email.
Some years ago in a land far away the customs wanted a form showing all the right signatures. So with a bit of cut and paste experience from the past I soon had a suitable prototype, then with a bit of artistic recreation the art work as ready and entrusted to the trusty(?) FAX machine. Honour done the customs then cleared the goods and everyone was happy. The contractor of the time wanted the original artwork to frame for his home office wall as a reminder of the good times he enjoyed in the land of the FAX machine.
Of course all those security minded folks do not remember the bloody awful paper that faded in 101 different ways, that jammed, that ran out at the wrong time and so on and so forth.
My local lot electronically transfer a lot of stuff point to point on their internal network not via the fred.bloggs.net network, pharmacists receive electronic prescriptions and place orders with the suppliers. I have even had MRI scans transferred that way. Better than the bloody paper files which are never in the right place when you make 60 mile round trips and pay a fortune for parking but cannot have a proper appointment, 'because the main file is missing'. Nothing too important of course, just what the references say is an aggressive cancer. I try again on Monday week, so one cancelled appointment, one useless appointment and now into week three. FAX was tired and useless in the 1980s that some clowns still have 1880s systems is their dumb fault, better not drop their quill pens into their damned FAX machines.
There certainly was a time where a signature sent via faxed was considered to be an actual signature for legal purposes while an email of a scan of the same signature was only an image of the signature and did not in itself have legal standing (that the actual signed document ... or faxed version ... would have).
That's why a few years ago the David de Gea transfer from ManU to Real Madrid fell through when 10 mins before the transfer deadline when the transfer documents were ready to be exchanged the ManU office found their fax machine wasn't working so the "signatures" couldn't be sent to the relevant authorities in time to meet the deadline.
"There certainly was a time where a signature sent via faxed was considered to be an actual signature for legal purposes while an email of a scan of the same signature was only an image of the signature and did not in itself have legal standing (that the actual signed document ... or faxed version ... would have)."
There was a mindset back then that said a fax was a faithful replication of the original, while anything scanned into a PC could be easily edited, even if the user only had the default MS Paint app. And to an extent, that was true. Faking a fax took a little more effort with actual scissors and glue/tape.
I once had the joy of attending a HR training course on checking an applicants right to work in the country. I was told that we could only take a photocopy of passports / visa documentation as scanning an electronic copy could easily be 'photoshopped'. Photocopies were more secure as they could not be altered. I tried to explain how a modern MFD works and that even taking a picture on a smart phone would offer the same level of security.
"About 2-3 years ago I had a little problem with HMRC (UK Inland Revenue). I had to fill in and sign a form and send it back to them."
The last time I needed a FAX from home, I'd already got shut of mine, so I set off for the local Post Office, which had one. On the way I spotted a café which offered the service, so used that instead.
That was last century though.
As I'd left it rather tight for time post-wise I phoned and said I could scan it and email it. I was told very firmly that they could only accept a fax.
When I was dealing with them heavily last year, it took a will fit them to receive a fax. No word of a lie. The fax was received immediately, of course, but it took a week to be passed to the correct department internally.
It's like they deliberately invented a ridiculously inefficient system.
Daisy-chained 128k Spectrums and thermal printers if they could get away with it at Colchester General - but they're more expensive than the utter cack that's there now (and arguably more functional) so that's out.
I'm surprised they aren't using carrier pigeons (carrier ducks were tried (for messaging and mowing the hospital lawns) but the messages got soggy. Also bird flu).
More funding would help, but at this point that's all it would do. The NHS is like a stage 4 cancer patient - it's already dead, the world just hasn't quite caught up yet. In order to fix the problems you'd have to divorce it from any government control and monetary limitations for at least 2 decades and probably more, while growing services and reducing hours (while increasing pay) and hoping fervently that there isn't any crises while you are doing it. That's about as likely to happen as Cliff Richard converting to Satanism (not that he hasn't sent his fair share of souls to the dark side - Mistletoe & Whine on repeat for example).
And for fscks sake - STOP doing pointless operations on 85-90 year olds. Some of them have so many artificial joints that if they go swimming at Southend sonar operators end up with tinnitus, in the bloody Baltic! When you can diagnose cancers and other diseases in teenagers and young people who are or will be contributing to the NHS, treat expectant mothers properly and with respect, not to mention a GP service that hasn't ended up locked in an era when landcrabs roamed the earth (Morris, not Macra). Then, and only then, may you start doing heart surgery on the meatspace equivalent of Cohen the Barbarian. Oh and if a consultant can't find their ass with both hands please kindly sack them.
The NHS was a good idea and still is a good idea. The enactment of that idea however has been an unmitigated example of how not to do it - for so long fuckup-ery is permanently and terminally ingrained
My Mother had both her knees replaced in her 80's. She lived until just shy of her 96th birthday in her own home. IF she hadn't had them done she'd have spent up to 15 years longer in a care home.
The Economic case for her knee replacements is pretty clear don't you think?
Mum got her message from the Queen last month and still gets around the care home on her own. Perhaps in your ideal world she'd have been knocked off by the state years ago.
Pah, Bah Humbug.
And that rattling noise wasn't the big ends on my old Sceptre, it was you missing my point.
Yes, the operation helped your grandmother, one of them helped my dad and a new hip helped a friend of his who is one of the few people on the planet I have respect for. But both my father at 65ish and Peter were still working and contributing. My gran was refused a hip operation which arguably led to a fall which ripped her leg open and destroyed the sight in one eye. The other grandmother was murdered by the No Hope Service...
They'd paid all their lives and were refused help or given wildly inappropriate medication by the NHS. I was well on the way to being killed by NHS doctors prescribing me medication that I shouldn't have been within 100 yards of - multiple times (although on the upside I'm no longer allergic to cats).
Lucky old your grandmother, and <insert deity heres> speed to her. But if she or someone like her getting money for a transplant meant that my partner got a second rate (let's be honest here, sixth rate (technically 10-15 guns, but you know what I mean)) oncologist who cost her her life at 22... Then I'd be asking Dickie Briars to hand me the Uzi.
I'm not in any way against the elderly - they're the best resource a society can have - especially with some of the sub average cretins in the latest batch - but there comes a point when welding up old grannies is like welding up old Allegros - it's a cost benefit analysis. When someone has a memory that lasts a shorter time than the 0-60 of the average Tesla - and a bladder to match, do you really think it's a good idea to try for a quadruple bypass. Or would it be better to use the same money to fund cancer treatment for a teenage abuse victim...?
"And for fscks sake - STOP doing pointless operations on 85-90 year olds. "
Ok. But you get to be the one to tell each and every one of them why they can't have the operation. Especially the generally fit and healthy ones who are still active, driving and looking after themselves quite nicely thank you.
"Especially the generally fit and healthy ones who are still active, driving and looking after themselves quite nicely thank you."
And, let's add, also looking after grandchildren so their own children can hold down a job. Although I suppose if the grandparents weren't there to look after the kids the kids could be sent into the factories to clean the fud out from under the spinning frames or down the mines to open the doors for the tubs to be pushed through.
Even the most expenses implant, some device they stick in the heart, cost about 30,000 ground, only need to keep the patient in their own home for about 2 years for it to pay for it self, just 2 years.
Knee, hip and other artificial joints that keep the elderly in their own home are no doubt even more cost efficient. Some of them only cost a thousand pounds each. This is why we have NICE to actually work through all these costs and see what is cost beneficial and what isn't.
...stuck to your shoe. I heard the last FAX machine in some office in the building finally died! It spawned itself two fold...Yes, there are now two, two I say! HOW is this moving forward with technology and security?
I've heard the phrase "Kill it with fire!" bandied about, I'm afraid that it's like feeding gremlins after midnight!
"The survey follows a report last year by artificial intelligence company DeepMind Health which named the NHS as the world's largest purchaser of fax machines."
Deepmind can't slurp Fax machines as easily! For sure the NHS needs to modernize, but you have to look at the wider agenda behind things. Who are the messengers here and what's the message? We know Google Facebook like to bury / promote research that suits their world-view!
10 minutes with the manual to change the header info that gets printed on the top of the page to indicate a difrrent originating number and company... 10 min in Photoshop producing a fake letterhead and you can fax anyone in the world pretending to be someone else.....
Faxes still have their places. When I moved to another state there was a screw up with DL. Now My choices were to drive back to California and hand delver the documents they wanted. Mail them and it will get there when it gets there or fax it(no they would not take email) Faxing it allowed me to clear it up in under an hour vs mailing it.
Change anything and it has to be done medical standards .....
I'm running a clinical trial. One of the official steps, argued over in many meetings, minuted, recycled as firelighters etc and finally agreed with the FDA:
Dump an SQL database on system 1, open it in Word, change all the occurrences of "centre" to "center", import the database into system 2.
The PC this is done on has a medical grade PSU and medical screen, the version of Windows and MS Office has been agreed and specified. The data analyst has to sign a form to say they have done this in accordance with the procedure and that they have been properly trained.
We wrote the analysis software and could change one line to accept "centre" but that would apparently take approval from 3 popes and the captain of a winning world cup team.
"Faxes still have their places. When I moved to another state there was a screw up with DL. Now My choices were to drive back to California and hand delver the documents they wanted. Mail them and it will get there when it gets there or fax it(no they would not take email) Faxing it allowed me to clear it up in under an hour vs mailing it."
And yet, for various security clearance I've had over recent years, emailed scans of documents have been acceptable. In some cases, an "authorised person" in our company has to put eyes on the originals and sign off that the scans are true and correct, but not in all cases.
I have spondylitis and need some quite powerful pain killers which includes tramadol and morphine patches. Both are controlled drugs and the way prescriptions are issued for them is a PITA.
Most of the meds I need, I order them online via the patient access app. Its issued electronically to the pharmacy and 2 days after its ordered a nice man delivers them for me. Except for the patches... I have to tell the delivery man there's a CD prescription to pick up from the doctors, who will pick it up, take it to the pharmacy, then it will be delivered.
There is no way for the pharmacy to be informed that a CD prescription needs to be collected, unless after I order my prescription, wait 2 days, then phone the chemist to tell them to pick up .
I was talking to the delivery driver about the idiocy of it and he told me that if yo do not have a nominated pharmacy your doctors can FAX a prescription, but if its a CD prescription, even a fax is not good enough.....
eat this...well If I dont eat my tablets my back feels like the trinity test site !!
The fax machine is getting long in the tooth, but it's a technology that people understand and it's a still a reasonable way to transmit a facsimile copy of a printed page. In the medical world, that can mean old patient charts or a doctor's scribble on something. Until paper is completely eliminated, fax machines will still be useful.
In my experience, working for a mental health trust, there was a lot of resistance to changing from fax to email. There were the obvious pitfalls with unattended fax machines, so they were in locked offices that were designated 'safe harbours'. If you didn't have a key you needed to find an accessible fax machine to get your documents sent to.
And the reason the like faxes so much?
Entirely down to deprivation of liberty safeguards. I mean, we had a handcuff policy, a lot of people were in our hospitals because they were sent there by a judge. Roll forward to the benefits of emails over faxes .... they don't need to go to a locked room, where they lie until they are discovered. You can put business rules around an email and direct it to more than one recipient,
And the downside with email? It doesn't work if the networks down (also true of T38 fax over IP), when a fax is sent it goes directly to the recipient machine. Sending it isnt possible if receiving it isn't happening at the same time, faxes are transactional, email is store and forward, if somethings broken with email the sender may not know for days, weeks, if at all, that it wasnt delivered.
Sometimes having something physical that can be seen and picked up as it comes out of the machine, can be held as you walk around and can be kept on the (real) desk top so that you can refer back to it is the best way.
Whereas the number of people who have a long list of unread emails in a mail folder points out one weakness of that system- emails seem to be easier to ignore (or get overwhelmed by). Perhaps partly due to the fact that because it is so effortless it becomes undervalued. A physical fax has a degree of substance that one more email just doesn't.
And since I had a fax on my 4in1 printer until a few weeks ago, when I had to replace it, I am very aware that a complaint email to a senior manager gets automatically fobbed off by the automated (or AI) systems, but a fax pretty much always got a proper response, and usually a resolution.
"(or get overwhelmed by)."
Arse coving emails are the prime reason for being overwhelmed by emails. We've all worked with people who will email after every conversation or phone call to "confirm" what has been said and enter it into the "chain of evidence."
"We've all worked with people who will email after every conversation or phone call to "confirm" what has been said"
And very welcome they are too. Though they could probably save time and dispense with the conversation. I'd much rather search my inbox than my memory.
"if somethings broken with email the sender may not know for days, weeks, if at all, that it wasnt delivered."
You can set email servers to report back on delivery status. Most are set to report back in a scale of days but can be set to hours or even minutes. If the receiving mail server is down, there's no reason the sending server can't inform you in a timely manner. That means all servers in the chain need to be properly configured to deal with time sensitive or mission critical email systems so it doesn't get received by a gateway then "lost" in a virus scanner without some sort of message being passed back up the chain to the original sender. (Of course, spammers can abuse this if not properly set up)
"You can set email servers to report back on delivery status"
The sending server. The one under your control. Nothing else it.
And there's no guarantee that the receiving server hasn't diverted it to /dev/null, or that the recipient hasn't auto-filtered it to the same location, or that he's not just 25,000 messages behind.
It's not just the NHS, needed to submit a form to the UK patent office but when asking (by email) which email address I should send the completed form to the response was...
"we don't accept that form by email"
Seems that while they do allow some forms to be filled in online this particular one could only be done via snail mail, courier or... wait for it ..... fax!!
The reason? Apparently this is because they need to have it date stamped and counted by their document reception department only for it then to be scanned in. Sounds like some wonderful job creation right there.
Given I've never sent a fax in my life I thought I may as well try before they go totally obsolete. How hard could it be, right... Easy, look, windows has a fax and scan app that will sort it out... NO. You'll need a fax modem for it to work, an ADSL modem is far too modern for that and you're totally out of "luck" if you're on fibre. Ok the local library they should have one... NO. Free wifi, access to photocopying but fax haa must be joking.
Searching online I found many places offering free fax but most require you to sign up for a contract to allow you to send, perfect if you need to send many, but for one single item seems a bit of overkill. I did eventually come across one that seemed trustworthy and provided a few free sheets called "hellofax" fairly straight forward so if you find yourself in this situation you may like to check them out.
It doesn't half seem ironic though that an office that is handling patents for cutting edge technology relies on fax.
"It doesn't half seem ironic though that an office that is handling patents for cutting edge technology relies on fax."
Wait! Are you saying patents something has to be cutting edge technology to get a patent? Or is it that "with a computer" makes it cutting edge?
"The reason? Apparently this is because they need to have it date stamped and counted by their document reception department only for it then to be scanned in. Sounds like some wonderful job creation right there."
This is a legal requirement. Under a first to file patent system the first physical filing is the one that gets the patent. Hence the requirement for a time stamp step. An email would have to be printed then time stamped or have some way to validate time of arrival. This could be done but getting the courts to accept it would take some doing.
The catch would be standardizing it and then establishing some legally-accepted system of authentication (both party-wise and time-wise). I mean, if push came to shove, you could do IRC Direct Client-to-Client, but try explaining such a system to a judge.
....was written like an advert of course. All fancy graphics and no substance. I know pagers are out of date, but they just wrote about 'pagers per bed' and 'staff members per pager' which infographic-style pictures. They made common errors like quoting figures to rather too many significant figures such as
"In the UK, the direct cost of pagers to the NHS is estimated to be £6,600,879". Really? £9 on the end of that, not £8 or £0'? And the savings from mobile software of £ 2,718,009!
But the thing that got me was the paragraph that read:
"This high figure is often
attributed to reliability of the
devices, which operate on radio
frequencies as opposed to
mobile or internet networks."
What in hell are they talking about?
All this leads me to think that the report is totally biased, while in fact there are genuine use-cases for pagers after all. And who knows? Maybe fax as well (but I doubt it).
"while in fact there are genuine use-cases for pagers after all"
Mainly that POCSAG standard pagers run at 150MHz and that frequency was chosen because it tends to penetrate buildings fairly well (the human body is more or less a 1/4 wavelength at that frequency, so pagers worn on the belt get reasonable coupling into a decent salty antenna, and the bit rate is low enough that they work even at really shitty s/n ratios.)
We demand you replace an old shit version of windows with a new shit version, whatever could go wrong?
In the meantime, what is so differnet about an emailed doc printed out and a fax?
Don't pagers have guaranteed delivery? I suggest they send a txt whenever ther'es an emergency in which a politician needs urgent care, hopefully this may lead to less of them spewing garbage.
The old version of windows is shit because it's ancient and out of step with computing in the 21st century. The new version of windows isn't so shit when you look at how many shitty things they're trying to fix. But I digress.
You wrote "In the meantime, what is so differnet about an emailed doc printed out and a fax?" - well, the difference is that an emailed doc DOES NOT HAVE TO BE PRINTED!! What is this fascination with having to print everything?
And you wrote "Don't pagers have guaranteed delivery?" and the answer is NO. For guaranteed delivery you'd need something like, um, a mobile phone, which can actually send delivery receipts with texts and also can run several apps that do the same such as whatsapp, google hangouts etc.
"What is this fascination with having to print everything?"
So that it can be kept where it's needed, such as on the patient's notes in this instance, and not on the doctor's computer at the other end of the corridor two floors down, or on the doctor's mobile when he's scrolled through a hundred other emails to find it, or on the doctor's mobile except it's a nurse who needs to see it, or....
"You wrote "In the meantime, what is so differnet about an emailed doc printed out and a fax?" - well, the difference is that an emailed doc DOES NOT HAVE TO BE PRINTED!! What is this fascination with having to print everything?"
Two words: paper trails. For many environments, having an unpowered, physical copy of something is a legal requirement. The biggest reason the paperless office went nowhere was because it ran smack into the law.
One of the reasons why NHS is still using fax machines is probably due to the adage: If it ain't broke, (then) don't fix/replace it.
My wife has retired, whenever we send insurance claim form (like up to 2017) she will always insist on faxing it to the insurance company (website allows email submission). When I asked her if they accept scanned email attachment she replied with "they will only accept faxed submissions".
It was only recently when she finally gave in.
Not being in the industry, but interested observer, I think the reason FAXs are so prevalent in the health industry is because printed documents transferred in "modern" protocols fall within HIPPA, and FAX's are preexisting tech and don't have all those silly data protection rules attached.
I've heard of medical billing outfits in the US that emulate 1,000's of concurrent online FAXs machines at a time so all those medical billings can go back and forth on paper, bypassing HIPPA rules.
I've had so many of my customers that have to process PHI billing just how they can do email with PHI and still be HIPPA. My answer of you can't just pissed them off all to no end. I think this is the industry's end-run to still have paper record shuffle.
If they substitute email, will the email be encrypted and signed? Will they set up TLS tunnels with everyone receiving such emails? Though not exactly secure, fax is still better than email.
(I once worked for a company that made inline encryptors for fax machines, complete with PKI. Very, very few people bought them despite their reasonable cost. We even had a sales demo of intercepting a fax, altering the sums, and sending it on. Usual response: that's not right!)
Maybe the negative comments about the use of fax machines ( in the NHS and elsewhere) tie in with various other posting around El Reg over the last few years, when for whatever reason Fax has been mentioned. There does seem to be a core of Commentards who just don't like Fax and won't hear a good word about it. To me it's just one more tool. And if it does the job and gets the result I need I'll use it if I can.. And why not?
and they are low risk machines. It's far more problematic that they _still_ use unhardened Windows boxes without the budget/competency to run them in any moderately secure way.
Complaining about Fax machines is like switching from fast terminal based unixoid systems to buggy and slow web services.
Having spent some time in hospital recently, as a victim of a weird spider/insect bite. The only successful process was the triage, driven by an ex-military doctor in trainers.
I was paying attention as well. The whole set up needs root and branch process analysis review. The administration is antiquated, slow and run by luddites, who haven’t a clue and fallen for the most basic of comercial tricks, such as decade long contracts, which you have to pay to end and such-like.
I even spent time in psych-ward, the most pythonesque experience, you can imagine, being chased around by women with no pants on. What do you do for a living? Wow, and you talk to your phone! You’re clearly bonkers and are making it up! What I’ve never met you before!? It’s ok the junior idiot is back in on Monday they understand technology...
There are so many areas for efficiency gains and costs savings.
To give you one example alone, it was quicker to find the ECG department on my own, get a scan and take the results back to the funny ward, rather the wait another day for the orderly had wheel-chaired my there and back and hand-delivered the results the next day.
I walked out at the first opportunity when the door was unlocked, before the results were processed and whatever my release from the unit is actually called. #oneflewoverthecuckoosnest
I left local government six years ago, so things may have changed, but the NHS would not let local authorities email NHS Trusts anything with patient data in it as this was only permitted within the NHS using their own secure email system, which the NHS was not prepared for us to be a part of. We had to send everything by fax (mainly water and food-borne disease case notifications and outbreak questionnaires).
Given that all kinds of non-NHS organisations exchange medical data with the NHS, including employers that have to organise and assess regular routine screening of employees, one wonders how they get on.
things may have changed, but the NHS would not let local authorities email NHS Trusts anything with patient data in it as this was only permitted within the NHS using their own secure email system
Amusingly enough, the NHS also wouldn't let the NHS email patient data. Because the central nhs.net service was encrypted but local Trusts' nhs.uk setups weren't necessarily.
Things have changed, a bit. See: https://s3-eu-west-1.amazonaws.com/comms-mat/Training-Materials/Guidance/encryptionguide.pdf (PDF, soz)
Seems like a bit of a faff to set up to be honest, so I wonder how much it gets used. But it also looks like they were aware of the problem and tried to address it.
As a trainee doctor, ward fax machines were perfect "push notifications". During a busy day we sent off blood tests, arranged investigations. While working on a busy ward it was brilliant that as soon as a result was available or a test reported, the fax machine buzzed. At next opportunity we would check the result, initial it, and stick it in the notes.
The current expensive network systems are miles away from providing the speed and convenience of this setup. We have no push system, and are reduced to repeatedly logging in and going through interface-hell to see if an important result is available yet.
Providing timely clinical information to busy medical staff in the NHS has without a doubt gone a long long way backwards since the 1990s :(
If a fax goes from your machine to the destination machine down a phone line, how easy is it to intercept?
How many Viruses are spread via fax machines?
If a scanned document goes out over the Internet via email, how easy is it to intercept?
How many viruses are spread via emails?
do you know how many fax communictaions are involved in a football transfer?
if the FIFA fax line goes down on deadline day, the deadline gets extended.
On the subject of the NHS, the system is broken, there is not enough cash in the right places and the wrong things are centralised and pushed to the edge. THere have been numerous attempts to remove the middle managment an beurocratics, but somehow regional and national and sub-national structures make there way back.
The current money wories in the NHS can be traced to the (finaly) former health secretary's Health and Social Care Act 2012, that formed the current funding system of the NHS, that sees these non-medical non-accountabale bodies known as CCGs get to choose where everyone in their area gets certain things done and by who, this frequently entails private companies who pay there less qualified staff considerably less than the NHS and get to deliver services from the NHS buildings.
A few points in reply to some of the comments made on this story.
1) No - we don't use thermal paper. For the love of God, it's 2018 !
2) Many of the "fax" machines are indeed part of a multi-function copier which in it's default configuration under the OGC (Office of Government Commerce) contract, has the fax option installed as standard.
3) Many departments have an analogue line for fallback, in case the VOIP system fails (and it can), so even if you rid the NHS of fax machines, there will still be a large number of analogue phone lines in use.
4) Fax isn't used anywhere near as much as it used to be - it is on the decline, but it's taking some considerable time for each use case to be resolved with other technologies.
5) Fax as a protocol is far more capable than you'd think. Unfortunately, the full possibilities never really took off much outside of Japan. Colour fax was actually a thing there !
1. Some places are stuck with them for lack of alternatives.
2. I have to use a fax modem because the scan unit on my MFP is iffy (tends to stripe).
3. What happens when it's the analog line that fails? Many places, if one goes, it's usually something that takes out the other.
4. As I've said, the big stumbling block is standardizing some kind of authentication system to lock digital documents. Perhaps instead of relying on format allowances, perhaps something prepended to the file.
5. Much like the typical photocopier, the usual response is "Who cares?" Color fax is even more 's niche case than color copying, to the point it's easier to e-mail for those rare occasions. No legal standard AFAIK requires a color copy of a document.
I was going to make a snarky comment about the use of "farcical", as since I were a nipper, the word was always "farcial" (pronounced far-shul). It occurred to me to wonder whether there'd been a change in the spelling of the term denoting "having the quality of a farce" over the years, as language and spellings do drift over the years (I'm old enough to have seen "shew" used on a [ublic noticeboard - archaic spelling of "show"). To my surprise, so far as t'internet is concerned, "farcial" seems never to have existed - and yet I know it was in common use. Similarly, "having the quality of fantasy" was "fantastic" not "fantastical"
Did the good citizens of Bristol manage to hack the worlds online dictionaries and thesauri or have I drifted in from the universe next door and only just noticed - or has the cider finally rotted my brain?
My money's on the cider, I've never heard nor seen "farcial" used. Could be the universe next door and the cider, that's a fun combination. I have seen both "fantastic" and "fantastical" though, so maybe I've paid a visit to your universe.
Cider is likely responsible for 'a [ublic noticeboard - archaic spelling of "show")', so I'll go with cider.
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