The Right to Reside and dodgy data
A former chief executive of the NHS has said most data collected about hospital discharges by NHS England is ‘useless’ and biased against social care.
Sir David Nicholson, chief executive of the NHS from 2006 to 2013, and of NHS England until 2014, added that “a lot of the data we collect…is designed for accountability reasons, not operational reasons”. Counting patients lacking the Right to Reside does not help plan discharges.
At the time of writing around one in eight hospital patients in England are waiting to be discharged – a proportion has been the same for several months.
An anonymous HSJ commentator added: “Every day in my hospital an army of clerical staff spend their time generating and responding to data which can be correctly described as worthless. What is more concerning is that the executive team seem to be more interested in this mumbo-jumbo data than the clinical services in the hospital”.
Another said Nicholson’s “profound insight is that discharge data is designed to assign blame not to drive improvement. And the whole process is bereft of any thinking about what and how to change discharge process to drive improvement. That is a damning indictment of many critical data sets across the NHS. And one of the major reasons why the system struggles to improve”.
“The general lesson is that the major purpose of data should be to support operational improvement not to assign blame. The NHS could improve far faster if it paid far more attention to collecting the data needed to drive improvement and on the quality of the data collected for that purpose”.
Source: Matt Discombe “ Former NHSE chief: ‘Most hospital discharge data is useless’” Health Service Journal .30th November 2022
Two short stories about pizzas
Story 1. Q: What’s the difference between a US Family Physician (GP) and a pizza? A: a pizza can feed a family of four.
Story 2. The Two Pizza Rule. Declining productivity is the curse of expanding teamwork. Amazon (booo!) tries to solve this by limiting team size to one that can be fed with two pizzas.
Source: Ethan Mollick One Useful Thing 2022; 10 (36)
Hope, at last?
Recent media stories about a great breakthrough in developing an anti-Alzheimer antibody drug, Lecanemab, relied on press statements from producers Eisai and Biogen released before the Clinical Trials on Alzheimer’s Disease conference (CTAD) in San Francisco, at the end of November. Lecanemab targets a protein, amyloid, thought to be crucial to the development of Alzheimer’s disease. Research to find a cure for Alzheimer’s disease has been carried out for thirty years with no sign of success, so there is much talk of ‘hope’ with antibody drugs..
Lecanemab Is being hailed as a game-changer even though its effectiveness is doubted by some researchers. Some researchers doubt that patients receiving it will notice the difference, which is an important flaw. Costly to produce, with a need for side-effect monitoring (because of brain swelling) and deliverable only by injection, Lecanemab does not look like a gamechanger to NfN moles
Roche announced results from the GRADUATE Phase III trials of gantenerumab, also an amyloid-buster, prior to the CTAD conference. A large scale trial of gantenerumab did not achieve its primary intention of slowing clinical decline in people with early Alzheimer’s disease. The level of beta-amyloid removal by gantenerumab was lower than expected. The failure of this trial seems to have attracted less media attention, perhaps because it offers no hope.
News from Nowhere has two thoughts about this story. The first is about the wisdom of disseminating science by press release, and the second is about the ethical basis for promoting hope when the scientific basis for doing so is skimpy.
Source: Ian Sample, That first breakthrough is like a hole in the dyke. The Guardian Tuesday 22nd November; https://www.roche.com/media/releases/med-cor-2022-11-14
It does what it says on the bottle
This year is the centenary of Stanislaw Lem’s birth.
So what?
He was a doctor who became an eminent philosopher of science, and writer of science fiction.
OK but what’s it to me?
He lived through the Pharmacological Revolution and believed that medicines’ names should reflect their purposes.
No more Aducanumab?
Exactly. And no more hundreds of other opaque drug names
What were his alternatives?
He started with psychotropic agents of the benignimizer group, the n,n-dimethylpeptocryptomides, which produced states of undirected joy. Psychoactive drugs from that group included Hedonil, Euphoril, Inebrium, Felicitine, Empathan, Ecstasine, Halcyonal and all their derivatives. Replacing an amino group with a hydroxyl yielded Furiol, Antagonil, Rabiditine, Sadistizine and other polyparanoidal stimulants of the Phrensobarb group, which were much admired by the military.
Why didn’t his ideas catch on?
These names say what it does on the bottle, which could be a problem. Too much transparency is risky. Better to make your illness opaque by taking medicines that are mysterious.
Source: Stanisalw Lem The Futurological Congress Futura Publications 1977
Read more News from Nowhere and articles on the NHS in ERA 3 at http://www.healthmatters.org.uk/