Last update 15th. May 2004


To the Choosing Health Consultation

Real Time Governance of the National Health Service

Further to the March 2004 Consultation document I am a Consulting Management Cybernetician and have been concerned with Public Service Management and Health since 1997 as Chair of a six member voluntary IT Design Group made up of leading academic and commercial experts.

We find the management of resources could be greatly improved if all therapeutic patient contacts were subject to Real Time recording on cheap reliable web technology PCs.

This would enable automatic alerting of staff and their managers not complying with best practice and focus prompting of better practice. As outcomes are systematically reported a data base of evidence is built up which enables evaluation of better practice. This is applicable in all treatment settings. Full real time audit of resources is enabled and thus global and local risk assessment in a patient and treatment cantered approach. This is the product of the clinical and patient record system now under adoption when subject to real time statistical analysis.

Environmental monitoring should also be improved notably air pollution, food, alcohol and tobacco consumption, demography and crime levels.

The re-establishment of respect for medical professionals will only come with an improved understanding of local and global procedural risk. Safety critical risk minimisation has to take over to make cover-up culture a thing of the past. This means rewards for managers detecting untoward incidents and bad practice and the establishment of a culture of excellence with no more lying to patients in the National Health Service.

There are a number of detailed technical management issues which you will want to discuss with members of the Study Group. We have developed some simple but very precise design rules which require strict compliance for success.

Please acknowledge your receipt of this submission and advise us of the name of the person responsible for evaluation and recommendations for further action.

Nick Green FCybS

Camden and Islington Mental Health Trust Public Patient Involvement Forum

Council Cybernetics Society


Real Time Study Group

Alerting, Modelling and Audit in Real Time

Professor Alex Gray Professor Antonia Jones

Dr Robin Bailey Dr Allenna Leonard Dr John Chandler

020 7916 0285

16th April 2004

email: Nick Green