Send to Kindle

I've recently come across a free new tool from Amazon. It is an application which allows you to send documents from your PC to your Kindle device. It converts to either pdf or azw. The application can be found here. Here's some more information about the tool. It seems to work quite well with a couple of minor issues on font conversion which I'll investigate further.

It is definitely worth a try.

Story Plot

It is amazing how just reading the daily news can give rise to plots for the next book. I was reading that the Eden Project has withdrawn from sale jewellery made with the rosary pea, sometimes called Crab's Eye peas. It turns out that the toxin contained in the peas is 75 times more toxic than the feared Ricin made from Castor Oil beans. Sometimes these peas have been found in ethnic baby rattles!

Ideal stuff for the bad/good heroine in my next book.  The peas can be purchased openly through the internet, including Ebay!

Background to TFOH

As part of my Adam Cranford series I've created a "Draft" of a member's handbook for the Foundation of Honour. I'd be interested to receive suggestions from fans of Adam Cranford to add to the text of the handbook. You can find it on Kindle .com and .co.uk .  If you don't have an actual Kindle Amazon do a free reader for PC, Apple, Android which can be found here.

Fresh breeze

There's a pretty strong breeze in Edinburgh at the moment.  164 mph on the Cairngorm.

Lansley's NHS

Andrew Lansley has published his plan for privatisation of the NHS, ooops I mean health reforms. They cement my view that the concept of the NHS Walk-In Centre is thoroughly dead. There is no mention of Walk-In Centres in the Primary Care bit of the plan (item 44), the GP lobby in the Lansley advice coterie is getting its way. They are determined that the public will attend their [private partnerships] surgeries at a time convenient to the well paid  GPs rather than the needs of the public. People go to Walk-In Centres because they either can't get the service they need from their GP or the quality of service is so bad that they seek an alternative.

Meanwhile I've been contacted by a Nurse Practitioner (30+ year's experience, Masters degree in medicine) who tells me his future employment is so uncertain that he's stopped buying a season ticket for travel to work. He now only buys a weekly rail ticket.

Hospital A&E Walk-In Centres

You'll have seen my earlier comments about NHS PC Walk-In Centres. In the main these are being closed, though sometimes a Walk-In Centre will be attached and managed by Acute Trust personnel rather than senior primary care medical staff. With the PCT WICs the emphasis is on successfully treating the person who walks through the door with subsequent follow-up by that person's GP. Where the need is serious andurgent the PCT WIC nurses will refer the case to the nearest A&E dept, usually following phone discussion between the WIC and A&E medics. The objective is to divert less urgent and less serious cases to the WIC.

When the WIC is managed by an acute trust and located close to an A&E department the nature of the service changes. The focus is much more dealing with unwarranted non-urgent patients to direct them away  from A&E. The focus is reducing the queues at A&E rather than treating the patients.

There's a case reported in the Daily Mail web site where a person who should have been treated by an A&E doctors was turned away by an A&E receptionist and told to go the WIC next door. The details in the Daily Mail report are not extensive but it appears the poor chap left the WIC with just eardrops and subsequently died from blood poisoning and brain damage. Here's the BBC report. It is very sad and my heart goes out to his family.

I do wonder however what the outcome would have been had the patient initially attended a PCT WIC where the nurses are trained to work autonomously (on their own) and give a through examination. Any urgent/serious cases are then passed immediatly to A&E, if necessary using a blue light emergency ambulance. There are clearly defined medical protocols the nurses are trained to follow which provide "red flag" markers of serious conditions.

In any event, patients presenting with a medical condition should not be turned away on the word of a clerical receptionist.

Rats or Birds?

One of the signs that something is wrong in an organisation is when several senior managers leave of thier own choice in a periods of a few months. A recent article in the Guardian Newspaper highlights a case in the Barts Hospital in London UK. The guy in question has worked at the place as a skilled surgeon for many years. Suddenly he finds it an unacceptable place to work! There have been several instances of senior administrative and clinical staff (5 out of 14 orthopedic surgeons) finding employment at an alternative location more attractive. Is it rats leaving a sinking ship or is it birds flying away before an earthquake? Has someone broken the spiritual backbone of the place? It is very difficult and expensive to repair a damaged corporate psyche. Maybe there is a programme of cuts using an experienced aggressive "Turn Around" Director?

The same kind of thing has happened in the North Staff's hospital. Now the administrators had to draft in Army Medics to keep their A&E  department running. Professional medical staff such as surgeons and specialist nurses will be caution about joining to work at a hospital with a damaged reputation.

It is a pity, because BARTS does some good clinical work caring for the patient. For example they're the only hospital actually checking the safety standards of surgical instruments. See the worrying Panorama programme in July 2011. They also do good work in research in Prion infection on surgical instruments. Perhaps the problem is the way the administrators engage with the clinical staff? Is there a climate of bullying? Are we getting value for money from these highly paid administrators?