I recently told the MND clinical team at the National Hospital for Neurology and Neurosurgery in London that I no longer felt strong enough to come to the appointments. The appointments lasted about 90 minutes every three months. With travel, it was about a seven hour day. At my advanced stage of MND, the people who make a difference are the hospice nurses and care home staff. However, it’s very helpful to be able to speak with the team at the National Hospital. I asked if we could do the appointments via Skype or indeed any virtual link with video. Answer was that Skype isn’t secure and there was not an alternative.

In Queensland, video links are an established way of doing medical consultations. See here and here. Business uses Virtual Private Networks for secure communications of information and for video calls. It’s so common these days. There is no doubt that the NHS could offer remote consultations. I found some evidence of it in Yorkshire.

When government ministers say that the NHS could be more efficient, they seem to non-expert me to have a point. A Norwegian consultant I saw last year at the National couldn’t believe that the systems and databases in the NHS were not joined up. It’s vital that information is shared and easily accessible. She described how it is in Norway and did this while writing me a letter on the NHS computer, which she could not send to me by email. She gave me a printed copy. I won’t forget her face, she looked at Lisa and I in disbelief. I said that she could always move back to Norway if that would make her feel better. She smiled and told me that she was happy to be going to Oslo for a few days.

As I have understood it, there are concerns about information security. How about everyone has a myNHS online site, with encryption like in personal banking. It could all be tied in with ID, criminal record, driving etc.

Let me just write this again.

The UK National Health Service only sends letters via snail mail.

2018, mobile, digital, data, instant.

Perhaps my readers outside of these islands can tell me how it’s done in your country. Looking forward to hearing from Estonia.

Check this out. On many, but not all occasions the care home needs to send its pharmacy prescriptions by fax.


I don’t want to use my precious energy to find out why.

Fax machine – popular form of long distance written communication in the 1990s.

Back to appointments. I always preferred face to face business meetings, also social is always better in person. For many types of appointments, the patient and clinician must be in the same room. Pollution, time, congestion, lower risk of catching something, benefits are obvious. I sound like I work for Vodafone again.

If you want to tell me the fifty good reasons we can’t be more advanced in this area, go ahead and we’ll be having the same conversation in five years from now.

In case you were wondering, faxes still make that reassuring sound when they transmit.

I appreciate the team at the National Hospital and I know we will have a video appointment by the end of 2018. I am on the patient list and we will stay in touch.

Author: Andrew Knowlman

I am a 50-year old father of two children, married to Jane. I live in Hertfordshire, UK. I was diagnosed with Amyotrophic Lateral Sclerosis in April 2015.

One thought on “Fax”

  1. Excellent read Andrew. And yes, you sound like you still work for VF!
    Here in the US it seems face to face appointments are still necessary. My dad has difficulty getting around and my mom can’t drive him into the city to see his specialist. Some video appointments would be a nice relief. But medicine is privatized and expensive here. In order for DRs to get reimbursed I’m sure the insurance companies require today and long into the future a face to face visit.

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