How I Use Technology

Carebit is the practice management system. Your record lives in it — notes, letters, documents, results, invoices, appointments — encrypted, and seen only by the clinical team. The part you hold is your patient portal, and it is not a copy of your record kept somewhere else. It is the record: the same one I am looking at.

In your portal you will find:

• • Your appointments, past and upcoming
• • The letters written about you
• • Your results, once they have been discussed with you
• • Your invoices and receipts
• • Documents either of us has added — and a secure way to send me a message or an image

Sending me a photograph. The most underused thing in the practice. If something on your skin changes, if a wound looks angry on day five, if a lesion is not behaving as expected — send it through the portal rather than waiting for an appointment. Not by email or WhatsApp: those are not secure, and the image then lives outside your record where neither of us can find it again.

Who sees it. Messages and emails sent through the practice reach my secretary as well as me — that is how you get an answer when I am operating. Photographs do not. An image you send through the portal comes to me, and only to me. Given what most of these photographs are of, that seems the sort of thing you should be told rather than left to assume.

This is not an emergency service. Sending a photograph is not the same as flagging it: a notification reaches me, but it does not tell me anything is wrong — so send the image and, in the same message, say you need me to look. And if you need an answer now, do not use the portal at all. For anything acute — you are unwell, a wound is spreading, hot or discharging, you have a fever — NHS 111 or A&E. My secretary answers Monday to Friday, nine to five, but is not there to triage clinically.

Taking a photograph I can use: daylight near a window, no flash, plain background. Three shots — one at arm's length to show where it sits, one close up, one from the side if there is swelling or curvature. A coin in frame for scale. Then one line: when it started, whether it hurts, what has changed. That sentence does more work than the images.

Video appointments. Not for everything: if you need examining, you need to be in the room, and I will say so. But for results, a follow-up, a change of medication, or the fee-free call after a first consultation, video beats crossing London for twenty minutes. It runs inside Carebit and lands in the same record as an in-person visit.

The recording. Your consultation is recorded and transcribed so I can look at you instead of a keyboard. It is made through Carebit's own ambient scribe, inside the system that already holds your record, on encrypted infrastructure in UK data centres, and the transcript is held with the same confidentiality as everything else in your file. I record by default. If you would rather I did not, say so — before we start or halfway through — and it costs you nothing in the standard of care.

I will not tell you more than I know. Precisely how the audio is handled once inside Carebit — what Carebit does itself and what its suppliers do behind it — is Carebit's to document, not mine to paraphrase. If it matters to you, ask and I will point you at their data-processing information.

Clynxx is the electronic prescribing system. What I prescribe does not become a piece of paper you have to keep hold of — it becomes a code that reaches you directly.

How it reaches you. Twice: once by email and once by text. They carry the same thing, so you only need one. You take it to a pharmacy of your choosing, and the pharmacist opens it with the code plus your date of birth. Nothing to collect from the clinic, nothing to lose in a coat pocket. Keep the message until it has actually been dispensed — if you lose the code before then it can be reissued, but that is a phone call neither of us needed.

Where it works. Any pharmacy in the UK or the EU, chains and independents alike — which includes being abroad in Europe and realising you have run out. It is not valid beyond the UK and EU, so if you are travelling further and will need a repeat, tell me before you go.

What it costs. A transmission fee of £1.24 per prescription, paid by you to Clynxx, not to me. It covers sending the prescription securely to your email and phone. I take no share of it and it does not pass through the practice.

The bit worth exploiting. The medication itself is a separate cost, paid to whichever pharmacy dispenses it — and private prescription prices vary between pharmacies for the identical drug, sometimes considerably, particularly on the medications used in andrology. Because your prescription is a code rather than a paper tied to whoever is nearest, you can ring round or check online and dispense wherever it is cheapest. I have no financial interest in where you go.

TDL is the laboratory. Requests go to them electronically, so there is no paper form for you to carry and none to lose. You walk into a collection centre and they already have the request — it was sent the moment we finished talking. Results come back into your record and are discussed with you before they are released: you will never open a result on your own with no idea what it means.

Go the same day if you can. Bloods done on the way home rather than next week usually means the results conversation happens at the follow-up already in the diary, instead of adding another appointment to your life.

Timing matters more than people expect, and getting it wrong costs you a repeat trip.

• • Testosterone — come in the morning, before 10am, and come fasting. Levels are highest early, and an afternoon or post-breakfast sample can read falsely low and send us both down the wrong path. This is what the European guidance specifies, not me being fussy.
• • Semen analysis — two to seven days of abstinence beforehand, the international standard. Shorter or longer and the result is harder to interpret, which usually means doing it again.

I will tell you which applies to you. If you have booked and are unsure, ask before you go rather than after.

Concentric is the digital consent system used for procedures at Chelsea and Westminster Hospital. It changes the most for you, and it is the one patients are most surprised by.

The form comes to you before the day. You read it at home, at your own pace, with the risks and the alternatives written out in front of you, and you sign when you are ready — not when someone is standing over you with a clipboard.

I feel strongly about this. Consent taken on the morning of surgery, in a gown, in a corridor, with the anaesthetist waiting, is consent in name only. Nobody absorbs a list of complications in that state, and nobody asks the awkward question they actually wanted to ask. Moving it days earlier is not an administrative tidy-up: it is the difference between being informed and being processed.

How to use the days you have been given:

• • Read it twice, on two different days. The first read is for the shape of it; the second is when the questions surface.
• • Show it to whoever is coming with you. They will ask something you did not think of, and they are the one looking after you afterwards.
• • Write your questions straight onto it and bring that list to the pre-operative call. There is no question too small.

And if, having read it, you are less sure than you were — say so. Changing your mind is a legitimate outcome of consent working properly, not a failure.

When “built around you” is taken literally.

One app, two halves, matching the two halves of the silence.

• • Polaris takes the run-up: what the procedure genuinely involves, step by step, what happens on the day, what to sort out beforehand — written for someone who is anxious, not for someone revising for an exam.
• • The Compass takes the recovery, paced day by day. Not one leaflet for the whole fortnight, but what a normal day three looks like, and day seven, and the specific things that would make me want to hear from you sooner.

Getting in. A personal link, a code, or a QR from your surgical team. No account to create, no patient details to type in. There is an Easy Read version throughout, plus text-size controls, high contrast, dark mode and reduced motion — because a patient on day two after an operation is not reading at their best and should not have to.

How to get the most out of it. Open it the day you are given the link, not the night before the operation: the whole point of Polaris is the time it gives you to think of questions. Read the recovery days ahead of the day you are on — knowing on day two what day five looks like is what stops day five being frightening. And show it to whoever is looking after you at home, because they are the one judging at 9pm whether something is normal.

If something in the app contradicts what I said to you in clinic, what I said to you wins — then tell me, so I can correct it.

What it is not. Patient Compass does not diagnose, decide treatment, or replace your surgical team. If you are worried, use the contact and urgent-help instructions your team has given you.