- The document proposes developing a system called VirtualNHS to standardize healthcare delivery in the UK. It describes the author's experiences identifying issues like misdiagnoses, inadequate physical exams, and overprescribing of antibiotics. - The author developed assessment tools to help less experienced doctors. This evolved into the proposed VirtualNHS platform, where doctors could create customized diagnostic tools and offer remote care. - The goal is to reduce unnecessary healthcare utilization by 70% while improving care quality and monitoring clinical practice. The system aims to save the NHS billions while preventing errors and "wrong doings."

1. Why Systemize Of Health Care Is Essential To Modernise Medicine
Unplanned hospital admission is costly for the healthcare system and for
children, straining finite hospital resources.
Once admitted, children are at risk of hospital-acquired infections, medical
errors, drug reactions and emotional
trauma.’
A reduction in unplanned hospital admissions
for children was one of the targets in the NHS
Outcomes Frame work which has failed.
Do We Need To Change? Asked Collin Powell,
in the Editorial. YES!! Because of reasons I
explain below that will make you think it is
essential to reduce cost, protect patients and
make sure we help reduce spreading infections in the community.
My PROJECT
In 1990s, the new batch of SHOs who came to work in the hospitals where not keen to
learn nor confident to diagnose and mange sick children. Some of them were simply
calling me to review every child brought in to hospital. Initially I made a list of
symptoms to help the SHOs decide when to call me, treat or send home. I reviewed the
ones who required admission..
Then I wrote a small simple programme in my Psion PDA called "PAT" (Pediatric
Assessment Tool) that worked very
well. The SHOs also learnt a lot using the
tool and were becoming confident. In
1996, I criticized hospitals using “Pre-
Printed Assessment Sheet” and said this
will result in doctors not adequately
trained and so not safe.
I did not think my tool would one day
help until I started working in a Nurse-
led Pilot GMS practice as a salaried GP in
2003. Article in BMJ is asking for a tool
to help (differentiate common from
serious illness) in-experienced doctors.
One dose of antibiotic is said to kill all the
good bacteria and the patient becomes a reservoir of antibiotic resistant bacteria. This is
not one we can brush aside because it is un-ethical to harm but also threaten our
existence by increasing resistant bacteria.
Colonization Of Bacteria In Surgery & Hospital
Visiting various surgeries in and around London gave me an opportunity to learn
about infection control and how bacteria spread from patient to patients.

2. What Made Me Think Different?
I was employed as a Salaried GP in this “Pilot PMS
Nurse-led Practice” (First one to be established)
linked to local Walk-in-clinic. Here I stared
identifying minor and serious mistakes committed
by nurses working in the local Walk-in-clinics and
the practice I was working.
I was also hearing what goes on in hospitals as my
wife working in St Georges Hospital, Kings College Hospitals as the SPR in Paediatrics.
Wrong diagnosis and treatment were making patients suffering and develop
complications. Diagnosing snuffles, ear infections, cough, fever, sore throat, diarrhea,
vomiting and rash is often wrong. Majority of doctors I asked to define “Inflammation”
often said “Infections”. This made me realize medical professionals have been thriving
on emotions and not necessarily using medical knowledge. Some incompetent and in-
experienced doctors are using published guidelines to shield their incompetence and use
them to protect themselves when things go wrong.
Problems I Identified Working As A Locum GP in Various Surgeries
Ear Infections
Pain in one or both ears is often labeled as URTI and treated as infection but in UK,
doctors and nurses do not use pneumatic otoscope but document as “Red ear”. This costs
NHS £24 Million every year and help increase antibiotic resistanant bacteria.
Majority of patients notes say wax++, red ears. But how can wax be present in the ear
when the eardrum is infected, red, hot and painful?
I hve never seen “Pneumatic Otoscope” in hospital or Surgery. I have used this for years
and also use tuning fork to perform Webbers & Renni test. Not many doctors or nurses
have even heard about this test and why and how I use this. These are standard clinical
examination methods used all over the world.
Chest Infections
Cough is used synonymously with Chest Infection. Not many Gps were documenting type
of cough nor clearly documenting clinical findings. “Chest Clear” or occasionally Crepts,
crankles, wheezy or mild wheeze are documented. When I ask patients whether the
doctor or nurse examined chest, majority of patients told me the doctor did not.
Examination of chest with cloths on can never be “Clear” because the cloths will rub on
the diaphragm and produce crackling noise.

3. PCT also investigated a complaint against
me because I requested a girl aged 18 years
to undress (her mother was present). The
letter clearly state she had seen numerous
doctors and nurses and no one had asked
her to undress.
Cough is the last symptom of so-called chest
infection and is said to be to help our body
clear the fluids (Resolution). Giving 250mg
of Amoxicillin is often routine. This is under
dosing and will certainly increase resistant
strain colonization. We must administer large dose of antibiotic to clear chest infection
because the antibiotics will not be secreted by exocrine glands & will not enter alveoli.
Urinary Tract Infection
Poorly managed and now we are left with one
antibiotic that may work. E-Coli threat is not
simple and is likely to kill more people than
we have ever seen. Swapping one antibiotic
to another because the culture sensitivity
report say the organism is resistant to the
antibiotic patient is prescribed. I have never
come across doctors contacting
microbiologist and discussing or trying to
find out MIC Used to test sensitivity.
Even if the patient is happy and well, the antibiotics are changed. This is poor
standard care. I was shocked when this girl seven presented with bloodstains in
panties. No doctor or nurse even bothered to examine her.
Most Gps Use Wikipedia Or Google As Reference Books/
According to a survey of the UK’s doctor’s surgery
receptionists, most GP’s use a combination of
Google and Wikipedia to diagnose patients and
prescribe medicine. Gps look things up on the
Internet or use iPad to help diagnosing patients.
A lot of the time they’ll work from home and see
patients via Skype, keeping Wikipedia open in
another window whilst they talk about their
symptoms.
These are only few clinical problems I am explaining about. The number of wrong
doings that go on is more than I imagined and so systemization is essential to see
what and how doctors manage their patients.

4. What I Did To Help Protect Patients
In 1996, I read about “Pre-Printed Assessment Sheet” in medical journal and so I have
criticized this approach and so started independent study to find alternative method to
offer emergency care. Since 2003, I have collected information about why patients come
to consult and compiled a list of patients who must be examined by a doctor.
I developed a simple set of cards that I could test and see if the tool offers the same
advice as I do. The number of symptoms we choose to compile the final set of common
symptoms was nine. The tool helped patients to differentiate “Common” and “Serious
Illness”
The number of patients demanding emergency appointment in the surgery reduced by
30%. These cards will also encourage people who have symptoms but assume it is
common and so they present late with complications.
In the last few years I went through all the literatures about patient access and then
wrote a simple programme that could work well. To make this very safe, I created a
database with the help of my friends in Bangalore. This is the tool you can access FREE
only if registered and will tell you whom you must consult Doctor, Nurse or a Chemist.
How Tools Help Identify Problems Early
Two reasons we must systemize (1) Make doctors commit to what and how they mange
their patienst and (2) Reduced unethical medical practice like wasted investigations and
treatment. Standardize care will be safe and gives us the opportunity to monitor clinical
practice, prevent wrong doings and allow doctors implement and incorporate advances.
VirtualNHS.COM
Now using the tool, I have created a "Virtual NHS" that will help NHS survive and protect
patients. I have not allowed people to browse through nor registering patients or
doctors. This tool allows doctors to create their own tool based on the list of common
symptoms that I have identified.
I am planning to offer this to NHS and make it available to every GP in UK. GPs will find
the tools helpful as it reduces wasted consultation, help boost their moral and doctors
patient interaction.
This site will “Systemize Healthcare” and so protect patients. The doctor can access,
change criteria, add or remove drugs, referral, and investigation and even perform some
basic clinical examinations. The present method of offering emergency care,

5. consultation and diagnosis offered in primary care is neither standardized nor similar.
Doctors and patients interaction occurs behind close doors and so only a doctors
(locums) have access to the notes and so can identify wrong doings.
Doctors can offer their service 24/7, 365 days because the tool will work like the SHOs in
hospital and eliminate common illness and offer advice and treatment authorized by the
doctors. This will reduce access by 70% and the doctor will have to only mange 30% of
their patients.
When the doctors set the criteria, authorized treatment, speak to doctor, referal or
consultation the tool will automatically refer seriously ill patients to hospital, call
Ambulance, refer and also send prescription to the local chemist.
The beauty of this work is it can be installed in computers at home, surgery or create a
Kiosk that can also be placed in super markets, gas stations and clinics .
NHS will not have to invest in establishing IT Department or spend £Billions to
implement this tool. I have created APPS for common symptoms that will work like a
doctor (help diagnose, advice management and suggest treatment) that could help me
cash in but am not releasing this now because I want the medical profession to survive.
I am not registering doctors or patients in VirtualNHS.COM because this tool can be
abused and so destroy General Practice. I feel we will need GPs to help support sick and
mentally ill patients at home)
I am in UK and my mission is to make sure this work is made available to every citizen in
UK. It is my duty as a doctor to help protect innocent people and prevent wrong doings.
You can download one of my WebApp in Desktop or visit my website and click on the
iPhone image to download Maya App in your smart phone if you click on the iPhone
poster. To access MAYA you will need to register (FREE) and use your User ID and
Password will be sent to you directly. Once you log in you can see how this works.
I need all the help you can offer knowing my ontribution is not only likely to save
£Billions but also become the tool that doctors and patients can use all over the world.
My work is almost complete but need to make her presentable and start saving lives,
reduce spreading infections and wrong doings in the NHS.
VirtualNHS will make doctors; nurses and chemist to standardize care offered by them
and so will make their work transparent. Now the system does not allow patients to
know or identify wrong doings that go on every day. I will be happy to come over to your
office or home and show you how this works. Its simple, easy and 100% safe.