Photos available now!

 This is the Lutheran cathedral in Helsinki - an impressive building which can be seen for a long way.

 The central square below the cathedral, complete with tram

 A view of the harbour and sea at Helsinki. I hadn't realised it even was by the sea!

 Further round the harbour looking across to an island that is connected by a bridge

walking back towards my hotel

Some of our group - Cesar, Agatha, Lorraine and Dian - most drinking coke as wine v expensive!

The complete group on the Monday - with Lars on left and Steve 2nd from right

The double-decker on the other platform

For Rob - our pendolino coming in!

My flat in Tampere (bed settee) with kitchen and shower room

So you will see that I have not only managed to get back onto blog - and this time in English!!! Hooray. But also uploaded photos and imported into blog so really chuffed with myself!
Today (Tuesday 15th May) Pirjo came to my flat and met me and then we went to the hospital - Tays. It is in the Pirkanmaa Hospital District which covers 22 municipalities. I have to make sure I get all this right as Pirjo said she had been on my blog last night!! We spent the morning going round the site. It is a very big hospital and is a university hospital - there are 5 in the whole of Finland I think. We spent about 3 1/2 hours walking round and I met a lot of people. It was Petri's birthday so I had a piece of really nice cake too! We went to my office - complete with computer, printer and Pirjo had a mobile office of equipment for me too. It is in the patient hotel - patients can choose to stay there before / after operations and their relatives / carers can stay there too. It is really nice and open to anyone to stay there.
Then we had lunch in one of the restaurants. The food was very good. It seems that most people have their main meal at work. Lunchtime is generally between 11 and 12 or 12 and 1. There was even non-alcoholic beer to drink!
I then met with Erkki who is one of the hospital directors. He was an obstetric / gynae doctor but decided that he wanted to move into management to make more of a difference to patient care. It was really interesting finding more out about Tampere and the surrounding area. Tampere has a natural rapids between 2 almost adjoining lakes. The energy from the rapids made it an ideal area for industry to develop - machinery, textiles, wood, pulp. These have since declined but it remains a thriving growing town with a population of about 215, 000. The hospital provides care for the residents of Tampere but also the surrounding areas which include many smaller towns and some sparsely populated forested areas where now mainly only elderly people live who are becoming increasingly frail and so requiring more health and social care.

Erkki explained that they are trying to improve their links with primary care. Traditionally primary care has been overlooked as it has not had the status of secondary care and not attracted the financial investment. The health centres are all independent and managed by the GPs. Tampere has about 12 health care centres. They are very reliant on the municipalities and have not been given the freedom to develop and expand. Their strength has been in the development of maternal and child health care. This is very proactive and with a strong focus on developing people's understanding of good nutrition and on reducing smoking. Their weaknesses are that they have to put all of their energies into providing reactive care in the health care practices and so all of their time and energy is taken up giving urgent care.
The new health care act means that patients will be able to choose where they attend for care. There is legislation to ensure that each hospital describes its strategy and service provision and they must try to integrate primary and social care.

Unfortunately like us they have the same IT problems - so can't take any solutions away! The hospital has 2 systems which don't communicate with each other, primary care has 3 and social care has its own system too! The hospital and the health centres do only have electronic records now - they just can't talk to each other!

I then met with Tiina from communications. They have a team of 4 people but they cover the whole Pirkanmaa area. They are currently trying to improve the information links into primary care using the extranet. In an attempt to reduce emails they no longer have a weekly staff newsletter but provide a live intranet link. They have been using Facebook for patients for about 2 years and think this is really successful. The only difficulty is that often patients needs clinical advice and the doctors and nurses are too busy to answer this. Like CityCare the focus is now on marketing and they are starting to develop their own marketing strategy. They are looking at using other forms of social media such as twitter and LinkedIn. They have developed a new log and are in the process of branding themselves.

I also discovered that the GPs use e-scripts now with the prescription being sent to a central database which pharmacists can then access to prescribe the mediations for patients. They are quite behind with nurse prescribing. Their nurses have to do a 2 year course to get their license to prescribe and can then only prescribe from a very limited formulary.

It has been a very full day and so much more to learn and experience. I have found the local supermarket and done my shopping so I have food to eat! I had forgotten what it is like to have to walk to the shop, find the items and then carry them home - I am certainly missing internet shopping! Tomorrow I have another full day planned but hopefully later in the afternoon Pirjo is taking me into Tampere to do some shopping. My suitcase fell apart yesterday and so I have to buy a new one, and hopefully I can see some of the Finnish shops and their wares.

Time to put my feet up now and maybe watch one of the DVDs I brought with me (I've got "The Killing" - a series set in Denmark, so it seemed quite appropriate!).
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