Some NHSmanagers updates from the Xmas/New year period:
Sitting is his study, making last minute arrangements for the Boxing Day celebrations; he knew he didn't feel right. A tightening then a crushing pain in the centre of the chest. An indescribable heaviness. It's never a good sign and in a man turned ninety, definitely a bad sign. It wasn't long before the helicopter was scrambled and he was in one of the best heart hospitals in the world.
At the other end of the country an older man, well into his nineties, was walking back from Tesco's, making last minute arrangements to join a family Christmas. Overcome with a pain in the centre of his chest, he sat on a low wall. He felt heavy. A passer-by asked if he was alright and kindly took his shopping bag and walked him slowly back, up one flight of stairs into his spotless apartment, where he lives alone.
He didn't like to make a fuss. "No, the ambulances'll be too busy to bother with me"....... eventually, late afternoon, a relative was alerted and negotiated that they go to A&E, by car.
By the time the helicopter had landed the on-call cardiologist was ready to meet him. The chief executive was on his way, a startled press officer was already cranking up the press machine. Within hours he had been diagnosed and treated with a stent. Routine, standard practice.
His visitors were met, greeted and taken to the side room to see their grandfather. No, they didn't want any tea, thank you. They didn't want a fuss. Four days later a procession of Land Rovers swept him out of the hospital, smiling and waving.
A&E was quiet but it was 1am before the man found sitting on the wall had been seen by a triage nurse, a doctor and admitted to the Cardiac Unit. Amongst the machines and monitors two nurses were busy but attentive. One wore a Santa hat.
Visiting the Cardiac Unit took determination. A blizzard of signs, union strike notices, press cuttings, posters, health and safety advertisements, clean your hands campaigns and League of Friends activities made it tricky to see what was where. Reception was in darkness. Past the cleaning and delivery carts, through the well worn corridors and past a room with the lagoon of water on the floor. Past the coffee shop; locked and abandoned for the festivities; eventually the lift.
On the ward, among the monitors, no sign of a cardiologist. "They won't be in 'till Tuesday" said the nurse in the Santa hat. And, no, she didn't know about the man's two outpatient appointments in the next few days; haematology and renal clinics. It would appear Christmas has an electromagnetic pulse effect, rendering parts of the NHS dysfunctional.
He was stoic. Didn't want a fuss. There were no chairs for the visitors. They stood around his bed for an hour. His clothes were bundled into a plastic bag, abandoned on the floor, under the bed. Covering him a beige blanket. No TV, no news papers, no distractions. The Friends' shop locked and dark. It's at times like this you find out who your friends really are.
The hospital is pushing a £30+m bow wave of debt in front of it. It looks like it. Worn, exhausted with the effort of staying afloat and helping to save £20bn to keep the Big Beast in a job.
The man in the helicopter was the Queen's husband, treated at Papworth. The man on the wall is my Uncle Les, Wednesday morning and still waiting to see a cardiologist at St Helier's Hospital, Sutton.
Happy New Year! Welcome back! I've learned a few lessons in life, hence; I don't do predictions and I resolved along ago, not to do resolutions but as we get off to a new year I want to say five things.
First; I have been in and around the NHS since 1974 and I have seen (I think?) 17 Secretaries of State. With the close exception of Patricia Hewett, who was universally hated but did a good job; LaLa is the worst.
Downing Street knows the damage he has done to the Tory NHS brand. However, they are not fools. But for the complications of Coalition politics plus the fact that LaLa gave Cameron his first job in politics, he would have been shuffled long ago. The backbenchers are starting to regard him as tedious. He will go this year. So, ignore him.
Second; the 'reforms' don't matter. The Bill will become a rag-bag Act of some sort. Operationally, to carry risk and cover costs we will have to end up with 80-or-so PCT-like organisations running healthcare. The DH will pretend they are new. They are not; they are salvage. GPs will have a bun-fight, squabble over money, overspend and fiddle around with local care pathways but they won't commission. Nothing will really change except waiting times; they will balloon.
Third; if you belong to the BMA, Royal Colleges, Confed, NAPC, Alliance or any other organisation that claims to represent your interests, ask yourself; 'what did they really do for me last year?' Ask: Did they take any notice of me; did they communicate with me, electronically and in a timely way? Did they seek my views and act on them? Did they survey me regularly to see what I think and how I feel and do something about it? Did they invite me to conferences at ludicrous prices or do they webinar when I can join in? Do they distance themselves from bad practice or avoid the fact that some of their members are crap? As the NHS is saving 20% of the budget, are they cutting subscriptions by 20%? If the answer is 'no' to any of these questions - leave, you don't need them. Join the AA it could be more useful.
Fourth: 'It's the economy stupid'. It will get worse and NHS demand will go up. Instead of the DH saying; "Look; you know the nation's finances are in a precarious position, we've been sheltered financially but the time has come to be frank. Please use the NHS resource sensibly, you may have to wait longer than we would like. Help us to help you." ....they will conspire to pretend funding is adequate and everything is innovative, integrated, fast and lovely. It's not. Get over it and get on with what you can. They are in a different place. The Big Beast has lost the plot. I doubt he really knows what's in the Bill. You know the truth. Tell five new people a day.
Five; quality standards in the NHS, taken as a whole, are not good enough. There will be more grief. To get it right means you, YES YOU, every time you go to work asking yourself this simple question, "Is this good enough for my family?" If it's not, fix it. If you can't; tell someone who can make it good enough for your family and theirs. If that doesn't work; tell the Big-Beast direct. He's paid a shed-load of money to put patients, not politicians, first. His email address will be in the same format as everyone else at the DH.
In 2012, let's shine a bright light on some of the dark corners of the NHS.