Saturday, 12 May 2012

NHS – the movie. Romcom or horror story?

The NHS movie rolls on, an on-going  franchise to outshine Harry Potter and nearly as long running as arguably the greatest film of all time, Citizen Cane. But is the NHS genre a romcom, family adventure, farce or horror? A bit of all of course as just a few hours feedback confirmed yesterday.

The day stated well – an 8am meeting in the operating theatre suite of a North West London hospital with a dashing surgeon. (yes – romcom would have done very nicely thank you…) We were discussing a project that should benefit patients, staff and the Trust and the consultant kindly spared an hour of his time before starting a full operating list. Just for the record, over the past few years in my role as a project manager, 99.9% of consultants I have met have been courteous, charming and constructive. They have given their time and shared their knowledge freely, often in their own time at the end or beginning of a long day.

Several other meetings later, I could confirm that many of the doctors, nurses, medical secretaries, IT and finance teams were all upbeat, busy but positive in their efforts to balance budget and care. I then visited to the stroke unit to find a community coffee morning going on to celebrate the unit achieving a high level of accreditation (a set of standards required to earn a higher level of tariff for the hospital – note to Andrew Lansley – targets can work). Stroke physicians, specialist nurses and therapists were welcoming patients who had previously been treated at the unit. There was a jolly atmosphere as medical teams were reunited with those whom they had cared for.

I realise this all sounds a little too good to be true and I have no doubt that the staff at this hospital continue to face the challenge of staff shortages, budget cuts and lumbering bureaucracy that is the daily grind of the NHS. However you could also be forgiven for assuming that this particular hospital is still functioning effectively with a viable future.

But then I got home and took two phone calls. One was from a friend whose 86 year old grandmother had broken her hip a couple of days before.  Suffering from early stage Alzheimer’s and osteoporosis, this poor frail lady epitomises the financial nightmare facing socially funded care but nevertheless she should expect exemplary care. Just a few hours after admission and confused at her surroundings, the poor old soul fell out of bed and broke her arm. It is highly likely the reason this happened was that someone forgot, or didn’t bother, to put the side guards up on her bed leading to increased suffering and further mobility challenge for the lady when she finally gets home.

Another friend, a counsellor, called to tell me of a case of a very sad young man who had just lost his mother. The tale he had to tell about the shameful standard of his mother’s care was shocking. Deeply disturbed, this tragic woman had attempted suicide on numerous occasions and had been let down again and again by her local mental health services. After taking yet another overdose and after a couple of nights in hospital, she was discharged without her family being advised. Clutching a ‘bag full of pills’ (probably her ‘take home’ drugs), she was taken to a bus stop to help her catch the bus home. Bless her – of course she didn’t go home and of course she took the pills but again survived. For some reason, she wasn’t sectioned (compulsory or voluntary residential mental care order) and continued to live with inadequate community mental health support until she finally succeeded in her tragic quest and killed herself.

You cannot help but wonder if these two tales of woe would have been different if those unfortunate patients had been treated in the hospital I described at the start of this post.

And this is the dichotomy of the NHS movie, feel-good plot lines, uplifting stories and exhilarating adventure tempered with farce, horror stories and tragedy.

The scandal of the NHS isn’t just about inappropriate funding – it’s about inefficient use of resources, and worst of all – inconsistency and inequality in standards of care.


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