I read earlier this week of the story of Deborah Lee, who is Chief Executive of Gloucestershire Hospitals NHS Trust. On Friday last week Deborah said, in her words, she ‘had a bit of a “turn” - lop sided and unable to speak’. Firstly, before I go on, I should make clear that Deborah says she is fine now, that the care she received down in her part of the world was fast and effective, and that she has no criticism of others in health and care.
But I, like most of you probably, can’t help but talk about work when at home and Deborah was the same at home with her family. She had lamented to her husband about ambulance delays. So when she had her ‘turn’ her husband, rather than call an ambulance, bundled her into his car and drove her to ED. Just over an hour later after triage and diagnostics, including a CT, Deborah was receiving a life-saving thrombolytic therapy and then on to another hospital for a thrombectomy. Simply incredible.
But what it does show is that all those issues of delays we’ve been talking about these last six weeks or so really does impact on patient care. Deborah speculated what might have happened had an ambulance been called and she’d have had to wait for a couple of hours depending on what category she was placed in. As Deborah said of the ambulance delays, which she says are no fault of that service, ‘my system is working unrelentingly to solve this but to no great avail. The problem isn’t the front door of hospitals, it’s the back. It’s a complete lack of flow, with no silver bullet’. I think we’ve all heard that in some shape or form.
That’s why our priorities for 2022 / 23 focus on time, especially people’s time. We want to reduce the time patients spend in our emergency and urgent care pathways. We want to reduce the time our patients wait for cancer diagnosis and treatment. And we want to reduce the time patients wait on waiting lists. (Our fourth priority is to improve outcomes for women and their babies during childbirth, but that is a discussion for another day).
With our system partners we’re moving heaven and earth to get patients out of the back door. Every single complex discharge is painstaking. That’s not because colleagues in social, community and residential care aren’t doing the same, they are, there just aren’t enough of them. We know our GPs, pharmacists and the very many others are doing the same in primary care to help avoid admissions.
As an example, a great GP from another part of the country was on BBC Radio 4 this morning explaining that she’d missed just two days of work in the past two years and often was up late into the night after the 8pm clinic had finished doing the paperwork that sits behind it all. The highlight of her job was seeing patients in person but very often it was better for them to do it over the phone, and if she deemed it necessary she could see them immediately. She couldn’t understand the criticism GPs seem to be getting and neither do I. They’re doing a fantastic job.
Reading up to this point it seems a tale of woe, and in some ways it is, I won’t tell you things that aren’t true. But the silver lining appearing on the horizon is the new Integrated Care Boards (ICB). Those of you with long memories in the NHS will remember a time when cooperation was the name of the game rather than competition, and the new boards, which come into being on 1 July, are the start of cooperation. Obviously we’ve made great strides during the pandemic of working together across organisational boundaries but the ICBs will push that even further.
I can’t tell you here and now the direction we will all be going in, but if today’s blog has shown anything it’s that a change of direction can only be a good thing. Using our resources in a different way to achieve better outcomes. Not having to rely on the quick thinking of Deborah’s husband. I hope we’ll all individually have a small or large part to play in this transformation.
In the meantime, on a day-to-day basis, we need to make sure our patients don’t come to harm, spend the money we have wisely, listen and act on what patients and our colleagues are saying, and perhaps most importantly look after each other and be kind.
Thanks for everything you’ve done this month. Hopefully you’ll all have some sort of break over the long weekend and the sun shines. You deserve it.