When the shoe’s on the other foot
To truly understand someone, they say you should walk a mile in their shoes. Seeing things from somebody else’s point of view is an important part of being a better person – I suspect we all know a few bosses, employees or politicians who could benefit from taking a stroll in someone else’s footwear. Anyway, the last couple of weeks has seen me having to walk in a new pair of slippers. As a frequent (but, I hope fair) commentator on the NHS, I have been the subject of their care following an emergency operation which, not to put too fine a point on it, saved my life.
En route to a much anticipated long weekend in Cornwall, we stayed over on Exmoor. I started getting severe abdominal pain around 10pm and by 3am, NHS 111 had despatched an ambulance to transport me from the wilds of Exmoor to the Musgrove Park hospital in Taunton. The paramedics were professional, reassuring and kind. More importantly, they carried morphine.
Immediately on arrival at Taunton, a CAT scan revealed some twisted lower bowel. I was in surgery by midday and conscious by tea time. There followed four of the most unpleasant days of my life – made bearable by the ministrations of a great clinical team, an endlessly cheery group of nurses and AHCs and my family.
Having been through the system, of course I’m left with a huge sense of gratitude. But, as a keen observer of all things health and social care, I couldn’t let the opportunity pass to talk to the many people who have – and still are – involved in making me well again. Specifically, I want to reflect my experiences in terms of the core challenges and themes currently facing the service.
Interaction started with NHS 111 – an experience that has not gone well for me in the past. This time it was a breeze and I was immediately elevated to a clinician. Well, my wife was. I couldn’t speak. They despatched the ambulance within 90 minutes. I learned that one of the paramedics had just completed his training – but was now set on finding something else that was more amenable with his young family life. It wasn’t the money – it was the shifts he had to work which, according to him, were so inflexible as to make him look elsewhere. Something of a wasted resource, perhaps?
Once in hospital – a brand spanking new wing with fabulous single rooms – the acute care system really kicked in. The wards, however, were at bursting point I was told – and I was moved on one occasion to free up space. I suspect I was the youngest patient on my ward by 20 years – many of my fellow patients looked as though they were getting new knees and hips. The nursing and AHC staff were from all over the globe – but with a definite over representation from Spain. But, to a man and woman, all as you would hope for in terms of care and compassion.
Was the much vaunted technology Mr Hancock promises to scour the world for in evidence? It might have been in the operating theatre – but everything was recorded and noted by hand. I lost count of the times I had to retell my story and my details. Did my discharge notes ping seamlessly to my GP? They did – but by snail mail.
A visit for a change of dressing took me to a spanking new health centre in Minehead. It was delightfully empty and I was promptly seen by the nurse practitioner-led team. A tick in the box for Lord Darzi’s suggestion in this week’s Times, then.
It was fortunate that Butlin’s wasn’t hosting one of its adult-themed weekends. Apparently on such occasions, queues form around the block with people seeking treatment for drug and alcohol-related injuries. This is not, I suggest, entirely within the spirit of NHS, but hey. It’s the familiar dilemma on where you draw the line on the “deserving” sick and those whose lifestyle choices might be considered questionable.
Returning to London, I required IV antibiotics, so had another 48 hour stint in St George’s. Lying on a gurney, the chap to my left had been badly beaten up for his phone. To my right, an elderly gent had been thumped for remonstrating with a bloke who’d been thrashing his dog. All of us were met with unquestioning kindness and care. I asked some nurses about the very long shifts the staff all had to do. Some liked it – others thought it crazy. Are 12 hour shifts really that sensible? One nurse told me she liked to do ten 12-hour shifts in a row because it then meant she could enjoy the best part of a fortnight not having to work. In all honesty, I’m relieved she wasn’t removing my stitches at the end of her tenth shift.
I guess my own experience risks lapsing into cliché. Like thousands of people every day, I got the NHS experience we all hope we’ll get when we need to be patched up in an emergency. But, in my brief observation, I was told about – and witnessed first-hand – what can only be described as abuse of the service. As a nation, we’ve got to get the prevention agenda front and foremost to ensure there’s going to be capacity to treat us when, through no fault of our own, things go catastrophically wrong. And then there’s the integration of social care to ensure we look after our old and vulnerable, preferably out of hospital. Oh – and there’s Brexit. How’s all that going to affect the NHS workforce? And what about those shift patterns? Can they really be the best method of deploying and keeping people sharp and motivated in a highly intensive and stressful job?
Yes, there’s a lot to think about as I shuffle an uncomfortable mile in a battered pair of NHS slippers. There’s definitely a will. We just need a way…