nhsManagers.net

17th August 2016

Live Health News | Weather | Archive

HealthChat

Ed Smith

Chair of Not-Monitor, or whatever it's called. In conversation with Roy L

Good conversation, networking and a glass of wine. What's not to like! Tickets are slipping away! Get yours.

Details here

So should you

News and Comment from Roy Lilley

If you've ever heard me speak at a conference, likely as not I will have talked about Fabrice Muamba.

He was a young footballer who, on the 17th March 2012, was playing in the Bolton v's Tottenham FA Cup quarter final game, had a heart attack and 'died'...

In front of 35 thousand people and in the hands of team medics, paramedics and a cardiac specialist, who leapt out of the crowd... he 'died'.

Except, he didn't 'die'. For over an hour his heart didn't function. But, he didn't 'die'.

His heart was sparked back into life by an electrical stimulus administered 76 minutes after he 'died'. He was saved by the miracle of medical technology.

He was also saved by some heroic management.

Instead of Fabrice being carted off in an ambulance to any-old A&E, where, like as not, he would have been seen by an 'exhausted junior doctor' who had not 'done one of these before'... he was taken to one of London's cardiac units, where he was seen and saved, by experts.

He lived to tell the tale; in his book I'm Still Standing.

Getting the cardiac and stroke units in place had involved the mother-of-all-rows. Coalescing excellence meant closing some units. The changes were led by Dame Ruth Carnell. Opposition came from a poorly informed public, wound-up by doctors, managers, NEDs, councillors, MPs and the Secretary of State.

If you think about it; it makes no sense to take a heart patient to A&E if a cardiac unit is the option. By-pass A&E, go straight to the citadel of excellence where experience and kit is on hand.

Stop thinking, for a moment, of a football pitch and think of Mr's Brown's front room.

Elderly Mrs Brown, who has early stage dementia. In this hot weather she has had a UTI bubbling away for a couple of days. Eventually, she gets giddy and ends up in a heap on the floor. A worried neighbour discovers her and she is blue-lighted to A&E.

In the confusion and bedlam of A&E Mrs Brown, amid the machines that go beep, the trollies that go bang, the lights that blare, the shiny floors that look like water and everything else that goes clang, is given tender loving care and in 3hrs and 59 minutes she is admitted to a ward... result!

On the ward she is confused becomes uncharacteristically aggressive and tearful. Determined to go home she gets out of bed and falls over. Now we have a frail old lady with dementia and a Colles fracture.

Plus the problems of pain control, feeding, immobility, restlessness and toileting.

In the name of care and caring it's all about as bad as it could be. The relatives are on the case. The grandson wants to sue everyone. The complaints people don't work at the weekends.

So as Mrs B's acuity goes down the pan, so does morale amongst the nurses caring for her, along with the Trusts reputation. Social services move her further down the re-enablement list. Mrs B is parked in the warm embrace of the wrong place.

Imagine Mrs B being discovered and blue-lighted, Silver Service, to a 'soft' dementia unit, seen by a geriatrician and a medic, in a place that has no boundaries between mental and clinical care. They just 'see the person'.

A place that has the confusion of doors and colours and surfaces designed out of it. A place that people know eating is 'what you do' because it looks like a dining room and other people are eating, so you know to join in.

A sitting room that looks like the sitting room you left behind. A quiet restful place that, in any weather links the inside to the outside. Specially designed armchairs, unique to them, bespoke prescribable, reliable telel-med kit to re-enable and get people home quicker and safer.

.... and by the way, it's really a hospital, with all the bells and whistles but you'd never know.

There is such a place.

I threw myself on the mercy of Virgin Trains (!) and went to Preston for the day, to see the excellent Harbour project, run by Lancashire Care ... so should you.

------------------------

Contact Roy - please use this e-address

roy.lilley@nhsmanagers.net

Know something I don't - email me in confidence.

Leaving the NHS, changing jobs - you don't have to say goodbye to us! You can update your Email Address from the link you'll find right at the bottom of the page, and we'll keep mailing.

----------
Disclaimer

Medicine for Managers

Exclusive from

Dr Paul Lambden

Oooh, my hip hurts!

'... if anyone sees me standing in the Underground...'

---------------

The Academy of Fabulous NHS Stuff

You may be here but we are still doing the good stuff

HERE

--------------

Doin' some good stuff?

Share here.

-----------------------

Dealing With Difficult People

This best seller is in its third edition!

Essential holiday reading!

See it here.

------------------

-------------

News and Stuff

-------------------

>> Patient's Association Row over report - the PA claim 753 operations a day are cancelled. the DH say this is misleading; the PA data is based on an incomplete data set sourced from 112 FoI responses. NHSE have given it a hammering saying it is statistically flawed... based on a misunderstanding of the RTT standard. The report is here. You be the judge. However you calculate a delay... a delay is a delay and one is too many.

>> Labour leader-wannabe - denies changing tune on NHS.

>> Farmers Market protest - at NHS development.

>> Health workers protest - at housing costs.

>> Hospital finances mapped - HSJ, very good.

>> A clear road ahead - strategy planning from the Health Foundation.

>> Viruses - more dangerous in the morning.

------------------------

Listen to today's eLetter

Here, for free.