17th August 2016

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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.
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. 
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