Gavin, 14 July 05
I’ve worked in healthcare and the NHS for a decade. Whatever the changes in national priorities, targets and methods of monitoring – it strikes me how much things remain the same.
Issues from a decade ago, raised when I started my current job almost four years ago are not just familiar – they are almost exactly the same.
There’s things to do with the complete and correct recording of information. This is still nowhere near perfect in the written record. Even at a beacon site the computerised information is somewhat behind. This all passes on to how outcomes and other healthcare indicators are assessed. There’s one hell of a long way to go getting all folks to just see how important this can be. That’s before time and workload pressures are even raised as barriers to proper use.
Another bugbear is communications. Even working somewhere where these things are taken really seriously I can’t help get a feeling that it’s going round in circles. Giving autonomy allows innovative practice, but at the same time allows for inconsistency – not only at a hospital by hospital basis – but down to ward by ward differences.
At one extreme such autonomy is seen as a plus. It allows localised decisions and practices to be tailored to local situations. But with doctors rotating at 6 monthly intervals there is some need for a degree of regional or national consistency. Especially when ward to ward differences exist or directorate to directorate differences are allowed, it is unlikely this provides a good framework for best practice.
I’ve seen some drastic improvements in the last decade – though I suspect a large part of that was moving from an under-performing Trust to a three star Trust which values people, development and governance. Yet even here – the issues today are exactly the same as when I arrived four years ago.
