Care and kindness beats NHS box ticking
The maternity scandal at the Shrewsbury and Telford hospital NHS Trust has become one of the worst in the history of the National health Service. Over two decades, hundreds of babies died or were left brain damaged, with close to 1,500 cases reviewed.
Grieving parents have now hit out at the NHS regulator — the Care Quality Commission (CQC) — for failing to listen to them. It told parents it would not support an independent inquiry into the baby deaths just months before one was ordered.
One mother said she had ‘absolutely no faith’ in its ability to regulate and spot future scandals. I’m afraid I tend to agree.
A few years ago, the hospital where I was working was inspected by the CQC and I witnessed first-hand how warped and unhelpful the criteria they use to assess a hospital are.
My hospital was by no means perfect, but the staff worked incredibly hard and were unwaveringly dedicated and passionate about their jobs. everyone really cared about trying to get the best for their patients.
Before experiencing a CQC visit, I had assumed patient care would be their primary concern. Silly me.
PRIOR to their visit we were warned that, rather than using reallife clinical encounters to assess how good the care was, they would instead focus on odd and trivial things.
For example, the inspectors might ask staff things like ‘do you know the physical location of the infection control policy folder?’
It won’t matter that they’ve undergone training and know the infection control policy inside out. They need to know where the folder with the typed instructions is. If they don’t, that’s a black mark.
At one meeting before the visit, someone realised that the carpet that lay between two rooms was the wrong type of carpet. Apparently it needed to be special carpet that doesn’t attract dust. It was regularly vacuumed by the cleaners, and the rooms were rarely used, but apparently that was irrelevant.
everyone ran round like headless chickens frantically changing carpets so that we didn’t get marked down.
It’s crystal clear that the people who’ve come up with these ridiculous criteria have absolutely no awareness of what’s really important to patients who are sick in a hospital.
If they did, they’d go round seeing if nurses brought you water when you were thirsty, or held your hand when you were scared, or if a doctor stayed late to explain something to a worried relative — or any other myriad things that actually relate to care and what affects people’s experience of the NhS.
As well as being an NhS doctor,
I’ve been a patient, too. I know what mattered to me when I felt unwell and vulnerable. A few years ago I swallowed an antibiotic that got stuck in my throat and eroded a hole in my gullet. In hospital I had to plead with a phlebotomist to take my blood after she refused, saying she was on her break and I had been sent at the wrong time. She eventually relented and, tutting, vindictively stabbed me in the arm with her needle. And it wasn’t an isolated incident. A grumpy receptionist brought me close to tears. A radiologist snapped at me when I turned round to answer a question as I was having my chest x-rayed. I was talked about as though I wasn’t there and, worse still, had people discussing their holiday while performing intimate procedures. If these things can happen to me — a doctor who knows his rights, what to expect and how to assert himself and complain — what must it be like for other people? Imagine being elderly, or confused, or having a learning disability. Or just being scared and in pain and not being treated in a kind, courteous and compassionate manner. Surely that is important? Not to the CQC it isn’t. Conversely, there was a kindly volunteer who found me looking lost and took me to the door of the doctor I was supposed to be seeing. I can’t remember what the doctor said, but I’ll never forget the volunteer.
Neither will I forget the nurse who gently took my hand as I was having a scope put down my throat or the porter who went the extra mile to find me a blanket when I was cold.
Small gestures that make the biggest difference.
These are the things that there are no tickboxes for yet, but which, for the patient, are vital. Sick people want care and kindness, not regulation carpets.
If we can’t inspect how patients are treated, what’s the point of doing an inspection at all?
IT’S often assumed private schools give children the best start in life. But researchers at University College London found state schools do not lead to worse mental health or lower levels of ‘satisfaction’ in adulthood. A private education may give children an advantage in life, but they aren’t happier adults.