During the time I was going round the area talking with people about the Friarage and the issues we face there, lots of people asked me about what “safety” really means. We use the term a lot as doctors. But how come services that were once seen as safe now aren’t? and it is a good question.
When I was chatting to one of my patients about this he said “ so its like old cars” I looked blank… he continued “ well in the past we all thought the cars we had were safe and we drove around in them happily. Then over the years there were seat belts air bags, ABS brakes, crumple zones.. the list goes on… now no one in their right minds would drive their toddler up the M1 in a vintage car without seat belts or air bags..” And he is right.. In medicine too lots has changed.. better drugs, better investigations, better technologies… And just like seat belts we don’t need them most of the time.. for 99.9% of the journeys we make it doesn’t matter if we have seat belts or not but when we do need them we are really grateful they are there. If I or one of my family was to be really unwell I would want them to be where everything they might need is there, just on case.
When I was fist a GP in Catterick I worked as a GP in the accident and emergency department of the Duchess of Kent Military Hospital. At the time it was a fully functioning hospital.. It was very quiet at night and when I worked there I was the only doctor in the hospital. I covered the accident and emergency dealing with road traffic accidents, injuries etc , paediatrics with children with fevers ,pneumonias etc, the high dependency unit, coronary care where people who had had heart attacks were monitored , and general medical and surgical wards where patients who had just had major surgery were recovering. I am a GP, not a bad one I hope, but I am not a hospital doctor. Specialist doctors were “available from home” usually 20-30 minutes away. At that point in time that was considered “safe” now it would be seen as completely unacceptable on the grounds of clinical safety. I suppose there was less we could do then ,but when I broke my leg last year I was comforted to be in a large trauma centre where I had the best and most modern care. Life moves on.
Monday 10 September 2012
Thursday 6 September 2012
Another step along a very long road
Oh dear.. It has been a while since I last wrote my blog….. life has been particularly hectic and everything else gets in the way of this.. but I guess that is real life taking precedence over a virtual one.. which is a good thing!
Having finished the conversations with the public around the possible reconfiguration of services around the Friarage hospital we have been completing the report and going through the various assurance processes necessary for the next phase a “gateway 0” review( which looks at the process) and a. NCAT review (which looks at the case for change etc). Both were very supportive and helpful. On of the things about the whole process that has surprised me is that so much of this we have had to learn as we go along. There doesn’t seem to be a blue print that guides you through, even though it has been done so many times before. Perhaps we will write one!
As a newly formed CCG, we struggled with the how do you get a really “clinically led” decision. There is the governing body of the group that has been given authority by the GPs to make some decisions in their behalf but this seemed like a really big recommendation so we wanted every fmaily doctor to have a voice.
So we decided to ask each practice to look at the three short listed options and score them according to various criteria ( these had been chosen previously by the governing body) and then each practice sent one of its members to a meeting of the GP council and all the scores were put together to come up with an overall score. There was a great deal of agreement between practices around the scoring of each option and we came to a decision everyone there felt comfortable with. We then went back and phoned the few practices who couldn’t come, and checked out the results with them..
It is now my job to talk to our partners about the recommendations the GPS have made, in the end it just another step along a very long road…. From here we go to the PCT board then through an assurance process by the strategic Health authority (management tier above the PCT and below the National Commissioning Board) and then probably out to formal consultation with the public….
We have had a few people telling us they are concerned about everything being aired so publically. I think it is absolutely how we should do things. We have made some “rookie” mistakes along the way because we are learning and there are polished operators out there who love to trip us up every time we falter. My only response is that we are trying to do the right thing and we will go on doing that. Hopefully we wont make the same mistake more than once.
I am learning fast…It feels like a long and challenging process but then it should be. It is a big change and will affect people so it is important that it is rigorous, open and challenging.
Having finished the conversations with the public around the possible reconfiguration of services around the Friarage hospital we have been completing the report and going through the various assurance processes necessary for the next phase a “gateway 0” review( which looks at the process) and a. NCAT review (which looks at the case for change etc). Both were very supportive and helpful. On of the things about the whole process that has surprised me is that so much of this we have had to learn as we go along. There doesn’t seem to be a blue print that guides you through, even though it has been done so many times before. Perhaps we will write one!
As a newly formed CCG, we struggled with the how do you get a really “clinically led” decision. There is the governing body of the group that has been given authority by the GPs to make some decisions in their behalf but this seemed like a really big recommendation so we wanted every fmaily doctor to have a voice.
So we decided to ask each practice to look at the three short listed options and score them according to various criteria ( these had been chosen previously by the governing body) and then each practice sent one of its members to a meeting of the GP council and all the scores were put together to come up with an overall score. There was a great deal of agreement between practices around the scoring of each option and we came to a decision everyone there felt comfortable with. We then went back and phoned the few practices who couldn’t come, and checked out the results with them..
It is now my job to talk to our partners about the recommendations the GPS have made, in the end it just another step along a very long road…. From here we go to the PCT board then through an assurance process by the strategic Health authority (management tier above the PCT and below the National Commissioning Board) and then probably out to formal consultation with the public….
We have had a few people telling us they are concerned about everything being aired so publically. I think it is absolutely how we should do things. We have made some “rookie” mistakes along the way because we are learning and there are polished operators out there who love to trip us up every time we falter. My only response is that we are trying to do the right thing and we will go on doing that. Hopefully we wont make the same mistake more than once.
I am learning fast…It feels like a long and challenging process but then it should be. It is a big change and will affect people so it is important that it is rigorous, open and challenging.
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