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.
I like the analogy Vicky. Nurse and allied health prof. short research projects @CLAHRC_NDL are tackling same issue. Highlighting issues which are partly due to higher expectations of quality of care. It's important to communicate this changing 'quality-context' so that work is seen as improvement rather than a negative criticism. Sometimes health practitioners can be harsh critics because they can't step back and see this changing context.
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