If you have read my last two blogs – and if you have, thank you – then you will know I have been sharing some of my family’s experiences of health and social care over the last six months.
Now that my father is home following his stroke we have entered a whole new chapter in all our lives. Visits to hospital have been replaced by visitations aplenty by carers, district nurses, physiotherapists and more. That the faces and names change more regularly than contestants in the Big Brother house is unnerving and undermining of continuity of care. The regularity with which appointments are cancelled or changed just seems symptomatic of a system that is dysfunctional to say the least. Frequently people turn up long after they should have done.
Last week my Dad was supposed to attend a hospital appointment. I phoned up several weeks before to book ambulance transport for him. He had to be ready by 12 to be picked up for his 2pm appointment, I was told. I was duly given a reference number. What a great system, I thought.
Well, on the day, my mum and dad were ready for him to be taken well before 12. It takes a bit longer to get yourself ready if you’ve had a stroke! It’s not a question of just putting your coat on. 12 o’clock cake and went. Time passes. My mum phoned. Reference number at hand. It’s on it’s way, she was told.
At 1.45 they decided to give up on it. It never did turn up. It may well still be trotting around Kent somewhere. After all, we’ve had a lot of mist and fog lately. We will see if it turns up on Monday.
Now, I can’t promise that the NHS and social services will make you better. But I can tell you that they are very good these days at ASSESSMENTS. There are all sorts of assessments I believe apart from the life-saving one you get on arrival at A&E. There are ASSESSMENTS of need, ASSESSMENTS of eligibility, ASSESSMENTS of ASSESSMENTS, face-saving ASSESSMENTS, we don’t know what to do ASSESSMENTS, and panic ASSESSMENTS.
Yes, if you are a patient – and family carer for that matter – you can expect to be ASSESSED within an inch of your life.
As you would expect, while care visits are subject to perpetual change, appointments involving an assessment have an uncanny knack of going ahead without fail and bang on time. Whatever happens to all these assessments heaven knows. The information is rarely shared with you. I remember my Dad was quite upset by something written in his discharge notes. I am sure the person wrote it meant no harm. But it had a big impact on his outlook for a few days. I would have been the same. If only someone could have gone through the notes with us first or, better still, completed them WITH us.
My sense is that the endless assessments and reviews are a sure sign of a deeply insecure service. A system staffed by people who are so pressured that they have understandably become uncertain about their own rights of decision-making. Take this paraphrased conversation with a district nurse:
Mum: I ordered some medical supplies with your colleague.
District nurse: Have they not come yet?
Mum: No, I’ve called the surgery twice and left a message on your ansaphone but no one has called me back.
District nurse: How do you know they are the right thing.
Mum: Because that’s what we’ve been using and they work.
District nurse: Ok, well I’ll check when I get back. But if I can’t find a record and I’ll have to come back and do an ASSESSMENT.
Most times my mum just buys the things herself. Anyway, I’m thinking of launching a new care service this coming week called ‘ Prevaricare.’ At its heart is continuous assessment so that should please the quality gurus. Constant prevarication. No actual care is delivered as a result. Patients hate it. And it wastes an awful lot of time by which point the ‘client’ (hate that word with a passion) has given up in every sense of the word!
For those looking for more serious news from this blog, I apologise. But here you go. A thought, leading to a hot topic and a helpful link. I have lost count of the number of times in the last month where everything would have worked a whole lot better if information and data was being shared within and between organisations more effectively. The District Nurse example is a small one. It might at least cut down on the number of assessments.
The importance of information and data sharing to the provision of direct care was highlighted in an excellent new report published by the Richmond Group of charities last Monday.
It is certainly sobering to think of data sharing in these terms where the impact can be immediate and life-saving. Rather than in the context of research or service change where the benefits might not be felt for many years.
You may have also seen this week NHS England’s announcement regarding a national data lake. I being a shallow person can’t quite get past that hideous ‘lake’ term even if the proposals have merit. Who thinks up these names?
Anyway, you heard it here first, Prevaricare is coming to you next week. Unless we change the appointment.