We should improve what the NHS already has rather than invest in vanity projects, says Dr David Turner
There are two things that elderly people will not do: elevate their legs and drink enough water. These are my opening words of wisdom for my undergraduate students when I teach elderly care.
The former leads to ankle oedema, which in an older patient is as common as having four limbs; while the latter leads to everything from UTIs to falls and subsequent hip fractures.
So, I was very pleased to learn of a new initiative in a hospital local to me: the hydration round.
For once it seems that someone in an NHS trust has come up with a good idea. An HCA does a regular round several times a day on the elderly care ward to encourage and support the elderly patients to drink water. It sounds so simple that one wonders why it hasn’t always been a part of routine nursing care.
But it is a good example of an inexpensive, low-tech intervention that is likely to have a significant impact on patients’ wellbeing and recovery.
I suspect it will not make any headlines in the national press and it is unlikely that health secretary Steve Barclay will be attending the hospital in question for a photo opportunity next to the water trolley.
This bolsters my assertion that what the health service does not usually need is new shiny things. Times are tougher than ever, and money is short; if we could just for once focus on improving what we have, rather than piddling away millions of pounds on the latest vanity project of whichever minister is in power, we could improve things for patients.
What would be my wish list? In no particular order:
- Investment to modernise and upgrade the current GP practice building stock.
- Improve the community nursing service. ARRS funds for nebulous, largely unneeded roles could be diverted to this.
- Eradicate anonymous referral to hospital departments. Allow us to revert to writing proper letters to named consultants stating what is wrong with a patient rather than trying to make their symptoms fit some tick-box form. Let the consultant prioritise their clinic lists according to clinical need.
- Stop wasting our time with appraisal and revalidation. It does nothing to improve patient care and costs a fortune.
- Redirect money from NHS funded weight-loss/exercise schemes into child and adolescent mental health. Generally, adults who want to lose weight and get fit will do so of their own volition, not because we nag them. However, children with untreated mental health problems will become the adults with chronic mental health problems of tomorrow unless we intervene early to help them.
Most of all though, listen to those who work on the frontline in healthcare and ask them what they think would improve the care they can give to patients. It may be something as simple as a jug of water.
Dr Turner is a GP in Hertfordshire. Read more of his blogs here
Here’s another simple – daring idea:
Invite GP receptionists to NHSE board meetings.
You can silence them, or let them speak.
The actual frontline to most rubbish heard.
They’re not regulated and you know what, they couldn’t care less who you are in your fake blue suits and party dresses, nor give a two hoots about your PC-cover up and nanny state system.
Dare you.
If we keep seeing appraisal as something negative and imposed, then it will always be wasted time and a missed opportunity. Like anything else in life, we get out of it what we put into it.
Being a professional means keeping up to date as a basic requirement. I remain curious and interested in medicine and enjoy reading and keeping up to date. The more I learn the more stuff I know I don’t know. But the meaningless requirement to put some piece of creative writing as reflection might appeal to the wordsmiths with OCD but for me it sucks all the enjoyment out of learning. Thus I write stuff to keep my license to practice in which I neither believe nor mean. This dishonest interaction is morale and moral sapping. I do reflect and learn but I am not a creative writer and failed English Lit at O-level. Like reading books hated all the dissecting bollocks that I was never convinced the author had meant or intended. So asking me to write something frankly is my kryptonite. I can honestly say that my one thing I look forward to retiring for is to never have to do this rubbish again. Were they to abandon it I may even work longer. I do not think I am alone in this. Dr Minas good luck in convincing me otherwise. Just over 3 years and counting
DJ: I see you commenting on here on a regular basis: maybe you like reflective writing more than you think?