I do not often post about current events on this blog, but today is an exception. Today the Francis Report into the care provided by the Mid Staffordshire NHS Trust was released. I have only skimmed the summary of the 800+ page beast, and what I read in the report (and in the many media reports) makes for sickening reading. Patients left in soiled beds, water and food not provided, patients left to attack other patients or patients falling and not being properly treated … the list goes on.
I work in the NHS. I am not patient-facing, but I am all too aware that if I fail in my job then, somewhere along the line, a patient suffers. I know this because, apart from anything else, when I have needed the NHS in my own personal life all too often I have felt abandoned on the midden. One of the primary criticisms of Mid Staffordshire, in how this tragedy came about, is that management (and others) were more concerned about processes. No doubt in an organisation as complicated as a hospital you do need processes to help make sense of the chaos – but it is not the process that is important. Also, sometimes, things fall through, either by accident or “ordinary” human error. Mistakes happen, and to pretend they never will is to live in cloud-cuckoo land. I was fortunate in my mental health that one individual in particular, when he realised that the processes had failed me, stuck by me and helped see me through. His manager supported him. From my initial reading far too few staff at Mid Staffordshire stepped outside the boundaries of process, and those that did rarely were supported.
In the NHS there is one particular group of staff that holds an especial responsibility for the care of patients – the Consultants. The summary of the report basically gives an impression of consultants who basically just gave up, who kept themselves insulated as if by ignorance they would protect themselves – in the one group of people who have the standing and clout to actually create a real stink to get things done. It is a shocking abrogation of responsibility, if I have read it right.
In my own work I often moan about consultants – because some of them are just very unpleasant people to work alongside. A few I also think are just lazy. Some believe they have an elevated position and regard themselves as lords, and everyone else as serfs. I am pleased to say, however, that however personally unpleasant to their underlings most consultants can be (and I have seen one consultant proudly announce they had just made a junior doctor cry) the vast majority I have encountered care deeply about their patients. In my dislike of some consultants I have to distinguish between those are just unpleasant and those who are caught up in the work of the moment, and really do not have the time to deal with this or that little irritant as they are trying to arrange the best care for their current patient. That I can understand.
The failures extended outside the hospital too, to the GPs and local MPs who did not properly pursue the concerns of patients and families, and also to national bodies such as a the Royal College of Nursing and the regulators. In other words this is an indictment at the complacency of the entire public culture that is supposed to hold one portion of the NHS to account.
Despite the fact I believe the hospital I work for does a generally good job of caring for patients, today I feel ashamed to be part of the NHS which in this case let down so many patients and their families. The culture of putting process before patient is a risk all NHS Trusts can suffer from, either in one department or across the entire Trust. Today’s report is going to change the NHS – and I hope for the better.
Meanwhile, if you live in the UK, and especially if you work in the NHS, look around you. If you cannot honestly say that you would be comfortable if you or your nearest and dearest be cared for by your organisation, find a way to speak out. That might very well be outside traditional management structures. But do something.
To paraphrase an old adage – Everyone involved with Mid Staffordshire NHS Trust knew there was a problem. Someone thought that Anyone would do something about it, but in the end Nobody did it. Those that do not look at the mistakes of the past are doomed to repeat them.
If you work in the NHS, like I do, even if one is non-clinical staff, one has a responsibility. Time to live up to it.