Do-nuts!

 

 

Thursday, up really early to get to the Doctors for a little procedure, but it all went a bit wrong. Finding blood spurting as I was leaving, always makes you stop and think, even when it’s nothing.

So, went back to get patched up a second time, then I had to get to the supermarket for the shopping. As I struggled around I got more self-conscious about the big bloodstain on my shirt.

Then I noticed the unusually large number of police officers around, nipping in to do a shop, some actually buying do-nuts, honest!

I didn’t want to turn into a crime scene. I looked as though I’d been shot; actually I’d only been “stabbed”. I just didn’t want to have to explain it all. 

Tough day, Monday, coming up.

 

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The battle to fix the NHS gets tougher – more revelations on the radio this morning; Gary Walker a former Chief Executive, fired from one of the hospitals that is now under scrutiny for having worse than average patient outcomes (that’s deaths) revealed that he had been forced to sign a confidentiality clause for which he was given £500,000 of our money to keep his mouth shut.

He went on to explain that he had wanted to postpone routine operations to divert money to emergencies. I know all about what that means. Good for him for coming forward now; the NHS has responded by threatening him with the lawyers.

Meanwhile this quote from today’s Daily Telegraph takes it all up a gear. Now we can see the kind of pressures surgeons are up against, how it hurts patients and the courage that is needed to fight against it. It’s referring to letters published on a local website in Lincolnshire from concerned individuals;

Daily Telegraph 14/2/13;

One letter described how an “otherwise well patient” had died two days after an operation by a surgeon who had had to carry out three “radical procedures” on the same day due to “target pressures”.

Another, from a clinical director at United Lincolnshire Hospitals NHS Trust (ULHT) said that managers had been subjected to “ruthless pressure from above”.

The letters emerged on the day that Gary Walker, former chief executive of the trust, spoke out about a “culture of fear” in the NHS - despite a £500,000 gagging clause he says he signed after being sacked in February 2010. The trust is now being investigated over fears that as many as 500 patients may have died needlessly because of poor care.

Mr Walker suggested that he was placed under pressure for prioritising emergency care rather than diverting resources to meet Whitehall targets for non-emergency operations.

But three letters leaked by independent Lincolnshire councillors, published on a local news website, reveal that there were additional concerns about the amount of work having to be performed by surgeons to meet the targets.

One strongly-worded letter – which has been redacted to conceal the identities of the addressee and writer - was fired off by a consultant “in the immediate aftermath” of the “tragic death” of a patient who had been operated on two days before.

The letter, published on the Lincolnite website and dating from February 2010, said: “The patient’s operation occurred on a day upon which, unusually, three radical procedures were undertaken by the same surgeon on a single extended list.

“Habitually, one or two procedures would be performed within this session and the additional case was required due to target pressures.”

It added that there was “enormous pressure” exerted by targets resulting in “ad hoc arrangements” for surgery at short notice, after working hours or at weekends, as well as on patients with whom surgeons have had “no prior contact”.

“This is not only prejudicial to ongoing patient care, but presents enormous and unsustainable pressure on the operating surgeons. This cannot be tolerated in all but exceptional circumstances.”

It demanded the recruitment of additional surgeons and said that doctors would no longer be willing to carry out extra operations to “chase the targets” in the future.

A letter from a second consultant surgeon, also dated February 2010, described the doctor’s concern over being put under pressure to perform a complex ten-hour operation shortly before he was due to go on holiday which would leave him unable to give post-operative care.

It had been pushed back because no intensive care bed was available. The surgeon said that while endeavouring to meet targets, the “absolute paramount importance” was patient safety and to fail to put this first would be to risk being struck off.

“I do not think there would be any defence either in court or in front of the GMC if I put the Trust’s target in this instance above the patient’s welfare.”

A letter in March 2010 from a clinical director to Paul Richardson, chairman of the trust, said: “I feel I must make you aware on my concerns about the balance between patient safety and target and inform you that in my view the current bullish and sometimes ruthless pressure from above on the management team in my Directorate is unfair and unacceptable.

“Such a culture that has evolved over the last few months has caused a subtle but significant shift in the balance between achieving targets and the quality and safety of our service to patients.”

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