Sunday, April 21, 2013

Not Waving But Drowning


Apologies for lack of posts. Denham Senior has been hospitalised with a serious heart condition and blogging has therefore moved to the back seat. But today's report from the Royal College of Nursing just has to be clocked.

According to their latest survey, NHS nurses are still "drowning in a sea of paperwork". Nearly one day in five is spent filling in forms, ticking boxes and ordering supplies. RCN general secretary Peter Carter says:
"These figures prove what a shocking amount of a nurse's time is being wasted on unnecessary paperwork and bureaucracy. Yes, some paperwork is essential and nurses will continue to do this, but patients want their nurses by their bedside, not ticking boxes."
Yes, indeed. And visiting Dad in two NHS hospitals over the last several weeks we've been able to study the process up close and personal.

The first stop was a large acute hospital just beyond the M25. It suffers all the usual problems: decrepit buildings, huge financial deficit, and a chronic - and I do mean chronic - lack of parking for visitors. Admission even for blue light emergencies like Dad is via a 12 hour plus trolley wait in A&E, and once finally admitted, care is in the hands of those overstretched uncontactable doctors. The nurses spend huge amounts of time behind the counter filling in forms rather than being out on the ward with patients, and you virtually have to book an appointment for one to stop by your bed. The whole impression is of an operation struggling barely to keep its head above water.

The second stop was one of Britain's top specialist heart hospitals, and it is much more impressive. What's done there in terms of heart surgery is truly world class, and its clinical staff are the business. The doctors are top notch, and the nurses do real nursing (Dad even attempted to take one home with him). Morale seems high, with junior nurses actually on first name terms with the top consultants. True, it's clear that staffing ratios are higher than in the general hospital, but much more striking is the excellent attitude and commitment of staff members.

Yet even here, the nurses told Dad they have a complaint. It isn't the hours, or the inconvenient shifts, or the stressful sometimes stomach-churning work, or even the pay. Their number one complaint is excessive paperwork. And even though they don't let it interfere with patient care, we watched them filling in great piles of paper in every spare moment.

So what's it all for? Why do we need all this paper?

Back in the dark days of the Commissariat, much of it was to satisfy the central planners that patient pathways were being rigorously followed, that prescribed risk assessments were being fully documented, and that every bedpan could be duly accounted for. Or rather, to provide a full audit trail which could be filed away to protect bureaucratic backsides in the event of a system malfunction.

But surely we're now three years on from all that. Surely we don't need all that now?

It's not that Jezza Hunt isn't aware of the problem. He's told us before of the million nursing hours a week spent on form filling rather than caring for patients. Of the nurse who had to fill in a 22 page form and 10 additional forms to get a desperately ill patient admitted to a trauma ward. And of the Hospital Trusts who have to report to, and comply with, 60 different regulatory, licensing, commissioning and public scrutiny authorities. Why, he's even ordered a review of NHS bureaucracy.

But he's attempting to tame a monster. The NHS is far too big, and the bureaucracy far too entrenched, for one single weedy minister to prevail.

The only way of getting on top is to break it up, give us choice and competition, and allow the hospitals themselves to find ways of managing their own affairs. They must be held accountable for results, not for how many boxes their nurses have ticked.

27 comments:

  1. Anonymous7:06 pm

    And the left will absolutely do their upmost to scream it down.

    Look at how the hospital staff all came out to "protect" Stafford Hospital, and the woman who's husband got such piss poor care he was drinking water from a vase, got hauled off by the coppers...

    It's producer capture, and it's a third rail issue...

    ReplyDelete
    Replies
    1. Bạn muốn sử dụng dịch vụ ship hàng toàn quốc. Hãy đến với Proship chúng tôi. Vì sao lại phải chọn chúng tôi?
      Vì chúng tôi có nhiều kinh nghiệm và đang cung cấp dịch vụ vận chuyển như dịch vụ giao hàng tận nơi, dịch vụ ký gửi hàng hóa, dịch vụ chuyển hàng thu tiền hộ, gửi hàng bằng xe tải, gửi hàng đi Đà Nẵng, cho thuê kho quận 10, cho thuê kho bãi trong tphcm với kho đạt chất lượng gsp, gửi hàng đi Hà Nội... Hãy đến với chúng tôi khi bạn cần gửi hàng nhé.

      Delete
  2. Dear Mike

    Good luck to the old man dude, sounds like he's bagging his healthcare on a try it on basis - good lad. I guess blokes are easier patients.

    Anywho - you mentioned 60 different orgs and you chucked in scrutiny right at the end. I've been around the block a few times and what are these scrutiny bodies of which you speak? If you're gateposting to what I think you are then scrutiny is the wrong word.

    All the best

    DtP

    ReplyDelete
  3. Ah... wondered

    Best wishes from a bunch of avid Wat blog followers down in Wiltshire.

    That paper? is simply, I'd say - for status reinforcement - the penpushers feel challenged and like the Hagfish they have a defence mechanism to deter threats. Not all of 'em - just far too many of them...

    ReplyDelete
    Replies
    1. Giảm cân có nhiều cách , nhưng cách giảm cân bằng ăn các loại thức ăn được nhiều người dùng đến , món ăn giúp giảm cân, thực đơn giảm cân cấp tốc sẽ giúp bạn có được thân hình đẹp và thon gọn. Khó ngủ hiện nay đang gặp phải ở rất nhiều người , cả già và trẻ .bi kho ngu phai lam sao ? Có nhiều cách trị khó ngủ .Gan là bộ phận lọc các chất độc trong cơ thể người , chính vì vậy việc giải độc gan rất quan trọng . thuốc giải độc gan tốt sẽ giúp bạn có được gan khỏe mạnh . Collagen giúp trẻ hóa làn da và ngăn ngừa các nếp nhăn , kéo dài tuổi thanh xuân, thực phẩm có nhiều collagen sẽ giúp bạn có được làn da đẹp và trẻ mỗi ngày . Ăn các loại thực phẩm tốt cho mắt sẽ giúp mắt sáng và khỏe mạnh hơn.

      Delete
  4. Budgie12:20 am

    Statement by hospital manager to a bunch of new junior doctors: "If you work overtime it shows you are incompetent (and we know where you live)". So as one of them said to me, what am I supposed to do when there is a complicated emergency admission 10 minutes before my shift ends, just go home?

    The one to two hours it might take to follow through, then doesn't get booked at all (for fear of the doctor blotting his copy book) and the manager goes home (after her 7½ day) happy that the WTD has been complied with (not).

    The managers have the real power and they are abusing it.

    ReplyDelete
  5. Anonymous7:06 am

    look this page for earn money: http://f392d42b.linkbucks.com

    ReplyDelete
    Replies
    1. Có nhiều loại collagen hiện nay trên thị trường , nhưng chất lượng rất khó kiểm chứng chính vì vậy có nhiều câu hỏi đặt ra như : super collagen c có tốt không, fine pure collagen gia bao nhieu, collagen shiseido có tốt, collagen maihada có tốt không, collagen de happy giá bao nhiêu, collagen youtheory có tốt không, collagen neocell có tốt không mục đích để tìm được loại collagen ưng ý nhất , vừa an toàn mà hiệu quả cao. Đông trùng hạ thảo là dược thảo quý từ thiên nhiên , giúp chữa được nhiều bệnh. Có nhiều câu hỏi đặt ra như : hướng dẫn cách sử dụng đông trùng hạ thảo, thuốc đông trùng hạ thảo chữa bệnh gì, mua thuốc đông trùng hạ thảo ở đâu, đông trùng hạ thảo có tốt không, Và những câu hỏi về đông trùng hạ thảo sẽ được trà lời trong bài viết.

      Delete
  6. Is that the only prime duty for the nurses?

    ReplyDelete
  7. And the problem with the paperwork is this:-

    If the paperwork says you did something then you did (even if you didn't).

    If the paperwork isn't completed then you didn't do the thing it refers to (even if you did).

    Have a guess which takes priority? The paperwork or the patient?

    ReplyDelete
  8. nice post. yup I too hate too much paperworks.

    money

    ReplyDelete
  9. Thank's for your information
    i like your post

    ReplyDelete
  10. Good one!
    You have done a great job with the post. Its cool!

    ReplyDelete
  11. It is the best post related to how to Make money online easily and recommended way which fully secure and safe.
    I really thankful to author for this post.

    ReplyDelete
  12. It is the best information share in this post and you can also come to know how to 'Make money $710,000 in 28 Days easily and recommended way which fully secure and safe.
    I really inspired from this post and really like it.

    ReplyDelete
  13. I get that a lot of paperwork has come from GP negligence claims and reports but surely if diagnosis's were made correctly in the first place there wouldn't be so many claims and paperwork!

    ReplyDelete
  14. Hi

    Your Money blog seems to be good and gives me many tips to run out a blog successfully and also I need the Necessary help from you to start a Blog

    Ads

    ReplyDelete
  15. Thank's for your information and i like this post

    ReplyDelete
  16. Anonymous3:35 am

    I’m an American and I suspect that most Brits are somewhat upset with our near default and the government shut down but don’t really understand how it happened. I wrote a summary of the problem starting with how the Tea party was born in the white hot crucible of the over the top right wing lies about the Affordable Care Act. See it at http://brianebaxter.com/

    ReplyDelete
  17. Hi,
    Great article. Thanks a lot for sharing such an informative post. Make Money Online Offline At Home

    ReplyDelete
  18. Great article.Thanks for tips on making money.

    ReplyDelete
  19. Thank you so much for sharing this. Taking control of our money is really essential and is always a must.

    ReplyDelete
  20. the solution:

       Procedure By Which conservatives Could Control  Parliament


    If UKIP  is  Lucky,  UKIP could  get,   perhaps,  get   five  to  ten   seats
    in  Parliament.  Do  not   forget,   the  public  still regards  UKIP  as   a
    one  issue  party.  To gain  control of  Parliament  UKIP  and  (and frie-
    nds) should  form a  new  conservative  party  with  a  platform that is 
    close to that of the existing Conservative party, omitting, of course, 
    policies that are objectionable to conservatives. The purpose would
    be to make a bed that would be easy for conservatives to slide into,
    including  the eighty  percent  of  the Conservatives who left Conser-
    vative  associations. UKIP and the  conservatives  should   then  form
     a  political  association  in  each  parliamentary  district.   UKIP   could
    merge with the new party, thus getting rid of the one issue problem. 
    Every one who would have worked  to  form  the new,  conservative,
     party   should   be   prevented   from    joining    the    new   party    for
    a  period   of time  to  prevent  the  impression  that  UKIP  controls  it.
    The two or three conservative parties should hold a primary election
    to determine who runs as the Parliamentary candidate, with the losers
    to help the winner. The cost of forming new associations can be raised
    by local contributors. It is suggested that the  new   conservative   asso-
    ciations and the political party be controlled by the lowest level of con-
    servatives, such as teachers, small businessmen, solicitors, professionals
    etc. If the  above   procedure   can  not  be  completed  in  time  to   get 
    candidates   elected   to    Parliament,  the  new  party  must  wait  until
    after the  election  and  hold  a  petition  demanding  that  the  elected
    MP  resign. Note: an MP  represents   every  person  in  his  district,  not
    just members and   supporters of his party. When the petition reaches
    fifty percent of those who voted in the prior election, the conservatives
    will be morally justified in demanding their MP"s resignation. Then the
    new party could run their  candidates  in  the  following by elections. 
     
    To select a candidate, a local  association should  advertise  for applicants
    or the position of candidate for  Parliament, then  select   the   best  app-
    licant  by using rigorous tests, including, most importantly,  psychological 
    evaluation. psychological evaluation is an absolute necessity as the psych-
    ological evaluation is the only way to tell who is honest and who is a con-
    artist; members of the public  cannot.  Testing  could  be  required  of the 
    association  officers,  committee  members and delegates, etc.

    The platform, selected by new party associations,  should be some what
     vague in order to facilitate integration  the platforms of the  new  assoc-
    iations into one platform. It is suggested that self forming cliques of those
    who are   honest  and   trust  worthy  be formed;  then form   self  forming
    cliques of those who have   political skills  and  capabilities,  within  the
    first described clique.

    The corruption in Ukip is a cause for concern. Information about the corr-
    uption may bee seen on the following websites:
    ukip-vs-eukip.com
    unfashionista.com
    eureferendum.com

    John Newell
     
    Please  forward  to those  who  might  be  interested.
     
    Request more information.     Comments welcome,       Questions answered.

    ReplyDelete