Saturday, December 15, 2012

Shoots of spring?

Maybe its the time of the year...maybe its the smell of Christmas in the air...maybe that's what is making things look a bit rose-tinted..but you got to live in hope, right?

As part of one of the roles I hold, was asked recently asked to look at a Consultant job plan...and a pleasant surprise indeed. Easily one of the best constructed job plans I have seen in recent times, it actually had the same person doing both acute Trust work, as well as work in the community! Yep, no split or coining of that term called "Community Diabetologist". If I have ever seen a title which has been at the heart of creating confusion amongst the diabetes community, it was the creation of that particular term or role. Isn't the hospital part of the community? Doesn't the hospital Consultant have any responsibility in the community? Why this divide?!
So, to see a  job plan which actually recognised the role of a Consultant across boundaries  across the boundaries called primary and secondary care. Heck, there was even time for virtual clinics...recognition of modern technology as tools to improve patient had to let loose a wry but satisfied smile. 

And that's not only it...back in July in Philadelphia, I had loudly wondered amongst similar minded colleagues why all the numerous organisations couldn't get together to create something that all Clinical Commissioners could use as a template to redesign diabetes care...why couldn't we have a think tank involving EVERYONE? So, in December, when a draft document with all the right ethos and issues incorporated lands in your email inbox, you know things are happening. By design or accident or simply due to pressure from data or patient organisations..or perhaps even a degree of a need to self-protect...organisations have joined forces to create something. It may not be the end all and be all...but to have a document which had ALL the organisations stamp on it...a very satisfying moment. 

Throw in some further recent phone conversations I have had with several CCGs...and there is no denying that there is a distinct thaw in relations between all parties...there seems to be the recognition that specialists need GPs as much as GPs need specialists...and at the end of the day, bring them to a table..cut past the politics...the grumpiness, the demeanour of being a "hard-ass"....once it dissolves down....yep, they all do want to make things better, in spite of being weighed down by the finances, the politics of the NHS, the ever changing paradigm....managers, doctors, nurses....they all want to do the right thing. Is that a bit too much of the rose tinted glasses...perhaps so...but somehow it just feels a bit different. Maybe the last few years since the drive to change diabetes care has exhausted everyone ability to simply "posture", maybe between all the uncertainties of the NHS changes, people may simply have seen it as an opportunity to give it a try. Who knows the reason...frankly who long as the right thing happens!

I am someone who has criticised organisations for sitting back while patient care has suffered..but at the same time, always happy to laud those who do shake off the past and try afresh. And to that end, ABCD, NHS Diabetes, PCDS and Diabetes UK...well done all for making the right call. These are interesting times...and lets make no bones about it, as cheery as one wants to be, tougher times are to come. 

But at least something is being tried, something different. Last week, was part of an interactive meeting where people from different sides of the "divide" had to spend time together and come up with a "model of care". It was stage-managed, and yes, there was lots of mirth...but people actually talked to each other...without any prejudice or seemed  at least even for those few hours...they least....trying.

Simply too much optimism? Too much of the Christmas spirit? Or genuinely something different? Time will tell...but for now..I am happy to accept them as the first "shoots of spring".I know the pessimists will always say that it could all be nothing but a false dawn and one swallow doesn't show a spring etc etc..but hey, they saying goes...always...and always springs eternal.

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