Saturday, January 31, 2015

Time to learn's done. And heck, it's been a long goodbye. July 9th was when I asked to be relieved of my position of Clinical Director of Diabetes- but as ever, man proposes and the NHS 6 months and a bit later, its finally done.

It's been a fantastic ride- highs, lows but more importantly a superb learning curve- not a single experience, good or bad has been wasted. Much has been achieved and I have spent much time on my blogs eulogising the team I have been a part of, our local commissioners who have helped, our executive team who have supported- so I won't rehash that.When I started as the CD in August 2009, I was told one thing by my senior colleague- and to this day, I have followed it which has helped us no end. He said "As CD, you are the departmental ambassador- to management, Executive team- and the sole patient advocate in meetings when daft suggestions are made from non-experts. You have one job- keep the patients at the forefront- and to do that, you do what you need to do".

I don't think I have had any better advice and you know what, I have never veered from that- the feelings of others have taken a backseat when the question of patient care has come to the fore- but as ever, the job wasn't to win a popularity contest, the job was to try and design a service which would be supportive to primary care needs, show that specialists are not just ones who sit in clinics, a service which kept patient care at the fore, was responsive to the need to have 7 day service- and one which was immensely proud of what it had achieved over the last 5-6 years.
In the history of the Portsmouth diabetes team , there have been many eras in the past- the one shaped by Partha Kar ends- hopefully history and more importantly patients locally will view it positively- warts and all.

It has given me time to reflect- the last 6 months and think about what i need to learn more about the NHS and its system. To this end, twitter has been an amazing educational media. Too often, I see everyone having an opinion about others- without actually having experience of what the "others" job involves. To me, thats an anathema nowadays- especially since I myself have been guilty of that fault in my yesteryears. I am supremely confident about my abilities- time and experience has allowed me to realise that doesn't actually extend to knowing the ins and outs of challenges others in the system may have.

So having a look through my own career- so far, I have been a provider within an acute Trust, a provider within a community Trust, a manager within an acute and a community Trust, have a role within a prestigious think tank (Kings Fund) why not broaden the horizon a bit? As ever in my book, nothing gained till have indeed taken the plunge!
Have recently joined a CCG board (Ascott & Bracknell) - and been to one of their meetings- which simply for me, has been nothing but an absolute experiential joy...felt like a kid walking into  his local comic book much to see and read, so much to..enjoy! Early days but I intend to enjoy this role- it's easy to criticise CCG boards or anyone who does commissioning- would love to be in a better informed place rather than simply criticise

The other body which everyone seems to have an opinion on is the CQC- I do see diabetes errors as a regular thing- reflected in the National Diabetes inpatient audit- a year on year exercise without a huge improvement noticeable...I would love to be able to understand how things work within the Diabetes seen as an important patient safety issue, is enough done to challenge Trusts, is enough done to protect patients, what about 7 day service etc much to learn, perhaps even advice the CQC about where to look...I hear those who say CQC isn't sensitive enough, not robust enough..well internal processes haven't really helped to reduce simple insulin errors - so why not see whether this national body can help improve the care of patients with diabetes? So join it is!

In between all that, the clinical work continues- just for reassurance- as at the end of the day, thats what the taxpayer did pay for to train thats my work, thats my love, thats what is my day job.
Exciting times indeed ahead- new arenas to explore and learn about- this isn't a year to do something special - this is just the time to learn.


  1. Inspiring to read of consultants who are passionate about clinical care while at the same time understanding the critical role they must play in shaping the system of delivering care. I love your point about the clinical director always having to keep patients at the forefront - unfortunately I don't see this often enough from my vantage point of serving in a nonprofit hospital in Delhi. NHS (and UK) is indeed fortunate to have people like you!

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  3. Good luck in your new role. Who is going to be carrying on your brilliant work?