Saturday, April 4, 2015

The last 5 years...

Elections are around the corner...and it's always great to listen to all how their working life has changed or not in the past parliament..and it made me think...what about us? The Portsmouth diabetes team.. and..what about me? How has it been in the last 5 years...shedding off all the views you hear, the angst...taking a step has it been really?
What I will put down in this blog...can I PLEASE make a disclaimer? This is my view, my personal one, my personal experiences...untainted by my political leanings, beliefs or otherwise. This is what we as a team did over the last 5 years.

Individually, has the new "new" NHS affected me? The reality is no- it hasn't. My basic salary has stayed static but personally its not gone down- and I always appreciate how lucky I am to have a job which offers that. There have been enough activity for me within the hospital and community to keep me busy- apart from other local and national stuff- so personally, nothing much has changed. I am pretty sure I speak for my colleagues too on that one. Perhaps the fundamental reason for that has been is that neither am I a GP nor an ED/MAU physician who appear to have taken the brunt of the changes. Tell you what has changed..we have locally in Southsea been a pretty cohesive bunch amongst Consultants and GPs..all I can say is that its more difficult to have the GP colleagues out for a drink...they seem to either turn up in the second half of the football matches..or not at all- and look overall a bit more tired, a bit more browbeaten. I will be honest, I have had my tired moments but mostly due to individual choices to do more rather than the persistence of the day job.

As a clinical manager, I must admit to not being exposed much to the previous system- but I have found it beneficial to have GP colleagues with clout who have been willing to listen. I have heard in the past, PCTs being full of managers who didn't want to approve projects- but have met the same individuals who have been pretty instrumental in making things happen for us as a team- we have shared a camaraderie, had lots of jokes and doing business with them has been fun. We have overhauled how we do diabetes care, majorly built on our relations with GP colleagues, raised the profile of the department, expanded the workforce of the department  and slowly and steadily, the outcome measures for patients seem to be turning. Early days, but let's see.

The tendering has been challenging but been through that too- and worked with all potential providers and then the individual winner to keep the service going- it has been an experience, perhaps an inconvenience and in the world of long term conditions, would love tendering to be held fof for a certain period of time, the projects given enough time to breathe, settle and then deliver.What can you do with a 2 or 3 year contract in diabetes..well pretty much nothing! I look at the Derby model struggling to survive and again, appreciate the fortune we have had with local Commissioners etc

The confusing bits have been the myriads of new bodies- who seem to be willing to help but am still to be convinced that there isn't reduplication. We used to have the National Patient Safety Agency- in our world, was an important  body..that disappeared. NHS Diabetes was a good organisation- that disappeared..and now we have networks, clinical and academic, senates, NHS IQ, NHS leadership academy...they all seem to be tripping over each other a bit- in my opinion..a bit of streamlining would perhaps be helpful! I don't know about other regions- but as regards diabetes care in our region, none of them have contributed much in the last few years- sorry guys- just saying as I have seen it! Look forward to being corrected in the future but I do get the feeling that we have too many bodies who most people on the ground struggle to benefit from.

So in short, perhaps the old system wasn't all bad, most certainly needed a bit more clinician involvement- but perhaps bit too much of an overhaul was done. Baby with bathwater syndrome needs to be avoided in future .

In my next blog, I will put down my views what would be nice to see happen in the next 5 years but as a summary, personally its been a mixed few years. A lot achieved, a lot done- if we get some stability, I promise we could get much more done too! I can't look back and say that it's been awful or amazing...its been mixed but perhaps tilted towards the positive....maybe call it a B -

Reading and hearing much of what is going on in the wider world, perhaps that's something to look back at with pride. Here's to the next 5.

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