Saturday, April 23, 2016

Three at a time

So here we are- a national role in diabetes. 7 years as Clinical Director, work with CCG as secondary care advisor, work with Kings Fund, CQC..a model of care- which for all its faults- is at least seen as a template to work on….the opportunity and the ask was perhaps at the right time. Working alongside the present National Clinical Director of Diabetes, Jonathan Valabhji…the opportunity is there to make some changes. The billion dollar question as ever is will I be able to? How restrictive will the trappings of central NHS be? How much freedom will I be allowed? The thing however is that self doubt is not really in my genetic make up- so after a fleeting few seconds, to me the job became pretty simple- you make of it what you want to, right?

Thank you to many patients, carers, colleagues for the kind words received, the hopes placed and the suggestions but I don't intend to change the whole world of diabetes overnight. A great tip for me when I set out on my management journey back in 2009 was always to focus on 2-3 things for starters. Get those right- then move on to the next phase. Try too much, you struggle to achieve much…so have mulled over many things, lots of conversations with my to-be partner in crime, Jonathan- and I think I am honing into 3 things…I suspect if we can get those things right, we will have progress.

Priority A: 

Improve Type 1 diabetes care: With my background, this was pretty much a given. I have always maintained that in the term "diabetes", we have meshed everything and done a huge disservice to all types- Type 1; Type 2, genetic ones- they are distinctly different with distinctly different needs and skill mix- if powerbroker/Commissioners don't know that or fail to recognise that, we will never ever improve quality of care for anyone.
Part of that will involve increasing profile, raising awareness, getting all to agree to appropriate pathways (and that has indeed been part of the reason for setting up the #talkT1and #TAD talks. Lets get the basics right.
Giving basic foot checks t folks with T1D isn't complicated, its basics. Ensuring a patient in hospital has their own insulin or even making sure they have it on time with food is not complicated, its basics

Priority B:

Getting everyone on one sheet: Do you know how many organisations there are in Diabetes in this country? Let me go through a few: Diabetes UK, JDRF, ABCD, PCDS…factor in RCP, RCGP- and you see the problem we have. Beyond all of them, there are many many patients, countless professionals who aren't part of those organisations…all individually trying to do the right thing, separately? A divided voice.
I want to have more TAD events- for all "stakeholders" to recognise the importance of joining hands. All of those bodies want to improve care…and if you genuinely want it, patients are asking for help- join hands and lets do it together.
Step up to the plate- and remember as a pack, sometimes different organisations may need to take a lead on different issues. Its not about who does it - its about what the whole collective wants to achieve. On that note, specialists have to step out of the breach- primary care needs support- lets do that- and do that properly.
Start thinking- do Vanguards offer anything? Does the GPforwardview offer anything? Look at opportunyies- any opportunities to offer primary care the support they need. They- and our patients want better access- in 2016,we must be able to do that

Priority C:

Technology- lets do this properly- not have meetings eulogising projects which have no legs. Let technology flourish. (I already thank Roy Lilley for putting me in touch with some interesting folks!) This is 2016- Skype is NOT an innovation- and no, the North Koreans are not standing by to hack anyones blood sugar readings.
Lets stop putting bureaucratic barriers and get things going. If YOU have an innovation, bring it to me- I want to know about it.
And please, think of this- does your innovation make life easier for the patient? If it does, I am interested- if its about you selling your wares, please don't bother.

Finally, I won't make any bones about it- I am a quintessential maverick. I don't follow rules, and I especially dislike them when its built to obstruct patient care. I may not be as clever either as many- but I do have a burning desire to make a difference.

What I do need? Not advice about my style or how I operate (am sure NHS England have hired me knowing all about that plus lets be clear- bar my parents, no one can do that- so don't waste your breath) but about what YOU think will help improve care. The door is open- and to anyone with any interest, patient, carer, nurse, doctor, Commissioner- please let me know.
No- you do NOT need to be part of any organisation or hold a title to do that- everyones view is important to me- and to be honest, I have grown more cynical seeing the roles some "leaders" have played in the junior doctor fiasco. As they say, silence is permission, silence is consent, silence is acceptance.

So contact me- and for ease- my email is Whoever you are, no ones view is immaterial- you want to improve care? As Frasier used to say…."I am listening". Yes, there are challenges- but I am confident we can make some good changes. All I need? Some help from you all along the way.

Shall we?

1 comment: