"Better Doctors Safer Patients"

Chief Medical Officer, Sir Liam Donaldson - Author of the 'Report Better Doctors, Safer Patients'

I am currently heavily involved in some work that has required me to read a 218 page report recently written by Sir Liam Donaldson, the Chief Medical Officer in the Department of Health.

The report is called ‘Better Doctors, Safer Patients’ and this is the culmination of inquiries, adverse reports and scandals about the behaviour of some UK doctors over the last few years. The best known is the infamous General Practitioner, Dr Harold Shipman who murdered over 250 of his patients. The exact number of patients he murdered will probably never be known.

A good friend and colleague of mine who is a well respected and high profile GP always says to me, “We must remember that Harold Shipman was first of all a murderer and secondly a doctor. All doctors should not be tarnished because of the actions of one murderer.”

I agree with that statement. The greatest quality I have come across among the hundreds (maybe thousands) of doctors I have worked with in 35 years in the NHS is their professionalism and their caring attitude for their patients.

Having said all those positive things I am nevertheless delighted to see Sir Liam’s report being so honest about the deficiencies in the regulation and continuing professional development of doctors. The report contains 44 recommendations and the report is currently out for consultation until early November.

To this point doctors have been the subject of mainly self-regulation and whilst there is clearly a place for that, it seems to me inevitable that the medical profession must be dragged – even if screaming - into the current world of appraisal from various interests rather than simply doctors judging doctors with all the inevitable problems that brings.

Sir Liam’s report is also interesting because the language used is generally straightforward and not full of intelligible NHS jargon. What a joy that is for a change!

I guess a few regular readers of Simplicity Blog might be interested in reading the report and if so you can see it at this by clicking here

One staggering statement is that once doctors reach ‘independence’ status – i.e. consultant level – their knowledge, competence, clinical skills or performance are not formally assessed from that point until they retire. That could be 30 years. Contrast that with pilots who are formally assessed up to 100 times in that same time period.

My feeling is that Sir Liam’s report provides a framework to protect patients, the medical profession and the doctors. This can be a win-win-win if the report if implemented and acted on fully.

Time to Savour a victory over our friends in America!

Biggest cheer of the day went to Darren Clarke, who broke down in tears after beating Zach Johnson 3&2

It was just wonderful to see Europe win the Ryder Cup for the third successive time.

It is not often we beat the United States so comprehensively in any sport so I hope my friends on the left hand side of the pond excuse me for making the most of this rare experience

Surely the most poignant thing was to see Darren Clarke win so soon after the tragic death of his wife who sadly lost her battle against Cancer.

Well done Darren, well done Europe - we will savour this.

The Nine Fruits of Leadership

I am delighted to say my new – and very brief book - The Nine Fruits of Leadership is published. More details here

This is a short, reflective piece about how managers and leaders can take our Christian beliefs to work. It intrigues and confuses me how some argue we must leave our faith ‘at the door’ of our place of work and become ‘someone else’ while we are at work. This makes no sense to me.

The nine fruits are Love, Joy, Peace, Patience, Kindness, Goodness, Faithfulness, Gentleness and Self-Control.

These will instantly be recognised by leaders and managers as what is often called the ‘soft side’ of management and leadership. My belief has always been that to achieve lasting success it is more important to focus on the ‘softer’ values than their opposites – often refered to as the ‘harder’ aspects which are sadly more ‘fashionable.’

I believe it is much more difficult and challenging to lead and manage using the ‘softer’ approach than the ‘hard’ approach which I have always regarded as the simple option.

The Nine Fruits of Leadership will be followed by 9 small pocket books (each on one of the fruits). These will be written with my two writing partners Felix Gerena from the Basque Country, Spain and Roger (Rocky) Noe from Kentucky, USA through our own publishing brand Sweet Friendships. Each of us will write three pocket books.

An exciting project that we look forward to completing in the next three months. This is our second collection under the Sweet Friendships brand after our recent book Three Amigos with One Message.

Felix, Rocky and I want talk to anyone interested in hosting a workshop about how three people from different continents and separated by thousands of miles, and who have never met, can collaborate ‘virtually’ to plan, write and publish a number of books.

By Christmas 2006 we will have collaborated to write at least 11 books (and possibly more) in 18 months. If anyone out there is interested in hosting a learning workshop about innovation and making things happen in our ‘virtual’ world then get in touch – we want to spread the learning.

Let's close a few large hospitals to improve the NHS.

A very serious matter today.

My apologies for the length of this posting but this is important.

The latest criticism of the Government’s health policy relates to a suggestion that some large District hospitals may have to close.

I totally agree with the proposals.

Why?

Simple really – Hospitals should be places we go to when we are ill, not when we are well.

Hospitals should only be places for those who are most ill and thereby offer the best care for those relatively few people who actually need to be in hospital beds. Many billions of pounds every year go into hospital care and much of that could easily be redirected to develop healthcare outside hospitals.

There is actually nothing knew in these ideas. Managers in the NHS have known this makes sense for years.

So why haven’t these ideas been introduced before now?

That is also simple – it is far ‘too hot’ politically – and a guaranteed vote loser for politicians - to even remotely hint that closing hospitals makes any sense.

No aspiring Member of Parliament will ever win votes by suggesting what is considered political suicide.

My argument goes like this;

By closing the hospitals and ‘releasing’ the money, we can improve services in the GP surgery; in the community; and in working partnerships between health and social care providers. This means all ‘less critical’ services can be provided more effectively outside hospitals, in more local care settings, for the vast majority of people who do not need to go to hospitals. This really is a no-brainer.

Ask yourself; Why do people have to go to the hospital out-patient appointments when most of the service they actually receive can be provided in the GP surgery just down the road?

The answers is; Simply because the hospital exists and that is the way we have always done it.

It is always seen as a radical suggestion to close big hospitals. Complex arguments will be put forward about why it is impossible to close even one large District hospital in the entire country.

And yet we all know it makes sense.

I suspect in 20 years time we will still be having these arguments as we were 20 years ago. And I suspect not one large District Hospital will have closed in 20 years time unless the ‘wake up call’ is really grasped

Closing hospitals makes great sense from another angle. They are dangerous and unhealthy places to be in.

If you think I am exaggerating or using emotive language about the dangers of being in hospital as a patient please read this and reflect:

‘It is estimated that around 10 per cent (900,000) of patients admitted to NHS hospitals have experienced a patient safety incident, and that up to half of these incidents could have been prevented. Furthermore, it is estimated that 72,000 of these incidents may contribute to the death of patients.’

Source: The Health Foundation
http://www.health.org.uk/ourawards/service/index.cfm?id=41