Tag Archives: hospital procedures

The Manchester Health service

Of course she’s been posturing under the wrong name for years.  The NHS.  National Health Service. With her separate clinical commissioning groups, her postcode lotteries,  her different ways of doing simple tasks between one hospital and another.  I always thought she should be called the ANHS. The Almost  National Health service.

And now it appears she may need another name again.   Or part of her does.    The MHS.  The Manchester Health Service.  A bigger split, more formal, making the care you receive from the NHS dependent even more on where you live,  rather than what you need.

There are lots of laudable reasons for the plan.  I’m in no doubt that better links between social services  and the NHS are long overdue.   There is a common conversation on wards between staff,  elderly patients and their families.  As you try not to listen through thin green curtains, you overhear again and again the problems of finding somewhere for Grandma to live because she’s now too frail to go home.

Better cohesion between the two services could really help in managing long term conditions like dementia and heart disease too.  No wonder George Osborne finds this ‘really exciting’.    Local people having more control over the decisions that affect their lives.  Or would that be local politicians George?

I’m uneasy.   Us patients know that we already have to endure problems in our health care because of  a lack of cohesion between different parts of the NHS.    We know if we go to one hospital rather than another, we’ll get a different level of care, different systems, different food.  Our doctors rely on snailmail to pass on vital information about us from one part of the NHS to another.  Experienced  nurses on our wards tell us they can’t give us our pills because they haven’t been through the training for that particular hospital trust.   We’re promised joined up services in Manchester.  Shouldn’t we be working on joining up the NHS in the UK first?

And there’s another problem.  What about those of us – and we are many – who have to travel to the Big Smoke because our treatment and care is too complicated for the hospitals and doctors where we live?   Will we be as welcome?  As budgets inevitably tighten, will our right to expensive treatments be discussed in the light of whether we pay council tax in Manchester?   Will the ‘local people’  making  these decisions be happy to open their doors to costly patients across the country when  their electorate are baying for them to improve local care?  I can see the election slogan now.  Manchester Services for Manchester people.

I have family in Wales.  A few years ago they were all trumpeting their free prescriptions.  Now they wonder whether it was worth it.  They complain of long waits for hospital appointments and inefficient care.  They try to arrange treatment across the border.  They’re not so sure local power to local people as far as the NHS is concerned is working for them.

I am not against a Northern Powerhouse but this plan concerns me, not least because of the speed in which it is being introduced.  In just over a year, full devolution of health and care services in Manchester will be in place, and yet all parties seem to agree the details of how this will work are still very sketchy.

And to cap it all, just a year later, Manchester people will be voting for a new mayor.    A chance for some bright politician to make radical plans for that £6billion health and social care budget.  Perhaps even to come up with a smart new name for the service.   I like the old one.  The National Health Service.

Sleep in hospital

Sleep.  The great healer. The time when our bodies recharge and mend themselves.  Without it we quickly feel poorly.  Scientists have linked lack of sleep to, among other things, diabetes, obesity, and even speeding cancer growth.  It is without doubt a great natural cure for our ailments and the reason our doctors, and our mothers, tell us to ‘Get a good night’s sleep.  You’ll feel better in the morning.”

Why then does the NHS put so little value on it?

It’s a recognised fact among us patients that we won’t get much sleep in hospital.  The staff from consultants to porters seem to recognise that too.  The cause is generally put down to other patients, snoring, the crazy ones who shout all night, those who simply weep, loudly.

But as much as other patients do sometimes keep me awake, without doubt, it’s more often the hospital staff and procedures that leave me tossing and turning in frustration at 3am.

Let’s talk about last night.  Lights off about 11pm.  I’d shoved in my headphones to drown out the sound of the two elderly, confused ladies alternately crying for help and ranting at the poor care worker on shift.   Then I’d managed to drop off to sleep.  Until, at 11.58pm,  I heard a voice. “Fiona.  Sorry love but can you wake up?  We need to move you to another ward.  Can you get up and pack please? The porter will be here in a few minutes.”   I travelled down some cold corridors, porter commiserating with me, (“It’s not bloody fair love, they shouldn’t move you at this time”), and probably woke everyone else on the new ward as I clumsily tried to unpack in the dark.  I was not surprisingly then a tad unrelaxed and didn’t manage to get to sleep until about 4.30am.  And of course they woke me at 6.30am to take my blood pressure.

Now if this was a rare occurrence I’d accept it as inevitable in a busy  hospital that has to admit patients through A and E in the middle of the night.  But in some wards, in some trusts, it seems to be an  acceptable, common way of behaving.  The night before last I’d been woken from my slumber by first one patient moving out at 2am and another moving on half an hour later.

And it’s not just the procedures but sometimes the staff themselves. There are those who seem to understand that it is in fact nighttime, who get on with the stuff they have to do but at a lower decibel level than they’d use during the day.  But there are many who carry on as if it’s the middle of the afternoon, switching bright lights on, talking in hearty, loud voices, waking us all up to ask a patient a few questions which could perhaps wait a few hours until morning.

So, NHS, here’s what I propose.  Let’s introduce sleep-protected time zones in the same way we have protected times for meals.  A period between midnight and 7am when everyone talks in whispers, lights are dimmed and no-one should have to move beds.  Of course there will be times when these rules will have to be broken for essential medical care.  Most patients would recognise that.   But if it’s not essential, let’s keep the ward quiet and dark so we can get a few hours uninterrupted kip.   We’re ill for goodness sake.  We need our sleep.