Thursday, 17 February 2011

The Point of Care?

The NHS has been in the news again with a stinging attack by the Health Service Ombudsman on the quality of care given to the elderly. However, this thinly veiled invective is based on only 10 cases (taken from 226 accepted for investigation). Ten cases, whilst each and every one deplorable, is not a sign of institutional failure in an organisation that employs 1.3m people. These are the 'bad apples' and the full weight of professional and federal law should be brought to bear on any involved in such neglect but it is the tiny minority. To tar the whole of the NHS with this brush is pure sensationalism and headline chasing.

That is not to say that standards have not slipped over the last 20 years with more emphasis on the pseudo-intellectualisation of nursing and the continued attempts to demean medicine from a profession to a job of work. The King's Fund's answer to this problem is to promote their "Point of Care" programme - designed to enable health professionals to reconnect with their patients despite the stresses of the modern workplace. Key amongst the initiatives is something called "Intentional rounding' (am I the only one who weeps in despair when he hears such meaningless patter?). Apparently this encourages nurses to go round the wards and visit their patients before they are called to help with something. This just used to be called 'nursing'. The very fact that a programme exists to encourage nurses to visit patients before they buzz for help is an indictment of their current training, not to say attitude.

Bad apples aside, most mistakes and cases of poor practice in the NHS are due to either laziness or the failure to carry out usually simple instructions. This in turn is a function of the deprofessionalisation of medicine and nursing caused by a loss of the values of the past in favour of the shallow ideals of today. To change this around requires a wholesale change in the education of student doctors and nurses from ground level up and a strong, respected leadership for them to aspire to. This cannot happen overnight an certainly requires more than an effete soundbite of a programme that amounts to an apologist for the lack of basic principles.

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