The discussion on Joint care pathways and time to treatment confirmed my
experience in trying to improve the care of patients in my Dept:
Excellence in the NHS costs money. If the NHS is not given the resources
the quality of care will be mediocre with perhaps a few areas here and
there which have above average funding and can deliver timely advanced
complex care to all patients.
Let me explain a bit. Our experience with introducing NOF Fast tracking
is failing like many others because of inadequate resources. External
audit 2 years ago in our hospital highlighted shortage of nursing
establishment by 6 WTE in A&E. This has not been corrected. I introduced
fast tracking Xrays and analgesia by nurses but a lot of the times it
does not happen as there no nurses available to do it.
Based on the Way Ahead 1988 we are short of 3 WTE SHO's This has not
been corrected either. Our Trust is overspent by £2.5 m this financial
year. Next year it will be £3.5m.
We had complaints about long waits: 6-8hrs at W/Es and nights for T4/5
pts. Shortage of nurses in the wards means closed ward beds, delays in
admissions from A&E, which mean more nurse hrs for ward care in A&E.
The Tust can not deliver the elective work effectively either.
ALL THESE ARE QUALITY ISSUES WHICH WHEN ANALYSED ARE FOUND TO BE DUE TO
LACK OF ADEQUATE FUNDS. QUALITY=MONEY
We are failing in these quality issues not because we are not trying or
providing leadership or not designing good care pathways but mainly
because we are not given the resources. The picture is similar in other
areas of hospital work (from talking to colleagues) and from talking to
my GP wife in Primary Care too. The NHS will fail the Clinical
Governance test if the resources are not provided.
Adequate staffing levels ( both clinical and non-clinical staff ) and
appropriate training at all levels and support of the staff mean revenue
costs.
Chris Maimaris
>----------
>From: [log in to unmask][SMTP:[log in to unmask]]
>Sent: 15 November 1999 16:24
>To: [log in to unmask]
>Subject: Re: care pathways
>
>
>>A database of care pathways is certainly useful to
>>record people's experiences and could probably be
>>achieved at little expense. Resources required would
>>be 30-40 minutes of Dr Ryan's valuable time (sorry
>>John...to volunteer you) in adding a facility onto the
>>BAEM website with some QA filters.....'biggest bang
>>for your buck'. Alternatively just use this group and
>>the threads created.
>
>I
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