Winter pressure, bad behaviour and hopefully some festive cheer
To be honest, it has hardly started. Our hospitals sustain and, to a greater or lesser extent, survive the winter pressure year on year. However the cost of that is often borne by those waiting for elective procedures and of course by the staff who need to function in an environment which is generally known to be overstretched, understaffed and underfunded. This week the national news headlines bear two very worrying accounts.
First, the financial burden under which the largest Scottish Health Board is labouring looks likely to prove to be just too much. For the first time it has issued a clear warning that it will be unable to deliver services within the budget provided by the Scottish Government. Even with attempts to make savings, NHS Greater Glasgow and Clyde has predicted that it would expect a £20 million spill over in excess of its annual budget of £3.1 billion. As a Board, it is unlikely to be alone in facing a deficit by the end of the financial year.
The second report goes beyond a failure to miss targets and involves a cultural approach which has come to light as a result of a member of staff speaking up, rather than standing by in the face of unacceptable behaviour. This is so disappointing especially since the reality of such harassment has been the focus of various campaigns – both medically and management driven. It is right and proper that the problem of bullying and undermining behaviour has been brought to the light of publicity. Indeed it is overdue. The focus here is on NHS Lothian – and not for the first time. One only has to attend an Accident and Emergency Department to appreciate just how difficult, and for some patients, unsafe, the delay in being seen and assessed can be. There may be many reasons for such poor performance against the national targets but to deliberately misrepresent the reality is not only unacceptable, it is counterproductive. It simply compounds the difficulties in order to divert any responsibility and the underlying problems remain obscured. How deep and systemic the problem may be will be determined by careful investigation and analysis. Excuses relating to particular pressures and case mix concerns for a particular group of hospitals are simply not credible explanations.
The Colleges, via the Scottish Academy, have become experienced and indeed adept at helping hospitals and Boards drill into their data and understand where the institutional pressures exist. There are many ways of tackling patient flow problems in our hospitals and it so often comes down to recognising the issues, identifying the working patterns than inevitably introduce delay and inefficiency and empowering those who can produce innovative local solutions. Often the resources and the solutions are readily available and it may simply need an external view to help make the solution more obvious.
On a brighter note and in recognition of the season, I was very impressed and encouraged by the heart-warming approach of the University of Glasgow for students spending Christmas and New Year in Scotland and far from home. In contrast to the negative news – it is amazing how hope springs from a dose of care and kindness. Check out the evidence at https://www.facebook.com/UofGlasgow/videos/1880603235292716/ I was not surprised to read the news that the University of Glasgow has been named Scottish University of the Year 2018 by The Times and The Sunday Times Good University Guide.
Have a wonderful Christmas and I wish you all a very happy and prosperous 2018!