Kevan Christie: Management jargon out of The Office won't save our NHS

The pressure upon NHS Lothian '“ which led to the health board recording the worst ever performance for weekly A&E waiting times '“ has been nothing short of a disaster waiting to happen.
The flu season regularly increases pressure on the health serviceThe flu season regularly increases pressure on the health service
The flu season regularly increases pressure on the health service

In the latest weekly figures, more than half of patients (54 out of 107) in Scotland who had to wait for over 12 hours in crowded emergency rooms were in the Lothians.

On top of this, health board staff took it upon themselves to make up their own guidelines on how waiting times should be recorded because the national guidance drawn up by the Scottish Government was “vague and ambiguous”.

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Now there’s a shock – hard-working NHS staff at the mercy of a target culture that may even be dangerous because the focus is shifted towards areas that are measured to the detriment of what is actually in the best interests of patients.

However, NHS Lothian certainly does itself no favours. A press release issued before the thunderstorm over waiting times broke declared the health board was “creating an innovative partnership” with the Scottish Government to boost performance and improve patient care.

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It seems if you’ve all but hit rock bottom in terms of a staff recruitment crisis, closed a children’s ward at St John’s Hospital in Livingston, have hundreds of patients trapped by bed-blocking and thousands waiting longer than they should in A&E, and require health secretary Shona Robison to bail you out – then an “innovative partnership” is just what the doctor ordered.

This partnership – and boy do they love a partnership in the NHS – will also work with the Edinburgh integration joint board to create a whole system dynamic review and targeted analysis at the Royal Infirmary of Edinburgh to help tackle delayed discharge and waiting times.

The more curious among us may quite rightly ask – “what’s a whole system dynamic review and targeted analysis?”

Is it perhaps a drive to recruit more nurses into NHS Lothian or increase bed capacity?

I don’t know, so I asked NHS Lothian but no-one was able to tell me what these nightmare management-speak phrases mean, other than they are going to have a meeting that will in their own words “zoom in” on processes and procedures.

Then a set of “whole system indicators” will be created to help boost and measure performance and attainment, while “obviously” improving the patient journey through hospital. Despite all this gloom and doom, the staff continue to do a great job against the odds. Everyone says that when talking about the emergency services or NHS staff, but it can’t be easy having to read a slew of negative headlines. I would urge them not to shoot the messenger.

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A glimmer of hope exists in the shape of a £4.5 million emergency fund allocated by Edinburgh council to tackle the “immediate pressure” caused by the delayed discharge in hospital of those waiting to be assessed.

The Edinburgh integration joint board, who have admitted the city regularly has the highest number of delayed charges in Scotland, has finally reacted. This is to be welcomed. For too long the good citizens of our capital have been fed on a diet of bread and circuses in terms of outward-looking projects that make the city look good. This “aw fur coat and nae knickers” approach needs to take a backseat as the local council and health board get to grips with providing much-needed services like healthcare for the people.