Spring In-Brief 2019 - Flipbook - Page 9
Continued from previous page.
A few years ago I had the fortunate opportunity to speak
to several clinical and management leaders from the
Children’s Hospital in Toronto. There was a clear – and
clearly articulated – organisational focus on finding and
replicating good practice wherever it was to be found.
Are we top decile? How? What is keeping us there? Are
we out of the top decile? Who is up there? Go and see
them and ruthlessly borrow everything they’re doing
which we could apply here. What will make us top decile
in five years’ time? How do we do that? If I had – heaven
forbid – a seriously ill child, I know what attitude I’d hope
for from their hospital. This one.
Teams which aren’t scoring enough goals may need
better tactics. They may need better players. If they can’t
afford or find better players, they may just need to make
sure that the ones they have are as well-trained and
well-organised as possible.
That might not make them win trophies, but they will win a
lot more matches that way.
So a plea. Let’s hear a bit less about the NHS stopping
repeating the same mistakes. And a bit more about the
NHS needing to start repeating the same successes. It’s
good practice which will eventually drive out poor
practice, not a fearful focus on not making mistakes.
Teams which are simply fearful of
mistakes, and which lack the confidence
to be better - don’t score many goals.
James Fitton is a Partner at Niche
James.Fitton@nicheconsult.co.uk
Listening to carers’ voices
The value of carers in evaluating the impact of services – Jenny Treanor
We all know that the NHS and Social Care are massively
dependent on the “thin grey line” of unpaid carers who
look after ill, disabled or elderly family members, friends
or partners. Illnesses that can be physical, mental, or
both. In fact, the line is not that thin. The 2011 census
reported that 6.5 million people in the UK are carers with
the figure expected to rise significantly. And the
population of carers is not static. Carers UK estimate that
each year around 2.1 million people become carers whilst
almost as many cease their caring role as the person they
care for recovers, moves into a home or passes away.
Involving carers in work to assess service impact (such
as evaluation) is not always easy or straightforward.
Carers may be under so much pressure due to their own
caring role that they become tearful and upset when
someone takes the time to hear their views, or they
simply lack the time to speak with us. If they only have a
few free hours a week they may (quite understandably)
be reluctant to spend it talking to someone doing an
evaluation.
Identifying carers can also be difficult as they are not a
visible group of people. Details are not always recorded
Because of their caring role these unpaid carers often
on health or social care records. The NHS Long Term
have vast experience of NHS and social care services.
Plan may eventually help here, with its encouragement for
My neighbour Sandra’s 80 year old husband, for example, a national roll-out of carers’ passports which will enable
has Parkinson’s disease. Sandra is therefore an absolute staff to identify someone as a carer and involve them in
expert on the quality and responsiveness of the local GP, the patients’ care.
community nursing services, community OT, the memory
service, the pharmacist, the aids and adaptations service, In addition, many carers have their own health problems
the Parkinson’s specialist nurse, the emergency and non- to cope with and rarely leave the house. The Carers Trust
report that 65% of older carers (aged 60 years plus) have
emergency ambulance service and more recently the
a long-term disability or health problem themselves. 69%
local hospital which she currently attends twice a day to
of these carers say that being a carer has had an adverse
feed her husband during his admission following a fall.
impact on their mental health. Being creative in our
He, of course, is an expert too, from a patient’s
approaches to finding carers who are willing to talk to us
perspective.
in order to inform our work is vital and facilitating easy
Carer insights about the services, which the person that
access, with or without an advocate or support person is
they care for receives, are often both insightful and
important. It is essential to be ‘carer led’ for example
informative. They may have been a carer for many years establishing where they would be comfortable to meet
and have experienced services changing over that time.
and prioritising this, recognising that they may be
They may have had to fight for those services. They may uncomfortable or embarrassed to meet in some
also know nothing about the flagship services which have environments. Read our practical and useful tips for
been set up to support people like them.
listening to carers at www.nicheconsult.co.uk
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