Happenings in Hinchingbrooke
Editor – In your editorial (Clin Med August 2014 p 333) you question whether making sure that ‘doctors and nurses can run things’ has caused ‘unprecedented turnaround’ at Hinchingbrooke. It is perhaps too early to judge the success of our franchise. Nonetheless I shall try to do so but insist the views stated are entirely mine.
The editorial admits quality is hard to measure. I agree, but believe it has improved. An anecdote may interest readers. While on leave two years ago, I received an urgent email from a ward manager (sister) on a Friday afternoon. Two junior doctors were trying to cope with the preweekend combination of 30 ill patients, irate relatives and ‘must-do’ to-take-out prescriptions. The rest of the team had been reallocated to ‘front-of house’ duties in my absence. I emailed senior clinical and management colleagues about the situation. On a whim I copied in the then chief executive officer of Circle Ali Parsa. Within minutes he had contacted the quality lead demanding an investigation and a report on his desk by the following Monday morning.
Another positive development has been some high calibre appointments. Previously applicants were put off by our uncertain future.
What has not gone so well? Sadly financial balance eludes us. We were one of 19 trusts referred to the secretary of state for failing to break even in 2013/14. This is a far cry from the optimistic projections when the contract was signed.
The press speaks of morale ‘soaring’ and ‘deteriorating’. It depends whom you ask and when you ask them. Undoubtedly, in the first few weeks there was a buzz about the place when all the staff were invited to meetings to develop a bottom-up 16-point strategy. Since then there have been ups and downs. As elsewhere, nursing morale plummets when wards close, reopen or reconfigure. Medical morale suffers when doctors have to do extra duties at short notice.
The management has gone through changes of personnel and structure. Initially we were divided into a large number of clinical units led by a senior doctor, nurse and middle manager. These typically represented one or two wards or services. They have since been rationalised into fewer, larger units. Ironically, the current make-up is similar to our first unit management board in 1987. I entirely endorse doctors and nurses making the decisions. Sadly, then as now, scope is limited by external diktat and stringent short-term financial targets.
Footnotes
Please submit letters for the editor's consideration within three weeks of receipt of Clinical Medicine. Letters should ideally be limited to 350 words, and sent by email to: clinicalmedicine{at}rcplondon.ac.uk
- © 2014 Royal College of Physicians
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