@ 08:30 pm today

Switch OFF the lights and all other electrical appliances @ your place/business for one hour to reduce your energy consumption and help taking action on climate change!  =)

 

I stood in the Critical Care Unit (CCU) at University College London Hospital (UCLH) today, for Governor purposes by the grace of God, talking efficiency-savings and cuts with one of the brilliant staff there. In the midst of our talking it suddenly occurred to me that the acronyms we were bandying about would have completely passed me by 6 months ago. What a time it’s been!

This afternoon I spent some time with one of the brilliant nurses in the CCU in the UCLH tower. I went to discuss the ‘Prevention and Management of Pain’ benchmarking exercise with the staff lead but will save that for next time. While I was there, she kindly took me around her area of work and explained some of the key aspects of their work and the challenges ahead.

The CCU, with a full 35 beds, is one of the largest units of its type in the country and provides care for around 2,500 patients a year. Critical care is a incredibly specialised area of work, where staff are trained to react quickly to problems as they arise and use state-of-the-art equipment to look after the very ill. This unit have a lot to be proud of as national intensive care audits have shown the survival rates to be some of the highest in the country.

Our CCU incorporates an adult intensive care, high dependency care, the Post-Anaesthesia Care Unit, a critical care outreach team and the critical care follow-up clinic. Critical care deals with a wide range of problems but typically patients have problems with one or more of their organ systems (e.g. lungs or heart).

The work and care being put into the patients is tremendous (thank God for the NHS) but the hard part for me was seeing loved ones gathered round the very sick as I passed the bays and isolation rooms. I can’t begin to imagine the heartache and awfulness of seeing someone you care about so very unwell. I am thankful for the work of the chaplaincy team and psychologists to support families and friends through these times.

As I understand it, no matter how many parts of the NHS become privatised, critical care units will almost certainly remain in the public domain because of the high cost of care. While private companies/hospitals will happily take on the simpler cases (easy money), any serious problems that arise with the patient will then lead to necessary transport out to a hospital with an A&E, critical care unit or similar.

I am reminded of a something a fellow hospital governor, and much more prolific blogger than myself, said in a post about specifically choosing NHS services over anything else. By always supporting and choosing your local NHS hospital services, those elements of the hospital that make a surplus (Richard explains that well in his post) help to support those crucial services the hospital provides that don’t, typically A&Es, CCUs, and similar difficult and complex areas of care. As Richard puts it “Literally, if you have you hip operation paid by the NHS at a private hospital, there will not be the money to treat sick kids.”

I was recently interviewed for the UCLH Trust’s quarterly newsletter to members and I thought people might be interested so here’s a copy of the interview, which you can also read in the newsletter itself here.

Fiona McKenzie was a newly elected governor in September 2010. Joan Bell, governor and UCLH news editor, talks to her on her achievements.

Congratulations on being our youngest elected governor!  What made you decide to stand for governor?

My experience of UCLH has been, on the whole, a great one. However, there have been instances with plenty of room for improvement. I stood, like so many others, because I wanted to help work towards creating a better patient experience. With NHS reform and budget cuts, billed by many as the greatest challenge for the NHS since it’s inception, this seemed like an excellent time to stand as I love a challenge. Finally, it looked possible, as a role, to fit around my full-time employment and I wanted to contribute and be part of effecting change.

How long have a been a member of the Trust?

I joined the Trust in November 2009 as it was becoming clear I was going to have a fairly lengthy relationship with UCLH at that point and it made sense to get a better idea of the bigger picture. I remember joking with friends that I had joined the hospital’s “loyalty programme”, having received a membership form along with my nth appointment letter.

You’ve been governor for just a few months and have already got involved in many areas of where you can make improvements for patients.  Tell me what you’ve done so far.

I am liaising with clinicians and external partners on ensuring patients with learning disabilities, one of the vulnerable groups of patients, are provided with the same high standard of care as others. I am working with Ros Waring, in the Membership Office, to recruit and engage more members. I have joined a committee which deals with quality and strategic priorities alongside patient safety and a group of Governors who focus on improving the full patient experience. I am taking part in a hospital walkabout looking particularly at non-clinical practical issues including cleanliness, food and facilities. Later this year, I will be helping with the ‘environment’ and ‘prevention & management of pain’ audits of Nursing and Midwifery practice, which help promote sharing of best practice across the Trust.

What do you find most satisfying in being a governor?

I look at what some of the long-standing members of the Governing Body have achieved and it’s tremendously exciting to see how much change they have effected. The most satisfying thing is being able to be part of that change now and in the future.

What influence do you feel young people would have in being governor at the Trust and would you encourage other younger members to stand?”

I would love to see more younger people standing in the Governing Body elections this year. It provides an excellent opportunity to play a part in shaping a community – it’s challenging, exciting and ever-changing and there is plenty of room for being actively involved in the work. While I have taken on quite a few positions, you can make the role suit and fit with your interests and time commitments. Many of the meetings happen outside 9-5, so it can fit around work commitments. Alongside this, many employers have specific HR policies providing extra leave for Governor responsibilities as part of their corporate social responsibility programmes. For me, the experience will help my career and, very selfishly, it’s a brilliant role to put on my CV. I think more representation from younger people would contribute a fresh perspective to the Governing Body and could also provide those younger people with skills and experience useful later on in life.

So in Wednesday’s edition of the Guv’nor chronicles you all found out I’d been elected a Governor of the University College of London Hospital (UCLH) National Health Service (NHS) Foundation Trust. Putting my experiences of the hospital to good use and helping improve the experience for other patients, as I like to put it.

It’s a bit of a funny term, though, this ‘Foundation Trust’ business, and I have to admit I had very little idea of what it meant so to help readers, members and anyone else unsure – here’s the low down on Foundation Trust status, from someone on the inside.

Back in the day, before 2004, UCLH was a simple NHS hospital trust, providing health care commissioned by primary care trusts with the help of strategic health authorities. Foundation trusts were announced in 2002 by the Health Secretary as a new step forward for highly efficient hospital trusts. UCLH fitted into this category and was one of the first hospital trusts to jump through the hoops required to gain more managerial and financial freedom as part of Foundation Trust status.

The stated purpose of a foundation trust is to devolve decision-making from a centralised NHS to local communities in an effort to be more responsive to their needs and wishes – which is where Governors come in. Local people, patients (& carers in our case), and staff can become members and governors and hold the Trust to account. It’s all very laudable…

Experiences seem to vary widely – while some Trusts place a lot in the hands of their Governors, other Governors feel less able to contribute and achieve improvements, at least according to research done (which I have a hard copy of but can’t find online). I am particularly excited to be on the Governing Body at UCLH because of the changes already put into effect by earlier Governors, some of whom retire this year. This bodes well for what I can work towards. We have a membership base of over 6000 and most elections are hotly contested. Governors get involved in a wide variety of activities aside from the most basic statutory requirements of the role (we’ll get onto that next time) and I’ll be blogging about many of these and other causes I’m working towards as part of it all. Such fun!

My new local hospital trust – St George’s Hospital Trust – are going through the steps of becoming a Foundation Trust and have recently released a lovely little 3 minute video about it.

Any questions yet? Do please ask and comment below.