Through much experience over the last 30 years, I came to realise two important things: a) at times I made mistakes in exceeding my knowledge and competence b) in recent years I’ve seen others doing the same. The big problem is that one does not have an idea when one is stepping into territory that exceeds one’s competence. It is like a novice swimmer not appreciating the dangers of swimming into a wide open ocean. After all, one cannot know ...
Over the last 10 years I’ve visited for work, many public sector health services. Whilst no service is perfect, at each place I found things that were fundamentally wrong. Nearly every senior manager knew about the things that were wrong but they were unable to implement changes. I am referring to things that were known as wrong for years – not just weeks. The topic of change management is not new to me. My reflections led me to dig deeper ...
Not so long ago there were stampedes of people rushing towards ‘leadership’ courses. Leadership Universities were set up. MBAs and other management qualifications were in high demand. All courses emphasised leadership in change management. In many health services a culture was promoted that ‘everybody’ had to lead, though it was never stated like that. The stampede going into and out of courses, led (from my observations) to people in teams all trying to lead. I could see that failing at ...
Health service work involves complex and competing demands on time. No one should be surprised by that. Psychiatrists are often given some time management strategies to work with in their basic and higher training. However, my experience over the last 20 years is that most of those strategies fail. The reasons are: Excessive workloads Increasing demands for quality based on a number of relevant standards (in the public domain). The frequent unexpected number of urgent and complex situations that turn ...
All public health services are accountable in the UK. This post provides an in-depth exploration of patient rights and accountability within the National Health Service (NHS) in the UK, focusing mainly on services in England. It delves into the sources of legally protected rights for patients, the mechanisms for holding the NHS accountable, and the challenges in upholding standards. The article highlights the importance of patient involvement in healthcare and outlines various ways patients can become more involved. The role ...
This post is an off-shoot from Strange Medical Treatments in History. Introduction I began digging deeper into many of those treatments but then got stuck on what was termed ‘Physician Assisted Paroxysms‘ (PAP). I became totally flabbergasted by what I found. It would have been too much to add to that post, so I decided to pull all that I could find into this one. In essence PAP was actually and originally manual masturbation of the clitoris. That was seen ...
This post was inspired by a non-medical colleague – initials L.R. See Hysteria, physician assisted paroxysms and sexual relations which follows up on this post. The practice of medicine is built on ‘belief’ in treatments. History shows us how misplaced beliefs led to some horrific treatments, mistakes and death. Many of the treatments now considered “weird” or “outdated” were conceived and implemented in an era before the establishment of rigorous scientific methodologies that are now a cornerstone of modern medicine. Here ...
The delivery of healthcare is complex business. Often times records are compiled by large numbers of people in teams or extension of teams about a single patient. The vast majority of Electronic Health Records (EHRs) are text-based. Understanding a patient’s condition(s) and needs from records is often demanding of time, effort and concentration. Many public sector healthcare organisations demonstrably fail to factor in the time that workers should spend reading the records. Time spent documenting in records is a separate ...
I was thinking about caring in the context of healthcare (only) for this exploration. There are some elements of care that involve providing services – for example diagnostics, investigations, nursing care, medical procedures and so on. But I needed to look deeper than that. I did not really want to see care as just services and jobs. Anybody could find a list of things that carers need to do to provide care e.g. risk assessments, filling in forms, taking pulse ...
Communication is a broad and multifaceted concept that can be defined in various ways depending on the context. Communication in health services is a very big issue. Numerous inquiries have found communication problems. NHS trusts and other health service organisations are unaware of the costs of communication deficiencies. It is a very difficult thing to assess the cost to their business and the costs to patients. The following general definition will be adopted for this article: “Communication is the process ...
