I've been to a number of meetings and conferences committees that have left me thoughtfully confused. As I've said before, I invest time in this malarky because if someone doesn't we'll get sold down the river, so it's best to at least chip in to have a voice in the process.
I think the GMC expect us to, aren't they about protecting patients? Ah no, their tag line now summaries that they too now are focussed on, "Regulating doctors, ensuring good medical practce." Well, they used to care about protecting patients. I'm sure as a doctor we're still obliged to protect patients from malign care. Thus, if managers are having a brainstorming session and generate what I would charitably call "idiosyncratic ideas" that will affect clinical practice unhelpfully, I like to be able to interject a bit of common sense and pragmatism in to the deliberations.
Mostly this works, which is why I keep doing it. I'm over stating it a bit, since in my corner the managers are actually pretty sensible and clever and helpful folk. The problems mostly involve evidencing something or doing something that we all know is nonsense but, for mind numbingly frustratingly incomprehensible and labyrinthine reasons just, "has to be done." So we get around a table and mull over how we do something we mostly agree doesn't truly need doing, and think of how it can have the least hassle for staff and least nuisance for patients.
Meetings with the SHA and PCT and partner organisations have been more . . . curious.
There's an enthusiasm to measure things. Evidence things. Prove things. Monitor things. Manage things.
This has lead to me knowing far too much about "things" which no sane man should know. Things like "quality metrics" which I won't sully your pure and beautiful minds with; enjoy the innocence, unfettered with such nonsense.
The notion proposed in my corner is that "quality" and "outcomes" are measured. Along with the work done (the content of a service line, i.e. the staff and resources). And the activity undertaken. And, for this work, the cost to our Trust for this. Anyone flirting with management will recognise this unholity trinity of Service Line Reporting (SLR) there, which is then fused with quality and outcomes and Payment By Results (PbR) and Quality Outcomes into some hideously ghastly abomination.
Zarathustra will love this. H P Lovecraft couldn't craft a finer tale of complexity, understated malevolence, despair and of something slumbering, quiescent, about to errupt causing "much badness." Reality is indeed more curious than fiction.
For now, within our corner, we're having to report to the SHA on quality. And report on Service Line Reporting to entertain Monitor.
So, over to you. What do you think will be looked at, when considering quality? For a patient, going through our service, what things matter? What is quality, what things should be recorded and reported and publically shared, to reflect whether we're doing well or not? I've my views, which I'll whitter on about another time, but for now, have a blank bit of paper. Add what so ever you will. If you're interested in a quality mental health care from our Trust, what would you be wanting to know about? What's on your list? What matters?