Thursday 19 July 2012

Ancient and Modern

In Bath. At a hospital founded in 1174 , then to one of the newest hospitals in the country. Both in gorgeous buildings; one the John Wood Palladian prototype for what became Georgian Bath , the other a Norman Forster. One run by a charity for over 800 years, the other by the independent  company " Circle Healthcare" which is 50% owned by doctors and nurses. 

2 hospitals but both demonstrating the value of a diversity of providers in our health and social care system. 

To St John's Hospital first; to see Jonathan O'Shea, the CEO and ACEVO member. A guided tour of the lovely Georgian buildings cheek and jowl by  the roman baths and Abbey and then a meeting of ACEVO members from around Wales and the SW. 

I like to make the point to health service professionals that we used to run the health service. St Johns is a great example of that care , but also the continuity of our great sector over the millennia.  Established as a refuge for the poor and needy of Bath it now provides health and social care, accommodation and support, and grant making for the elderly.  

And the diversity of the sector was illustrated by the fact that for 2 of my members at the lunch their biggest problem is the movement of the property market. St John's has no state funding but a large endowment built up over centuries of generous benefactors and legacies. 

We had members from hospices, addiction services, trusts, disability, homelessness, medical research and social care. I like doing these lunch time events with members because you get a great feel for what is going on at the sector front line. It also keeps you in touch with what members want from you. One thing is for sure, I've not yet met the sector CEO that does not tell you what they think! 

And the lunch ( splendid hospitality Jonathan! ) gave me a real positive affirmation of what we do to support CEOs in their leadership role; its a job only ACEVO can do. 

Going on from an ancient and venerable institution to a brand new and brilliantly designed Forster building was a treat. This hospital is a standing rebuke to those in the NHS who say there is no role for competition or for different ownership models; but the key is whether other parts of the NHS will learn from the way they do things. 

They base their model on clinical decision making, on a toyoto model " stop the line" approach on safety , on " hospitality" so treating " patients " as guests and a customer first approach. So their clinics start at 7.30 and finish at 9 to cater for those who work and are open at weekends! Some 50% of the patients come from NHS referrals under the choice mandate. 

What I found particularly impressive was their ideas on hospitality. Simple really; food and customer care is actually part of the process of recovery; well being requires both medical and personal care. So the food provided is of top quality; menus designed by a Michelin star chef; staff headhunted away from a 5 star local hotel.  And a realisation that nurses and doctors should provide the medical care but the skills and the work of supporting patients and feeding them is a different skill set and you need to free up nurses from the hospitality tasks better done by others. 

The food is locally sourced and served when the patients want their meals. And it does not cost more. Most NHS hospitals I know regard meals as a chore, the food is often appalling , as I have seen myself. When you are ill a little pampering is in order. Good food ( and indeed they even have a wine list! ) Is essential to good health care. The NHS has lost sight of some of the basics of health care- they provide world class medical care but sometimes forget the "patient". The feedback Circle get from their patents is superb because they feel they are treated like guests. One feedback form said they got a 99%mark of satisfaction. The other 1% dissatisfaction was because they had to go home. How many of our hospitals could you say that about?

And there is an interesting link here between the 2 hospitals; one third sector, one independent; the emphasis on " hospitality". As the history of St John's says, 

 " St John's was the first hospital in Bath...though this was not a medical institution; it was a place of refuge and care, where hospitality was dispensed in the form of food, shelter and charity. " 

Circle have rediscovered the value of such hospitality in our hospitals. This is a wider message for the NHS I hope they will learn. 

I got home and found a strange echo of that same message when I caught up on a BBC series of 60 Elizabethans featuring third sector heroine, Dame Cecily Saunders, founder of the hospice movement. Whilst working as a nurse in Tommies in the Second World War she realised that patients were getting good medical care but at the end of their life they needed compassionate and spiritual care which was not being provided. She said you have to treat the " total pain" of a patient which is both medical and personal. You need to provide both medical support but also " bring hope and consolation at the end ".
So again, hospitality in a wider context- back to the idea that inspired  Bishop  Fitzjocelyn to provide his refuge for the people of Bath. 

It is the inspiration and innovation that our charity sector can bring to the provision of health and social care

1 comment:

Sir Robin Bogg said...

It might be nice when referring to a third sector heroine if you managed to spell her name right. Cicely not Cecily. Or is this you providing another example of being flexible and doing things differently?