When I started writing this blog a couple of weeks ago there had just been the GMC ruling over Dr Bawa-Garba. Not surprisingly it sent shockwaves through the medical profession. One of the main issues was around rota gaps and trainees being stretched even further in order to cover them.
As I’ve mentioned before I am the Forth Valley medical rota lead. Some refer to it as the ‘Poison Chalice’. I roll my eyes whenever things like this are said in my presence. Why? Because it shouldn’t be so difficult or complicated to run a rota.
With that in mind I think it’s important to remind people that rotas are a fundamental necessity of the NHS. A service that is about patients. Or people. People who are sick. People who are vulnerable. People who need people to take care of them.
This service can only operate if the doctors, or people if you will, are not over tired, stressed or lack the skills or support to do it safely.
This service of caring also requires processes to help facilitate the safe delivery of it. Sometimes we refer to these processes as people too. Behind every flow chart, piece of paper and email are people whose job is the smooth running of this mammoth organisation.
However in every high pressure service there can be obstructive, confusing behaviours or opportunists trying to push personal agendas. I’m sure we’ve all experienced this at some points in our careers.
Now I can appreciate that people are apt to do to unusual things when they are under pressure. I can also accept that some lack the insight or self awareness to recognise when they do. What I can’t accept is when it appears to be wilful. Blaming others for their mistakes, not taking responsibility or being accountable in any way.
So how does this change?
You need formal governance around any rota work. Without it there can be no consistent management, cohesive policies, guidance, processes or decision-rights to allow the safe running of the service.
The GMC have said there should be a ‘guardian of safe training’. Now I would love if Chris Pratt came and fixed it all but this seems far fetched. Well is it so far fetched to have processes and people that work for the service instead of against it? A service that strives to care for people. Well I don’t think it is.
This week I had several conversations with those instrumental in improving it. They were long, they were at times difficult but we made progress. I could not be more proud or impressed with the way people showed up. I don’t just mean physically. I mean actual showed up and had the uncomfortable conversation from a place of honesty and willingness to change.
It’s been a long, cold, winter and I think we could all use a little respite. So as the sun begins to creep through, I think it’s going to be alright…..