Saturday, 29 June 2013

Keogh Review


The Keogh review team visited my work place. I volunteered to meet them. Twice. Once as a part of a group discussion. Again on what was supposed to be a one-to-one drop in session.

The group session was very interesting - individuals and as a group there was a delicate balance on many fronts. The one I found really intriguing was the pride we felt about our work place when faced with these external bodies which had to be balanced with the view that if we were really worthy of the pride we felt those external bodies would not be in our hospitals in the first place. Difficult emotions to cope with.

The group session was supposed to be for people who had signed-in before but eventually allowed people who had not registered. The advantage of a free discussion was probably cancelled out by poor management of 'air time'. There were some highly placed persons whose attendance might have dampened the sessions but I cannot be sure about that. The one-to-one drop in session turned out not to be one-to-one at all, I was invited in to sit as a previous person was talking to the Keogh people and a person who followed me was invited in to join as I was speaking. Of course we were asked if that was okay with us, what is the point of asking if it fundamentally changes the nature of the session. In my case the person before me and after me have a history of thinking on similar lines so I did not feel constrained and the person who followed me mentioned no feeling of constraint (in a private conversation later)

The Keogh people have promised that this will be a very open and transparent enquiry. So I am not going to put out what I said or did not say, as obviously without the bigger picture context in place I cannot make sense. In any case, if the promised transparency turns out to be true everything that we said (though anonymised, I think) would be available to everyone when the review is published.

I took the opportunity to ask them some questions. I wanted to know who exactly will write the report for my trust and whether that person or persons were actually present in the premises as a part of the visit. They were not sure about that.

I asked how the success of the Keogh review will be measured. They were unsure about that as well. 

There was an assurance that there will be all the support needed for the 14 trusts to deal with their problems. I am particularly keen that Keogh review should only be called a success if the 14 trusts under review were no longer outliers two years from now and remained so for a further four or five years. Having commissioned a review on high mortality, in my mind the obvious end point will be the reduction of mortality for which Keogh and DoH should take joint responsibility from now. To publish a report, however well informed it is, to provide support however intensive it is, will be meaningless unless our mortality gets low and remains low. Having lent his name, Sir Bruce should have no choice but to link his success to ours.

We discussed my motivation for meeting them. It was very simple - I live and work in the area, if I had a problem by default I will end up in my hospital's bed. If my hospital's mortality statistics are bad, it will be foolish of me to think I might escape from its clutches. So I want to see it get better.

We will have to wait and see if at the end of it all Keogh review will give us the keys we need to get out of this hole or will simply become a keyhole review. My healthcare, my life, my family's healthcare and my family's livers, my neighbours' healthcare and lives, my friends' healthcare and lives are at stake - so there is no other option than to get this right.

Follow me on twitter @HemadriTweets

No comments: