The vicar of Halifax Minster, the Revd Canon Hilary Barber, has just finished his second day shadowing key figures in the public sector. He spent Monday with A & E Consultant Andy Lockey at Calderdale Royal Infirmary:
(pic courtesy of the Huddersfield Examiner)
This is his report:
The Accident and Emergency Department at Calderdale Royal is part of the Calerdale and Huddersfield NHS Foundation Trust, covering principally Calderdale and Kirklees. The Trust currently operates two A & E departments located in Halifax and Huddersfield. I had the enormous privilege to spend some quality time with Mr Andrew Lockey, A and E Consultant at Calderdale Royal.
The Health Service has become somewhat toxic in the media, dogged by competing claims made by politicians and sensational headlines in the media. Whilst the sound bites are written and political decisions are made or not made, health professionals simply try, as hard as it may be sometimes, to simply get on with the job of providing Accident and Emergency Services 24 hours every seven days. From the canteen staff and cleaners, to porters, nursing staff and radiographers, to junior doctors and consultants, they all work their socks off, day in day out, providing the best care that they are able to give to patients who present themselves at A & E.
Fortunately, there were only some 35 patients in the system when I arrived, and mostly were minors and not majors. This meant Andy Lockey had a few minutes to talk before the day took off. When a patient presents at A & E, they book in and head to triage, where they are immediately assessed. Category 1 – 4 with 1 needing life saving immediate intervention, and 4 to be seen within 2 hours. The Sister in A & E has the joy and challenge to ensure the system works efficiently and effectively. There are 10 A & E Consultants in the Trust, with 5 on each site. It’s difficult to attract staff to work for the Trust as it has A&Es on two sites, and the stress generated by the nature of the job. Consultants cover 8am - 10pm Monday to Friday, then it’s On Call and Weekend Cover. Sundays and Mondays are generally the busiest days of the week.
The staff manage a jigsaw of administering medicine, quality care for the patient, and the finances. Everyone is aware of the challenges, as the number of patients seems to be growing. Andy has worked at the Trust as a Consultant for 15 years, after training in Leeds, York (as a GP), South Africa, and now in Halifax. Andy finds the Trust an inclusive organisation with a ‘can do’ attitude. His length of tenure demonstrates his vocation and ultimate job satisfaction in the career he has chosen.
The Sister in charge has her desk suitably positioned to be able to see most of what is going on. Aided by computer systems, she can monitor each patient who is booked in, and ensure that they are seen appropriately. She tells me that often they are short staffed, which means longer hours and longer waiting times. The red phone rang – this was the Stroke Line – a patient was on its way and would arrived in 10 minutes. The Sister then alerted the Stroke Team that a patient was on its way. By the time the patient arrived, they were met by two Stroke Consultants and the specialised Stroke Nurse, the patient was taken by the Paramedics straight to Radiology, where a team of six staff were ready with a scanner, to see what was happening in the brain. This patient was local, and the hospital had their file on their system, had the patient been visiting the area, this would not have been so. The patient had other complications and other long term conditions, all essential information for medical assessment. Back into Resus, more observations could begin, and for Stroke victims, the speed of medication is hugely important in having the best outcome. Here a well-drilled routine was actioned, and the very best of patient care was provided. The NHS working to its strengths. A bed in the Stroke Unit was available and arrangements were made to transfer the patient to the ward.
I now had a chance to spend time in Triage, observing patients arriving and being assessed and prioritised. First in was a patient with a sore foot, followed by a septic finger, followed by a pregnant woman with stomach pains, followed by a mother with a sickly child, followed by an older patient slightly confused. The patients came in all day and the majority were minor complaints, most of which should have been dealt with by the local GP. A separate Triage deals with Ambulance arrivals.
Here lies the conundrum, with regard to the large numbers attending A and E. We now live in a society where we demand instant access to everything including health. Gone are the days when the GP would see us in a day or two, and we would happily wait for something non-urgent. Today the mother with her child came straight to A and E, and when the Triage Nurse enquires if the child had been given any medication such as “Calpol”, the answer was no! The breakdown of family life has left a number of parents with little resilience to deal with basic health care, both for themselves and their offspring. We want medical care and we want it NOW!
This plays into the drama over the proposed closure of one of the A & E departments. The decision has gone to the Secretary of State with a Judicial Review pending. Sensational headlines outline all the negative arguments over improved health care, better use of resources, more effective and efficient financially. I’m no expert, but the staff at Halifax A & E are convinced that by having one A & E department, wherever it is located, is a significant move forward in the right direction. Whilst the final decision drags on and on, it becomes harder and harder for the Trust to recruit and retain staff, and the real fear is that Kirklees and Calderdale could end up losing both A & E Departments, with everything being centralised in Bradford and Leeds. The large conurbations in urban Britain have become used to accessing hospital care on the doorstep, and the honest answer is that those days are now over, for medical reasons and improved patient care, never mind the financial implications. This vision of the NHS needs to be carefully spelled out by honest politicians and civic leaders across communities, making sure that the energy of opposition and protest can be challenged into positive action for increased spending and quality care, and improved hospital environments for the sick and dying.
Generally, the media only tend to report of doctors and nurses when something has gone terribly wrong. Rarely do we read about their amazing vocation and commitment who work hours of overtime, and who haven’t had a significant pay rise for years and who care selflessly for thousands of patients year in year out. The NHS certainly isn’t perfect by any means, but for those who work at the coalface, the professional care and attention to detail cannot be faulted, and of their vocation, there is no question. Many doctors and nurses had come from abroad to support our local hospital, and, to experience one of the best health systems in the world, and to them I’m truly grateful. Goodness knows what effect Brexit will have on our health service – I shudder to think. It was immensely humbling to spend a day shadowing Andy Lockey and his team, and it leaves me with much to reflect and pray about, and in good faith, to know that people who work for the NHS really do care about the communities they serve.
Canon Hilary Barber, Vicar of Halifax Minster .