Can Do Health & Care - NHS Uncomfortable Truths Report

Part 1: WHY as system leaders we need to address culture to improve outcomes | 19 Recruitment is a challenge, but also retention. Answering the phone on 111 is a living wage level job as it is a non-clinical role, many of our staff come into the role with great intentions to make a difference but it is relentless work, and having to listen to patients’ abuse and frustrations makes it very difficult. Tanvir: I am a clinical consultant for out-of-hours in Norfolk and Waveney, working in parallel with the 111 service. The amount of vitriol that the call-handlers face is tremendous. By the time the patient speaks to the doctor they have already been asked their problems twice, and they are at fever pitch in their disappointment with the service, so you have to apologise. The patient then asks which country you are from, and you have to reassure them sufficiently so that you can start to address their medical problem. Dental issues are a significant issue, as the GMC does not allow GPs to prescribe antibiotics for dental matters; in the out-of-hours service we prescribe them and have to explain this is on humanitarian grounds, but the patient feels we are doing them a favour and talking down to them. The call handlers have to follow prescriptive pathways which don’t always lead to the right outcome for the patient. Harprit: Nationally across the NHS, from a workforce of 1.3 million, 15-20% of our staff have experienced physical assault from patients or service users. The rates are higher in the ambulance and mental health services, and staff can experience multiple incidents each year including being punched, broken bones, lost teeth, or chemicals sprayed in their face. There is significant under-reporting as incidents are seen as just part of the job. We place the onus on staff to manage these situations, telling them to be more resilient, or to have more training. “We have to be able to work together, for us to understand the impact we are having on our communities but also the impact our communities are having on us, because if we don’t resolve this we are not going to have a workforce left.” Younger people have very different expectations from their employers and for their work, so we have to get this right for the next generation. Melanie: In the last few years emotions have been up and down across the country. We had clapping and valuing the NHS, a feeling of flexibility and freedom, volunteering for the greater good, and just being there for each other as we didn’t know if we had a future. Now the level of anger and outrage in the UK is at an all-time high, with people not acting for others and community groups losing their army of volunteers. This is important as a fifth of voluntary sector organisations work in the field of social care, many very small organisations dealing with very complex needs, and if they close this will be very concerning. Uncomfortable Truth 8: Nearly a third of female NHS surgeons have been sexually assaulted by a colleague over the past five years. University of Exeter, University of Surrey and the Working Party on Sexual Misconduct in Surgery