Cancer cell

What Audi could teach the NHS about patient care

By: Ben Gowland CEO NHS Nene Clinical Commissioning Group @ccginsider
Published: Monday, October 20, 2014 - 16:59 GMT Jump to Comments

When I was 31 I went to see my GP about a mole on my right leg. The GP looked at it, mumbled something about not worrying and referred me to hospital. I never met him again.

A couple of weeks after I went to see my GP I sat for 3 hours in a corridor in St John’s Institute for Dermatology at St Thomas’ Hospital.  Eventually my name was called, and I entered a large room with a consultant and 8 medical students. 

The consultant largely addressed the students, who took it in turns to inspect and touch my mole.  Finally the consultant turned to me and said that it would be better to take it off and check for anything suspicious (we weren’t using the ‘c’ word at this point).

To receive the results of the biopsy I was to see the plastic surgeon.  I had done my research and, without being explicitly told, knew that a cancer diagnosis was on the cards.  If it was, it was all about the ‘Breslow thickness’.  Essentially the thinner the better.  I arrived, nervous.  An hour passed.  A second hour passed, and then a glimpse of the consultant as he left the clinic.  Half an hour later he returned, eating a sandwich.  A further hour later I was called.

‘Well it is what we thought it might be’, he started.  My heart jumped into my mouth.  What’s the thickness??  He told me.  Panic.  At first I thought he had said 3.3mm (5 year survival 60%-75%). But he hadn’t, it was 0.33mm (5 year survival virtually 100%). And breathe…

A week later I arrived at theatre reception for my surgery (I was having a skin flap) at 7.30am, as instructed in my letter.  The door was locked. 

I banged on the door and eventually someone answered, annoyed.  ‘I am here for my operation’.  ‘Well we don’t open until 8am, so can you come back then?’.  ‘But the letter told me to be at here at 7.30?’.  ‘That’s because patients are always late’.

I hadn’t slept in a dormitory since I left school, and as I recovered from my operation I reflected that I didn't like it then and I didn’t much care for it now either.  The surgeon (different from the one who had given me the diagnosis) was keen to protect ‘his’ wound, and wanted me to stay over the weekend.  It was only by threatening to self-discharge that I managed to get out.

When the cast was removed the hospital told me to get the dressings I needed from my GP.  I rang the practice who insisted that I come in to receive the dressings.  I told them I couldn’t walk.  They told me that unfortunately those were the rules.  A friend ended up buying them for me from the local pharmacy.

For three years I went back to St John’s Institute for regular follow ups.  Each time I went I saw a different doctor, and would have to begin by explaining what had happened to me, while they furiously flicked through my notes to try and work it out for themselves. 

Eventually I was told follow ups were no longer needed, but if I had any concerns to come straight back.  I am not sure even now whether I can call the hospital direct or need to go to my GP first.

In many ways the NHS provided me with great care.  I have been completely cured, I have a very tidy scar, and I have learnt which moles I need to worry about and which I don’t.  But at no point did I ever feel that the NHS was looking after me.  I was navigating my way through a system designed to serve itself rather than my needs.

A few years ago I bought a car.  I walked into the Audi showroom and was given a cup of coffee while I waited.  10 minutes later I was with one of the staff, a young man called Matthew.  I know he is called Matthew because from that point on he navigated me through choosing the model I wanted, arranging finance, and taking delivery.  He rings me every 6 months to check that I am happy with the car, and to see if there is anything else that I need.  Any problems he sorts out straight away.

For me it is not ok that the experience of buying a car is better than the experience of being treated for cancer.  The world around the NHS is changing.  Businesses work hard to ensure that what they do is built around the needs of the customer.  But in the NHS we are still lost in organising care around the needs of organisations and professional groups.  It has to change.

The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of The Information Daily, its parent company or any associated businesses.

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