Dr Cheung-Judge is a world-renowned expert in organisational development. Here, she shares personal reflections on the NHS, the exceptional care she has received over the past two decades, and why a new narrative must emerge on the nation’s health service.
An effective organisation delivers effective services to the constituents it serves, regardless of the ups and downs in the environment. It has a culture that supports its strategic direction and leaders who work hard to ensure the organisation increases its functionality. And it has staff who are motivated, engaged, and work collaboratively to overcome silo mentality – and that stay agile and adaptive, with a positive ‘can-do’ mindset.
My experience as a patient over the last 20 years has shown me that the NHS is still very much an effective and healthy system. Here’s why.
My NHS journey
In 1997, I was diagnosed with chronic renal failure. Since then, I have been under the care of the Oxford Renal and Transplant Unit at Oxford University Hospitals NHS Foundation Trust. I have undergone renal dialysis (ambulatory peritoneal and then haemodialysis) for close to three years, and received a three paired kidney exchange transplant in 2011.
In November 2017, I was diagnosed with Post Transplant Lymphoproliferative Disorder, as well as bilateral renal cell carcinomas – they were close to ten centimetres diameter on the right kidney and two centimetres on the left. The following month, I received four rituximab infusions and took daily doses of oral ibrutinib. This was followed by laparoscopic radical nephrectomy in February 2018 and four more rituximab infusions between February and April 2018. The outcome of my treatment will be confirmed in May/June this year.
The last 21 years have made me appreciate four things about the NHS.
Joined-up ways of working
As the two types of cancer I had required different treatment plans, coordination was critical to my treatment. From the very beginning, joined-up working was evident among the three consultants charged with my care: Dr Mason, my consultant renal physician since 1997; Dr Collins, the consultant haematologist, and Mr Sullivan, the consultant urological surgeon.
Dr Mason ensured a consistent joined-up approach; Dr Collins appreciated that while the treatment of the lymphoma needed to go first, a timely radical nephrectomy was also critical; and Mr Sullivan was OK waiting for a ‘go ahead’ signal from Dr Collins.
The next layer also worked together
The staff supporting these three pillars of my care played a crucial role in keeping the communication flowing effectively. This included the haematology fellow who served as a communication hub; the research nurse for the TIDAL trial who handled complicated scheduling; the theatre scheduling nurse who made sure I got to have my surgery as soon as possible; and the secretaries of both consultants who made sure my situation was kept in mind by busy doctors.
The cancer day treatment unit, the urology nursing team, and Mr Sullivan’s senior registrar all pulled together to ensure I had the best and timely treatment/care, and willed me to recover – which has been most touching.
Cheerfulness and personal care
Most cancer patients feel precarious, so it was a special gift to walk into the day treatment unit and be greeted with cheerfulness and personal warmth. When the first round of treatment finished, I actually missed not going in. Nurses in the urology unit were personable, competent and had a great sense of humour. The three consultants made sure I understood the seriousness of my medical condition, yet portrayed just the right amount of positivity to keep me going.
After both medical interventions, all three consultants showed genuine excitement that things were moving in the right direction. Given how overstretched they are, I am impressed they still managed to show such a personal touch with their patient.
Consistent patient experience
The renal care I received from Dr Mason and members of the renal unit team (the pharmacist, the dialysis unit staff, the transplant unit staff, etc.) has been consistently excellent, which speaks volume about what the NHS stands for. This level of consistency should never be taken for granted.
It is impossible to say whether my experiences in Oxford are representative of the whole NHS, and I am sure there are different stories. But one thing I am certain of is that the bad press the NHS receives does not match my experience. Those who are critical of the NHS should understand the systemic factors that affect the NHS, such as the lack of joined-up government policy and funding decisions that have cut the social care budget.
Rather than focusing on the difficulties faced, it would be better to focus on the positives, such as “what are the core strengths of the NHS?” and “what has gone right within NHS?”. I am sure if we did that, there would be inspirational answers to balance the bad press. A new spirit needs to emerge, with NHS personnel affirmed and appreciated as our unsung national heroes.
Mee-Yan Cheung Judge is one of the leading thinkers on organisational development and is the driving force behind Quality & Equality Ltd, which she founded in 1987.
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