First thoughts on arrival back in Blighty

My first thoughts working for the NHS are a jumble of admiration, dismay and puzzlement at the mixture of differences from Australia. Probably some of these differences are simply being in a stand-alone children’s hospital, but others will be universal. One of the main differences compared to working in Queensland is the pride people take in the organisation they work for. Whilst staff in Queensland often talk about “Queensland Health” with open hostility and frustration, the staff in the UK are proud of the institution that is the NHS, despite their frustrations. Does that hostility mitigate against improvement? During the 2012 Olympics the NHS was showcased as part of the opening ceremony. That reflected the pride that all of Britain takes in the NHS. The public “ownership” of our NHS encourages a partnership approach with the patients/consumers/clients of that health service. Whilst the NHS is the “National” Health Service it is quite clear that there is nothing national about the health service at all. The service is divided up into Trusts which cover areas of varying size and varying demographics. As a result the provision of services varies from trust to trust, depending on the services commissioned by the Clinical Commissioning Group. In Liverpool that group is comprised of both doctors and lay members. Of the ten doctors all but one are GP’s. The NHS is in a constant state of reorganisation, even having changed structure between my interview in October 2018 and my arrival at the end of January 2019. So if you want a whistle stop tour of the NHS then watch these, bearing mind it has changed a bit since then!

https://www.kingsfund.org.uk/audio-video/how-new-nhs-structured

https://www.kingsfund.org.uk/audio-video/how-does-nhs-in-england-work

So I don’t want to be political but it is impossible to ignore the biggest constitutional crisis since we beheaded Charles I. And so to Brexit….. Well first of all we are officially advised to call it EU exit. Of course no one takes any notice, but that is the British for you! So, three quarters of our drugs come from the EU and of that the majority comes through the port of Dover. The Centre (NHS HQ in London) has arranged for drugs to be flown in to avoid Dover. Legislation has been passed to allow community pharmacists to change medication to similar formulations, not generic but similar. After an immediate outcry anti-epileptic medication was exempted from the legislation – as any good medical student would have advised, antiepileptics are not substitutable. Our hospital has a full time team with responsibility for Brexit preparation with weekly briefings for the Executive team. Replicate that across the NHS and you can see where the £350m/week is going!