Sunday, 16 September 2018

Hip, hip hooray for the NHS


I am a great believer in serendipity. When thinking about this week’s blog, I found myself ‘stuck’ on the news of the appointment of Lord David Prior as the Chair designate for the NHS England. I say ‘stuck’, as I wanted to say something about my dismay at his appointment and what I thought it might mean for the NHS, but also pulled away from developing such a narrative, as I try to avoid political commentary in my blogs. Lord Prior is well known in the NHS. He was the former Chair of the Care Quality Commission (CQC) before stepping down to take up the role of Under Secretary of State for Health in the previous Conservative government. He has held Chair positions at a couple of NHS trusts, and currently remains Chair of University College London Hospital (UCLH) NHS Trust. 

I found it interesting that, despite what I thought was the hospital’s and associated medical school’s well-deserved international reputation, the UCLH was only given a ‘Good‘ rating by the CQC at its last assessment. More interestingly still (at least for me as a researcher and academic) was that UCLH was only ranked 40th in the UK and 607th in the world by the Ranking Web of World Hospitals*, whereas Wrightington,Wigan and Leigh (WWL) NHS Trust, where I sit as a Non-Executive Director (NED), is ranked 27th in the UK and 503th in the world (*other ranking organisations are available). 

It’s at WWL where last week’s serendipitous experience happened. I was sitting in the car park waiting to go into a meeting and as I was early, I decided to start to write up my blog notes on the inappropriateness of Lord Prior’s appointment - the original focus for this week’s blog. I noted that he had made a number of controversial comments on the NHS and healthcare during his career – including that… continuing to fund the NHS through taxes ‘must be questioned’ and that ‘even God would struggle to manage the NHS due to its size‘. I am not sure of the degree of independence he can bring to the role and it certainly looks like his appointment is another example of the creeping politicisation of the NHS.

Although my heart wasn’t in it, I promised myself I would return to the notes in due course, and closed my laptop and went to meet my colleagues. I was at Wrightington Hospital, part of the WWL family, and a hospital with an international reputation for orthopaedics. I was there to undertake a Leadership Safety Walkabout. These are regular events in our hospital calendar and an opportunity for Executive, Non-Executive Directors and Governors to visit clinical areas and meet the colleagues working there. This visit was to the theatre suites. After meeting my other walkabout colleagues, I was asked to change into surgical scrubs – which sadly for me (as I always wear black) only came in a fetching duck egg blue. 

We were taken on a ‘patient journey’, which as well as being a great way of gaining an understanding of how the theatres operated (sorry), also provided our hosts with the opportunity to give us a brilliant history lesson on how services at Wrightington have developed. The person most associated with this history is the late Sir John Charnley. In 1958, he pioneered the first hip replacement operation. This is now one of the most common operations undertaken globally. The first recorded attempt at hip replacement was carried out in Germany in 1891 (a crude operation that used nickel screws, Plaster of Paris and glue). The first metallic hip replacement surgery was undertaken in the US. However, it was Charnley’s dedication to research, science, and collaboration with biomechanics, which had the biggest influence on contemporary orthopaedics. 

He created the Wrightington Centre for Hip Surgery, and has educated generations of orthopaedic surgeons through his textbook on conservative fracture treatment. In the early days, he persuaded 99% of his patients to let him have the ‘hips’ back when they died. These he tested for wear and tear and this information allowed him to refine the design of his implants and approaches to fixing them. This research and development meant that by 1970, Charnley’s design almost completely replaced all other designs.

His presence is still very tangible within the theatres. He created an isolation zone within which to operate – this is now replaced by a similar sterile zone enabled through pressurised air. Everyone I met during the walkabout held his work in great regard. There was great pride in the work they do, and in the sense of belonging they all shared. At the group discussion in the coffee lounge, the conversation was wide-ranging. What stood out was the shared consensus that the NHS was still the best way to provide specialist health care, and the NHS was better kept as a public service – Lord Prior take note! Getting back to my car I deleted the notes I had previously made and knew then what I wanted to write about in this week’s blog…

Ps – this week’s blog is dedicated to my friend, colleague and fellow NED, Neil Campbell, who very sadly and suddenly died last weekend. His contribution to health and social care has been phenomenal, both in Scotland and here in Greater Manchester. He will be greatly missed and my thoughts are with his family at this sad time.  
  

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