Inside the CT scan- from Surgeon to Patient

It took a matter of minutes to convert me from a Consultant Vascular and General Surgeon to a patient. As a professional, I am aware of the funding crisis and the increased need for NHS care which is outstripping current capacity. Whilst I knew what was going on in the background, as a patient I was shielded from this everyday chaos. I was given time to talk in my appointments, my operation took place on the day it was planned, and I had all post-operative care as needed. I never felt rushed or that I was wasting valuable clinical time. The nurses, though overstretched, made me feel as if I was the most important patient every day and the physiotherapists forced me to walk, even though I did not think I could do it!

How this experience impacted your values as a surgeon?

This experience has reaffirmed my values as a Surgeon that the patient always comes first and you must do the right thing, first time to the best of your ability. The Surgeon was fantastic and although there was a 40% chance of facial nerve injury, I managed to escape this devastating complication, due to his skill. The honest discussion during my consultations, which were frank and informative, helped develop a strong bond of trust and faith in my Surgeon and their team.

The experience has also reinforced how vulnerable a patient feels under one’s care as well as the wider impact to the family and friends. The surgeon’s role is not just to ensure that the patient is looked after but also that the family are kept up to date with post-operative care and discharge plans.

What was apparent was that the Surgeon’s leadership was evident in the behaviour of the ward and more junior team. Being a Consultant Surgeon is not just about the surgical skill, the compassion and communication as well as leadership and development of the surrounding team, ensures excellence in patient care.

There is a lot of frustration both with communication and compassion, not only with patients but with NHS staff. What can the NHS do to survive?

The NHS is a valuable institution and the recent survey by the Kings Fund, evidences that the public still consider this to be vital to the United Kingdom. As a member of the public, we need to ensure that the NHS is used wisely. It is sad to see patients not attending outpatient appointments, tests and operations. Each of these wasted appointments costs money but also stops another patient from using this time for their own care.

As a Clinician, we need to be aware of the cost of tests we order and practice evidence-based medicine. There is a constant need to innovate and to challenge ourselves to deliver the best care in the most efficient way possible.

The NHS has its own hierarchy, economy, and while looking at systemic flaws, we have a moral duty to acknowledge the rapid growing demands for healthcare. What are politicians missing to understand and address, what they need to know from your viewpoint as a NHS Enthusiast and Survivor?

Politicians are aware of the crisis that is developing within the NHS, mental health and social care. The current promise of £20 billion is needed immediately to avert capacity issues but this must be spent across all the sector. The ageing population has not yet soared as the post war baby boomers are still young at 70 and intend to live well into their old age. There is now an increasing need not just for health care but social care as the family networks have disintegrated increasing the need for government aid.

The need for investment is not just cash based. The NHS has long survived on the goodwill of altruistic staff, but the removal of NHS bursaries and the Junior doctor contract discussions have developed a major chasm in the NHS culture. Investment is now needed in developing the NHS workforce of the future.

You are known for your contribution as an educator. How important is education in the work place?

Being an educator, mentor and trainer, brings huge rewards. The small daily investments in your future colleagues across the multidisciplinary field soon causes major ripples. Once one has invested in you, you feel duty bound to invest in another. This circle of kindness, care and interest in the work place creates an atmosphere that engenders innovation and a wish to try without recrimination. This is the culture that needs to permeate through the NHS but sadly is still only palpable in small pockets.

You received The Dr Rose Polge Award. While a doctor never chooses to be ill and they did their best to get free from it- is anyone prepared to give them a chance while struggling with their own mental health challenges?

Receiving the Dr Rose Polge award was humbling. Dr Polge’s death was tragic both for her family as well as the NHS. We need to look after each other and this just takes an investment of one’s time and a passion to nurture. If just one trainee reaches out, then this is worth it.

There are very few ‘Difficult Trainees’ and if one probes sensitively, there is always a back story to the trainee in difficulty. It is important that the culture supports the notion that no one comes to work to cause harm or intends to become ill. Doctors are human and have the same life challenges as everyone else. Bereavements and family circumstances may cause an individual to become the sole bread winner whilst managing a taxing career. Illness may creep up slowly without an individual realising the effect on their work. Support and understanding at this difficult time allow a doctor to return to their profession in some way that allows them to succeed. The NHS is supportive of health and wellbeing, but services remain stretched as the NHS becomes more and more challenged fiscally.

There is still a long way to go to eliminate not only the stigma of current mental illness among the medical profession but raising awareness for their wellbeing. It is a global epidemic and there are no easy answers. What does it take to change NHS attitudes towards doctors’ wellbeing?

One of the major challenges in supporting doctors is the pride and stigma of health and mental illness. There is a fear that once one is labelled, one cannot return to a normal working life. It is imperative that the work place champions the idea of asking whether one’s colleagues are okay and creating a safe place for individuals to talk if they need to. All hospitals have an occupational health department and they are fantastic at signposting to services that are available. From a personal point of view, the support I have had from colleagues has empowered my return to work with an increased loyalty to the NHS that looked after me.

Communication is the very fabric of the healthcare profession. For centuries people went to the doctor and told their story and the doctor prescribed a remedy based on what they heard. While this is a very basic definition of the patient- doctor relationship, do you think communication is utilised to our advantage at present? How can we use the power of words to communicate better as a patient and as a healthcare professional?

The basic tenant of communication remains the story telling by the patient to the doctor. The details of the story are vital to the diagnostic abilities of the doctor but the skill of asking the right questions is still key. Underlying this is the need to develop trust to enable the story to be told without any concerns that the information will be used unwisely. As a patient, this was the key in ensuring that my treatment was a positive journey.

Consultations often carry explanations of difficult concepts and details of complex management plans. These conversations are embedded in the delivery of bad or difficult news which engenders fear, desperation and the defence mechanism of denial. It is therefore difficult to ensure what is said is what is heard, whether by the patient or the professional. Listening and checking what has been heard and understood is essential to reach a common understanding. Key to this communication is the multidisciplinary team who encompass a wide variety of skills. The specialist nurses are a fantastic resource that are not only extremely professional and knowledgeable but also approachable providing care plans in a practical and long-lasting relationship.

Are you a doctor who survived trauma or illness? We want to hear your story…