Coming Full Circle in Respiratory Health
After an early career in International Development, four years ago I found myself managing clinical services in a Merseyside paediatric hospital. The work was intense. I attended endless meetings looking at how many patients were waiting, how long they were waiting for (some more than 12 months to see a tertiary specialist) and how we could squeeze in additional appointments. I tried to manage the clinical teams who were delivering the frontline service. There were constant gaps due to staff sickness, national shortages and consultants relocating abroad for ‘an easier life’ resulting in widespread low morale. Finally, I responded to complaints from families, unhappy either with waiting times or their quality of care. As a mother myself, I was sympathetic to their situation, but despite my best efforts and those of the teams I was working with, I really couldn’t provide the level of care that they expected. It was tremendously frustrating.
The data showed growing demand in almost all areas. One time I spoke to a friend outside work, a GP, to ask why so many patients were being referred to specialists who potentially didn’t need to be. She stated that many GPs felt pressure from patients and were increasingly afraid of litigation in case they missed something. Easy to do when you only have a 10 minute window with your GP. It was a ‘failsafe’ approach that was pushing pressure further up the NHS tube.
It wasn’t all doom and gloom though. I had made a connection with one of my consultants, a paediatric respiratory doctor, who on a regular basis would catch me in the corridor and drag me with him saying, ‘come and meet this family on the ward’. I’d try protesting, not enough time, but in reality it was my favourite part of the job. He’d spend ages talking to families and I’d listen in. Yes, he talked about physical symptoms and treatment, but more importantly, this doctor would ask questions that went much further. The condition of the house, how many people were living there, smoking, exercise, sometimes even stress at school. One boy who experienced severe asthma was being badly bullied. No clinical intervention was helping. The doctor advised the boy’s mum to change schools. He did, and the asthma was brought under control.
Over winter hospital admissions shoot up due to increased respiratory illness and every year our teams were asked to relieve pressure on beds. Every year, the respiratory consultant would say ‘It’s too late! We should have been talking to expectant mums about smoking cessation last year’. Whilst overly simplistic, his response made the point and for me the penny had dropped.
Our hospital served some of the most deprived communities in the UK and clinical response alone had limited impact for many patients. It was everything else around that child that was creating or exacerbating their medical problem. And whilst previously I may have subconsciously judged poorer parents who didn’t feed their children a balanced diet or ensure safe living conditions, I came to realise that ‘everything else’ was usually out of their control. It ignited a passion to do something about the ‘everything else’ and I eventually moved on to work for a social housing organisation managing health and wellbeing programmes for residents.
This year, we’ve started a project, training parents to be peer educators in the community. They reach out to expectant and new parents, sharing health messaging about improving respiratory health, from smoking cessation to indoor air quality and when to access medical support. Here’s to doing our little bit to help the NHS. Cheers!
