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Joined-up working in the NHS does not go far enough

Basics outweigh theory, insists Jane Bates.

Basics outweigh theory, insists Jane Bates

The NHS is good at joined-up working, said a social worker friend. If you have an accident requiring treatment from different disciplines – say neurology and orthopaedics – there is well-established co-operation on all sides.

It’s good to hear the NHS praised, especially from someone who works alongside it… and he’s right. This is where it often excels. But there is a glaring exception: psychiatry.

Mental health provision shortfalls have been well documented in recent months, even by royalty, and about time. The Mental Health Foundation in England says one in four will experience this kind of problem in any given year.

Even at the ‘milder’ end of the spectrum, any disorder of the mind can be life-changing; complicating or running concurrently with our physical wellbeing.

Patient A needs urgent cancer treatment, but has addiction issues. The system, it seems, has gone to pieces. No one liaises with anyone and the GP, who has tried her utmost, is probably hiding under a table somewhere, weeping.

The patient is not fit for surgery and not reliable enough to turn up for treatment, so how do you help her? Try telling her grieving parents, who may well be looking after their daughter’s children, that it is her choice.

Then consider patient B, with mild dementia, who is prescribed a cocktail of medication for other serious conditions, including eye drops for glaucoma to preserve his vision. He’s being monitored by various specialities, but who really knows which drugs he is taking, and how many, when he is trying to cope alone?

These people matter as much as anyone. As so often in the NHS, the solution comes down to basics – adequate staffing, better training, improved channels of communication. Without those, all the theorising in the world is futile.


About the author

Jane Bates

Jane Bates is an ophthalmic nurse in Hampshire

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