From an NHS in
‘meltdown’ to domestic politics in turmoil and recent tragic news events,
‘crisis’ seems to be the word on everyone’s lips and certainly the media’s! Last
month as I sat at Heathrow watching the BA screens turn black, just a week
after being in the midst of a cyber-attack on the NHS, Rudyard
Kipling’s famous lines came to mind; ‘If you can keep your head when all
about you are losing theirs and blaming it on you’, I realised that I had
already learnt that there is always another way of doing things.
The newly
elected WHO Director General, Dr
Tedros Adhanom Ghebreyesus, reminded us that the status of global health is
in a far direr place; ‘still, half of our population doesn’t have access to healthcare.’
But why is this
still the case and what can we do when our own NHS is struggling? Having
proudly worked for the NHS for over 30 years and seen daily the dedication
staff continue to apply, I feel a duty to stand up and say that things can
change and I know at least one way to go about it. For a start we need to start
listening and learning from each other and not just through echo-chambers
between NHS departments, but exploring the way healthcare is done around the
world.
In the last month,
I have acquired first-hand experience of working in an NHS hospital during a
cyber-attack, and of trying to board a BA flight on the day of a global IT problem. These unrelated but equally disruptive events
made me wonder what the NHS and the aviation industry could learn from our
dependence on the idea that we know best. I came to the conclusion that the
NHS, at least, could and should learn from hospital colleagues in lower income
countries.
My hospital was
not directly affected by the cyber-attack, and compared to some, the disruption
was minimal. Others had big problems.
Hospital pharmacies and most other NHS departments are increasingly
reliant on computers for pretty much everything. In many hospitals in Africa, however,
medicine bottles and boxes are labelled by hand and ward stock is accounted for
by writing in ledgers using a pen. Many health facilities do of course have
computers but power outages, surges, and internet issues mean they can’t always
be relied on.
My recent
experience volunteering in Mozambique with the DFID funded Health Partnership Scheme (HPS) has given me an alternative perspective, and
as such I approached the challenges posed by the cyber-attack from a different
angle to many of my colleagues. The Scheme’s emphasis on mutual learning, on
teaching new skills to our overseas
counterparts whilst improving and furthering our own knowledge left me feeling
that I gained more than I gave and as the attack continued, I began to realise
just how crucial the experience had been. For a start, the lack of computers
and inability to send and receive emails left me unfazed. We still had working
telephones, after all. WhatsApp groups were also being used for general advice.
Although no IT
expert (ask my colleagues!) I do see the need and great benefits of technology
in the health sector, however given the increasing frequency of IT system
failures, we must ensure our backup procedures are resilient. Patients were both treated in hospitals and
passengers flew on commercial airlines long before computers – it must be
possible.
The HPS has
given me the opportunity to think and learn differently, and develop and
problem solve in ways I never thought possible. It has also given me new
perspectives not only on my NHS role, but also on life in general. In the grand scheme of things, complaining
about a cancelled holiday (and missing by all accounts an excellent party),
seemed a rather trivial first world problem.
In the last two
weeks, the UK has been left not knowing which way to turn, and the NHS
cyber-attack revealed our need to not forget the ‘worn out
tools’. The NHS is considered the greatest learning institution in the
world and a global leader on patient safety. We can learn a great deal from
colleagues overseas and write in a few simple lines to our procedures
reflecting how to best maintain a service, without the luxury of highly complex
integrated IT systems.
“In the midst
of chaos, partnership has been exemplified and is something I hope will
continue to be championed. Certainly as I attended an event in Woodbridge on
Sunday as part of ‘The Great Get Together Weekend’ in celebration of Jo Cox’s
memory[1], it was clear in my mind, that these
events, articles in the media and other joint contributions will continue to demonstrate
the need for working and learning together and from each other wherever we come
from and whatever our beliefs or established systems.
Sarah Cavanagh
Acting Director
of the East Anglia Medicines Information Service, Ipswich Hospital
@SarahM_Cavanagh
