Inspiring Future Champions

FeaturedInspiring Future Champions

#ChangeTheNorm Stories Series by Dr Stella Vig

Published by Sovereign Magazine

 

The world is changing rapidly, and society is struggling to adapt to the change. This column will highlight those who are recognising the challenges and developing solutions to accommodate this change.

I have been saddened by the level of knife crime that continues to plague our society. Anyone who has children will hope to see them thrive and achieve more than the parents, whether this is financially or socially. The tragedy of investing in your children and seeing their lives cut short at such a young age cannot be imagined. The senseless violence that has engulfed us is no longer in isolated violent communities but is now on our doorsteps. It is happening to children of friends and colleagues.

This week I interview Dr Mark Prince. His son Kiyan Prince died violently on the 18th May 2006 whilst trying to prevent harm to another child. The loving nature, by which he was known, was what made him step in and defend his friend who was being picked on by another youth. The incident took place outside the gates of his school, the London Academy, located in Edgware North London. Kiyan attempted to resolve the situation in the most peaceful way by directly challenging the aggressor.

The ‘killer’, 16-year-old Hannad Hasan, felt that Kiyan had disrespected him because he stood up to him. He then turned and callously killed Kiyan – plunging a knife straight into his chest. Kiyan died of a single, but fatal, stab wound to his heart.

Mark has set up the Kiyan Prince Foundation, with a vision to “work with young people to increase awareness and address the consequences of gun and knife crime through education. It aims to empower young people by promoting a sense of belonging, self-worth and purpose that can be found outside of gang culture and offending behaviour through providing access to diversionary and preventative activities”. He has been honoured with an OBE, for services to tackling knife and gang crime in London.

Please tell us about yourself

So, this could take all day to answer! Be a great start if everyone could buy The Prince of Peace on Amazon that would help, but for interview purposes I would say that from a young age I have always had a love for reading books, learning and dreaming big. I also love sports activities and I mean any sport activity. I had my favourites like football, cricket and basketball but I just love being active and developing skills. I had a Dad who was extremely harsh to say the least. The recurrent dishing out of punishment led to emotional and physical damage on my part which took a long time to recognise. I ran away from home at 15 initially getting into drugs, alcohol and criminal behaviour. Being a determined young man with dreams and aspirations I decided at 21 to break the cycle and change. I decided that I wanted to be a champion and become a professional boxer. This determination and hard work led to me becoming no1 in the world ranking and fighting for a world title.

This journey changed me as a person, and I developed the character needed to set and attain goals which made me proud. This in turn made my friends and family proud of me which was not present in my former lifestyle.

Life continued to throw testing experiences.  I buried my stillborn baby, my high profile career abruptly ended after a freak accident that left my knee out of its socket tearing all the surrounding ligaments. My mum was given a 30% chance of surviving an operation to the brain to release a blood clot but the most severe one was having to identify my son after the doctor announced his death by stab wound to the heart! This left me an utterly broken man. I was tested on every level as a human being rethinking what I stood for and what I had taught my son, those values embedded on his journey to be a man.

I found out a lot about myself during this experience. I would say I am determined, I am truth, I am forgiveness, I am love, I am a leader, I am growing, I am life, I love life, I love people, and I love the manufacturer of human beings, my creator God.

Would you describe Kiyan and his love for life as well as the tragedy that sparked The Kiyan Prince Foundation?

To describe Kiyan is very simple, he was very funny, laid back, caring and peaceful son. He was a leader that left an impression amongst his peers and grownups alike, even when Kiyan was being cheeky or naughty you liked him!

Kiyan, played for Queens Park Rangers Under-16’s football team. He was dubbed ‘The Bullet’ because of his speed and he was hailed as the next Wayne Rooney… tipped to play for England. After his death QPR confirmed that he was going to be offered a professional contract.

Kiyan was a beautiful, thoughtful, kind and considerate young man. How he lived was reflected in the way he died. Even though he must have been very scared and in pain, in dying he still represented the life he lived. His heart was so full of love and empathy for others. In his final minutes his thoughts were, even then, still of others. As he lay bleeding, he told his friends: “if these are my last words… tell my Mum I love her’.

The tragedy that sparked the foundation is a very sad story, to leave school and walk up to an altercation peacefully trying to break it up is not where you expect to die. To start the Foundation because of your son’s death and impact on so many young people’s lives is not where you expect to find your purpose!

What problems are you trying to solve with regard to knife crime?

The main problem we are solving is changing the negative narrative that this is a problem with only an isolated demographic of youth. This is a problem with leadership, from government leadership to parental leadership. Even social platforms of leadership i.e. online music are sending out negative messages. We need to change the narrative and sending out positive message to empower young people and this needs to be solved by changing people’s mindset and this can only be done through education and inspiration.

Who are the people who could benefit?

People with low self-esteem, behavioural issues, negative mindsets and anger problems. Partly this is a phase of life, but this needs a senior steer. These children have an untapped talent potential. These children fall into several groups, primary age 7-11, secondary age 12-16 and young adults age 16-24 groups. The other group are the young offenders. What we often hear from our volunteers is that anyone who works with these young people often find that they benefit from the interactions with these children too.

What are the challenges to make the public aware of your work?

Funding is always a challenge because we need to be sustainable to continue reaching these children. We lack premises and this is a huge issue because there are so many young people we want to reach out to. We know we can continue to support them with our programs, but we have nowhere to deliver these especially as community youth centres and programmes have been discontinued.

What keeps you going?

It is difficult. I get a special boost when I receive the many messages from young people expressing how they have changed the way they think regarding carrying knives and their peers carrying knives. I feel like I can let Kiyan know that children are telling me that I have become their new role (real) model and have saved their lives and they have never been so inspired before. This and evidence that the work being done continues to make a difference keeps me going.

What can we do to help?

You can highlight positive stories where we have demonstrated we have evoked change. Please encourage people to make donations so we can continue our work.  Everyone needs to help change the negative narrative that media normally cover on this issue, this is not just an issue of poor black criminal boys. Share the Kiyan Prince Foundation’s work and encourage Corporates to adopt us as a Corporate responsibility. If anyone can signpost to premises that we can use, we would be grateful.

What key message do you want to highlight?

That we are all here for a purpose and as individuals we have great value to add to this planet with our talent, gift and positive thinking. Our roles should be inspiring young people and supporting the children who are disenfranchised and disadvantaged. This is a society and community role.

We must educate and demonstrate leadership qualities. By doing this we can educate and role model to our children, so they recognise when they are being led astray.

My interview with Sovereign Magazine!

FeaturedMy interview with Sovereign Magazine!

I was delighted to be interviewed by Sovereign Magazine about my patient journey but also the wider NHS.

Stella Vig is a Consultant Vascular and General Surgeon at Croydon University Hospital, South London. Born in Bangor, North Wales, she trained at the University of Wales College of Medicine. She was appointed as a consultant in 2006.

Stella has a strong interest in training and encouraging medical students and foundation years to pursue a career in surgery. She is a champion and advocate for trainees, ensuring their voices are heard. Stella was awarded the NHS Leadership Academy London Mentor of the Year in 2015 and the Silver Scalpel Award as well as the Dr Rose Polge Award in 2018.

She developed an Acoustic Neuroma and underwent surgery in 2017.

We reached out to learn more about Stella’s story, the story of an extraordinary woman who had no choice but take the journey from being a surgeon to become a patient and survivor.

You brand yourself as an NHS Enthusiast and Survivor. What was your recent experience as a patient?

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Luckily, I had an Acoustic Neuroma, which is a benign brain tumour. I can remember realising that I had a mass as I came out of the CT scanner. There was an immense relief when I found out that it was not a cancerous growth and that there was an option for surgery.

The NHS was amazing throughout my journey. I underwent a CT scan rapidly and was given a diagnosis by a Consultant before I could blink! In fact, it was too quick, and I had to spend time catching up with my diagnosis and coming to terms with it.

I had fantastic care both at Croydon University Hospital and then at John Radcliffe Hospital in Oxford. My surgery took over 12 hours but was uneventful. My Surgeon explained that it would take 6 months to recover and though I was desperate to beat these odds, it did take me 8 months to be anywhere near normal.

The NHS is in dire crisis right now and as a healthcare professional you have experienced both sides of the NHS. Stripped of who you are as a mother, friend, wife, and NHS Professional, what has the doctor, Stella Vig, learned from being a patient?

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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.

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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, is anyone prepared to give them a chance whilst they are 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 well-being, 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 well-being. It is a global epidemic and there are no easy answers. What does it take to change NHS attitudes towards doctors’ well-being? 

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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.

Please click here to see the entire magazine!

 

 

Happy Mother’s Day: Developing a nurturing environment in the NHS

FeaturedHappy Mother’s Day: Developing a nurturing environment in the NHS

Happy Mother’s Day to all of you.

This week has seen the celebration of International Women’s Day and ends with Mother’s Day in the UK. It has been a week of highs and lows, realising that so much has been achieved but that there is so much more to do to ensure parity for women all over the world and in every career.

Women and men are different, the basic difference is that we bear children. This is an amazing feat of nature and I have two children that make me immensely proud. This natural phenomenon of having children should not define us: women should be able to make the choice to succeed however they wish.

My mother was a great lady and always stated that there should be no reason why I could not do what I wanted to do (just like my father!).

My mother was born in India in the 1940s and lost her father when she was five. Bringing up 6 children as a single mother was a feat for my grandmother, especially when you consider that all six children were university educated in a system where you pay for your education. My mother was caught up in the atrocities when India and Pakistan separated and the whole family moved from Rawalpindi to Ludhiana. She walked with her cousin, crossing the border, seeing killings at first hand, surviving but never forgetting that time. She never really talked about it but just filled up with tears and so this topic was seldom brought up again.

She had wished to do medicine but as one of the oldest had to qualify and start earning, to help put her younger siblings through university. She mastered in politics and geography and rapidly became a Headmistress of a school in India.

My father had moved to the UK and settled in North Wales, finding the people welcoming in Penmaenmawr. In 1965, he returned to India to visit his mother and an unexpected arranged marriage meant that my mother left her fantastic job and returned to the cold, isolated village of Penmaenmawr, with no friends and no job! She tried to break into the teaching system in the UK but her qualifications were not recognised and all the possible jobs were in Birmingham or London.  She became pregnant with me in the second year of marriage and never taught again.

My mother spent her life working hard alongside my father developing skills that she could not have dreamed of doing in her life time. They refurbished a four storey house, developing this into a guest house and shop. My mother learnt to wall paper, put up polystyrene ceiling tiles, paint and sew curtains.

They opened a successful shop, named Wonderland in Penmaenmawr, when holidaying to the North Wales coast was the way to spend your summer! My mother became a stock taker, saleswoman and continued to be a great mother.

She worked on the markets with my father, supporting him and innovating the business. She put three children through school, embedding a culture of nurturing, success through education and responsibilty in all three of us. She loved people and ensured that all our friends were welcome and always well fed and is always remembered for this!

At every stage, when I questioned how I would achieve, she would encourage and just tell me to get on with it! This included my mad decision to become a Surgeon.

When I qualified in 1991 from University of Wales College of Medicine, there were very few female surgeons in Wales. Although I knew that this was the career I wished to pursue, I procrastinated about my career choice in my first year as a doctor. Luckily I had a supportive husband (boyfriend then) and also a great boss. Mr Kieran Horgan, a Breast Consultant and my first boss as a house officer, sat me down over a drink and said’ If you don’t reach for the stars, you will always regret it and wonder, what if…’

I was appointed as the first Calman registrar in Wales and worked hard, delivering 101%, ensuring that no-one could say that I was not up to the standard required. I had two children and returned to work at 12 weeks on both occasions as I did not want to let the team down, but also because I did not feel that I could take any more time away from work. There was no overt pressure to do this but the culture of surgery embedded this internally as there were no other women around me having children and a career in surgery. I was lucky to have supportive colleagues and although there were highs and lows in training, remember this time as hard work but enjoyable.

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Just this week, I met up with four previous colleagues from Wales, four of us had worked together as juniors with our Senior Registrar and we came back together on a course. We remembered our time in Wales with happiness and all three females had felt encouraged by our peers. In the background of this picture you will see a painting that hangs in the Royal College of Surgeons of the Court of Examiners. What is striking is that although many of our old bosses are portrayed in this beautiful painting, that they are white and male!

The surgical environment is changing and now 11% of Consultant Surgeons are women but it is still not an easy career choice. Many students are put off by the myths that:

it is hard, a job for the boys, requires sacrifice of motherhood and a relationship, sacrifice of a social life amongst so many others.

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These myths need to be dispelled as all jobs are hard and one does not become barrister, fashion designer, pilot, a success in business without hard graft. This is no different in Surgery and the difficulty is not based on gender.

What shocks me is that when we have had female Prime Ministers, Heads of Police and Fire Service, Presidents of Colleges, Chairs of Education and Business, female medical students continue to believe that a successful career in surgery is not achievable.

The Twitter campaign #ILookLikeASurgeon showed how women are great surgeons and combining all facets of their life with this ambition. Surgery is open to all and it is our responsibilty as the Surgeons to welcome medical students and foundation trainees into our daily lives, encouraging them by valuing them and supporting their career decisions.

The Royal College Women In Surgery held a successful evening on International Women’s Day this week, where many myths were dispelled by male and female role models. Professor Farah Bhatti is the Chair of WINS and is a great role model.

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There are now increasing women in the Court of Examiners, as Chairs of JCST, members of College Council and this is much welcomed.

But surgery is a career that should be open to all and we need to encourage the new generation of Surgeons by embedding a culture delivered by my mother:

A culture of nurturing and supporting,

A culture of success through education and belief

A culture of responsibilty and value in the team

A culture where the belief that the sum of the whole is much more that the individual parts is all encompassing.

These are values that need to be embedded into Surgical Training but also into the NHS as a whole. The recent suggestion that NHS staff may achieve a 6.5% pay rise but at the cost of losing annual leave to balance the pay bill undermines the above culture. Unless there is a dramatic and rapid turn around in the value and belief in the NHS workforce, we will continue to lose amazing individuals that will innovate and advance our healthcare system, which has so far been lauded across the world.

 

A year on.. A message from a professional patient on behalf of the NHS

FeaturedA year on.. A message from a professional patient on behalf of the NHS

This is a series of blogs starting from the day I was diagnosed with an acoustic neuroma. If you want to start at the beginning then please follow this link: 

https://stellavig.blog/me-and-my-acoustic-neuroma/

I have had a wonderful but difficult year since my operation on February 27th 2017. I have celebrated my 50th birthday, my son’s 21st and had a great Christmas and New Year! I have reread my thoughts from a year ago and they are still fresh in my mind but almost feel like those of a different person.

I now realise that I should have listened to my Surgeon and my Husband! (sshh don’t tell him that!) during my recovery as they had realistic timelines for my recovery. I needed to go back to work to escape being a patient and challenging myself to be a professional again. I was lucky to have an employer that valued me and allowed a prolonged phased return to work. I went back on call early, despite advice, as I needed to prove to myself that I could do it! I was exhausted most of the time but this improved slowly.

I finally feel almost back to normal. I still get headaches and balance issues if I get too tired, especially at night. This has made me redefine my abilities and resilience, a process which is so frustrating. It is impossible to multitask in the way I used to but I have developed strategies to cope with this and my friends tell me they can’t see a difference.

My hearing has not improved and I cannot localise sound at all. My kids find this very amusing but it is so annoying. If someone asks me a question when I am giving a talk, I cannot see where they are and cannot hear where they are either! I have to declare my hearing up front to the audience so that they can let me know where they are. My hearing has also become an important part of the WHO checklist in my theatre. This ensures that everyone is aware of anything that might cause a risk in theatre and ensures that theatre staff do not whisper into my right ear! It is really funny when I sit in meetings and the person to my right whispers something into my ear and I have to do a 180 degree turn to find out what they are saying!! Not discreet!

The follow-up scan confirms that although there is a small sliver of residual tumour, it is still benign and not growing. Full resection was sacrificed to ensure that I still have a working facial nerve which was most important to me. It has been confirmed that I will need ongoing scans but at longer intervals and that these can be carried out locally rather than travelling up to Oxford.

The original acoustic neuroma was 3cm in size and although this has gone, I have gained so much experience to guide me to deliver patient care.

I had only been in hospital before with the birth of my two children and needed care when I developed a ruptured anterior cruciate ligament (and was on crutches for 9 months). My other experience was as a daughter with both my parents needing acute care provided both locally in North Wales and in London. My father died two years ago at 91 and required carers as well as acute recurrent care. Although I thought that this and working in the NHS itself allowed me to deliver patient focused patient care, I still had much to learn. I am now still learning and hope to role model and teach this to my trainee colleagues.

The amazing Elizabeth O’Riordan, a Consultant Breast Surgeon who herself developed breast cancer recently said’ The one thing I have learnt through being a breast cancer patient was that I knew nothing about what is was like to live with breast cancer although I had spent 20 years studying it’.

I felt that I was enabled to seek the advice I needed, to consider and develop my thoughts and decisions with regard to my treatment. I hope that this is what I have already practised for many years, giving my patients all options open to them and helping them decide what they wish to do. I am often asked ‘ what would you do?’ and explain that I cannot give them this answer. I found myself asking the same question of my Surgeon but also of my colleagues and getting the same response.

What I had underestimated was the impact on my family and friends. I could not have asked for better care and positivity from them. My current and previous trainees were wonderful and kept me buoyant. My husband, children and siblings were amazing and helped me to recover quickly. My close friends got me up and walking and fed me, my next door neighbour visited daily, more than I would ever have expected. They all rallied around and I just cannot say thank you loudly enough and owe them so much.

My husband was involved in all my decision-making and never once told me that I was wrong. He was able to give support as he had been involved in my consultations and asked questions that helped. We are always taught that if a patient is competent that they can make their own decisions about their care. I was competent and a professional and still needed support to make my decision. Healthcare professionals understand that when we break ‘bad news’. normally cancer diagnoses, that support, often with nurse specialists, is of benefit. Patients are encouraged to bring an advocate with them, not only to support them but also to remember what was actually said and not what the patient wishes to remember. I was given leaflets and advice but learnt so much through the blogs of others and social media. Liz O’Riordan comments on the same. Maybe we should encourage our trainees to reach out to these sites to understand the patient journeys that they start their patients on. A nursing colleague has used my blog in her teaching for her junior staff and I have had many people reach out to me on behalf of themselves as well as relatives, just as I reached out to those who had gone before me in various Facebook groups.

So how do people who are on their own access support? Or those who are not IT literate?  How do healthcare professionals support these individuals if they are on a benign journey rather than one that is supported by cancer nurse specialists?

When I was in hospital, my family were able to be with me and my inpatient time was short. I valued the ability to talk to them and they were reassured by my improvement and desire to get home! Current governance does not allow healthcare professionals to discuss patient details over the phone with relatives unless consent is given. In addition, with nursing and medical staff shortages, often the teams are busy or not available when relatives come in to visit after they have finished work. I have witnessed families feeling lost as they are unaware of what is planned for their relatives, when they visit in a weekend and are told that they need to wait until their team comes back in. Patients may not even be aware of who is the attending Clinician as many teams buddy up care and rotate on a daily or weekly basis. This is where I have really tried to change the way that the teams and I behave. Patients and their relatives need to be engaged in decision-making including timing and dates of treatment and discharge.

In surgery, this process is easier as one can normally judge the time needed to recover in hospital. In medicine, this is much harder as most inpatients are admitted as emergencies and many in crisis, due to a paucity of social care and mental health funding. We often say that discharge planning should be started as the patient enters the hospital but due to staffing and pressures within the system, this may not happen. This may lead to inefficiencies and patients staying a day longer than expected but with the reduction in the NHS bed base, each day and hour matters. All patients should have an estimated date for discharge as they are admitted allowing everyone to plan accordingly.

In a system that is not fully resourced, healthcare clinicians are struggling to provide excellent patient care and this shows with the recent dissatisfaction for the first time with the NHS.

The public and politicians need to decide what they want to do to resource the ever expanding need for healthcare. I received excellent care from my clinicians despite being treated in a Trust recently placed in special measures. The compassion and communication encompassing my care was excellent and enabled my family, friends and I to return to normality rapidly.

Communication is an enabler within the NHS and healthcare professionals need to ensure that this is embedded at every level despite funding and time issues.

The NHS will only survive if we value our staff and ensure that this is both in morale and salaries. There is also a need to empower our patients to regain independence as much as they are able and understand the health choices that they make and encourage them to be the decision makers.

Stella Vig, an NHS Enthusiast and Survivor

 

 

 

 

Happy New Year 2018 from a NHS Survivor!

FeaturedHappy New Year 2018 from a NHS Survivor!

Happy New Year!

It is amazing how time passes faster the older you get. It seems like yesterday that we were celebrating New Year’s Eve 2016. It was a quiet one as we were not sure what the following year would bring in terms of my personal health and whether I would be able to return to the job I love, working as a Surgeon in the NHS. We had just told the children of my diagnosis, fearful of their reaction and with the optimism of youth, they were not worried at all!

The appreciation for life also becomes more profound. Family and friends have passed last year and many new ones were born. The grief is intense on losing those who are close, and although people always tell you that time will heal, this is not understandable until you go through it yourself. The grief fades into the background but the memories become more striking with time. They become triggered by the most odd things: scents, foods, colours, words amongst so many things and the menories make you laugh or cry at the most insane moments.

And there are so many memories. I remember celebrating New Year’s Eve with my parents, brother and sister. We would all stay up until Big Ben chimed and then my parents would send us all to bed. As the years passed, we would have to try to keep our parents up until midnight with increasing difficulty.  We have done the same with our children. Watching the London fireworks has become a tradition as has phoning our nearest and dearest. Communication has enabled connections across the world in seconds compared to the old airmails that Mummy would send to India that would take several weeks. These are the times when I really miss Mummy and Daddy. They both continue to give me a drive for life and enable the success and health of others.

I cannot thank the NHS enough for my care last year. I would not be here, back to working, without the excellence of the team at Croydon University Hospital who diagnosed my acoustic neuroma or the skill of my neurosurgeon at the John Radcliffe in Oxford. The care I received was without reference to my background, wealth or culture. How many countries can boast such an altruistic system. It never crossed my mind to seek private healthcare as I knew I would get the best within the NHS.

I am proud to be working in the NHS. I see my colleagues, in all aspects of healthcare, working so hard with the scant resource, trying to ensure that patient care is delivered to the highest standard possible. Time is precious and there is no doubt that there is waste and inefficiency in the system but most of us spend our time firefighting, trying to manage the crisis caused by targets which do not allow longer term planning. Change is being forced centrally at pace and there is no time to evaluate whether this really will be to the benefit of the NHS and the patients it cares for.

The junior doctor dispute was bitter as was the decision to withdraw bursaries for those who wish to pursue roles within the NHS, often as a second career. It sent a clear message to the workers: those who manage the NHS do not value their staff, they are not thought to be integral to the NHS, as people who invest their careers in one company for a lifetime but rather as expendable workers. No wonder so many have left the NHS or changed their allegiance to a different country or even to Scotland or Wales. Brexit has added to these pressures as we have already sent out the message that we do not value our EU colleagues although they are the backbone of our NHS.

NHS-area-of-work.jpgThese decisions have culminated in a system where there are gaps at so many levels within the NHS. In an effort to make the money go further, there is a cap on locum and bank pay and spend for medical and administrative staff. The NHS needs to cap the salaries of non medical NHS staff in the same way to ensure parity. Those who are still working in the NHS are covering these gaps by working innovatively to ensure patient safety but this cover has now become a struggle.

Consultants are being asked to cover registrar shifts, trainees are missing training opportunities and the NHS has lost the ‘firm’ structure that ensured that we all worked in teams, allowing emotional support, debriefing and rapid feedback. Nurses are staying beyond their shift times to help support colleagues with sick patients and all staff within the NHS are contributing free hours as many of us are altruists and cannot see patient care being compromised.

There are limits to what can be achieved within the cash envelope which is NHS funding. The winter crisis of 2017/8 has been and continues to be difficult to cope with. The NHS does not do Christmas or New Year holidays, everyone keeps the ship running, with relentless targets for cancer and elective care needing to be met. There have been surges of emergencies for many Trusts, due to increasingly sick and frail people as well as those who have self-inflicted the need for NHS care. Mental Health provision is extremely challenged and ambulance services ensure these people find a safe provision of care which is often the acute sector, often at a time of crisis rather than semi elective care. GPs are on their knees and there are reasons that trainees are not choosing to follow this profession and decide on portfolio careers to allow a pressure valve when the NHS becomes too hard. The extra winter funding is a start but without funding for community care, this does not improve the flow through the acute sector. Most Trusts are in deficit and will not achieve the impossible financial control targets and even the John Radcliffe Hospital, a world-renowned centre of clinical excellence, is struggling financially. The NHS is spending millions on turnaround teams and consultancy firms, perhaps we should pay the internal staff better and allow them to get on with running the NHS well.

I am proud to be back in my job, working as a clinician and a manager. I see the skill of colleagues in clinical and managerial practice, trying to balance excellence with finance. We need to make a decision soon as to what we want. The NHS achievements over the last 70 years have been astounding but are costing more and we are all living longer and expecting more.

DSNcxJ1WkAAsPPK

From an aspiration of care delivered without cost at the patient face in 1948, the only cost implemented is that of prescription charges but even this has exceptions for those in need factored in. Do we now need to think about charging? Or just changing the way we respect the care that the NHS gives? The NHS gives freely, Grenfell, the Bridge attacks, Manchester. Each time the NHS has to deliver excellence, it does. Perhaps the public need to give excellence too.

Why do people fail to attend hospital appointments, even dates for surgery. Each of these episodes costs all of us already but we just don’t see it. Recently, I have witnessed bookers trying to persuade patients to take dates offered for surgery, to be told that these are not convenient as they have social plans. Really?

Each NHS user should be asking how they can do their bit to use the NHS resource as well as they can. Trainees sent out to accompany ambulance crews were shocked at the number of calls for inappropriate reasons but also as to the number of frail, elderly people or those with mental health problems, just about coping at home until that final straw breaks the unstable status quo. Have we stopped being a compassionate society where we looked in and knew the neighbour next door?

I am looking forward to working in an NHS to the end of my career and will continue to invest in it as it has in me. I have loyalty to the NHS as in the past it had loyalty to me. Our younger trainees and staff need to feel valued now as do the Senior Staff who are the memory and innovators of the NHS.

To allow it to succeed, the NHS needs to be unshackled from many of its targets that have become beasts that need to be fed. The fines that are applied for missing targets need to be reviewed: we should be learning not being penalised for processes that need improvement. The question of finance must be addressed this year and a cross party working group may enable how we can continue to deliver a NHS that we are all proud of.

I am looking forward to this year, looking forward to getting my strength and health back to normal. Learning to cope with my hearing loss and ensuring that I develop a new work life balance. I am looking forward to my 50 (again) birthday this year as well as the 70th birthday of the NHS on the 5th July.

I have had another chance at enjoying my family, my work and continuing to chase my dreams. Let’s work together to give the NHS that chance.

This is a series of blogs starting from the day I was diagnosed with an acoustic neuroma. If you want to start at the beginning then please follow this link: 

https://stellavig.blog/me-and-my-acoustic-neuroma/

Happy New Year 2018 from a NHS Survivor!

FeaturedHappy New Year 2018 from a NHS Survivor!

Happy New Year!

It is amazing how time passes faster the older you get. It seems like yesterday that we were celebrating New Year’s Eve 2016. It was a quiet one as we were not sure what the following year would bring in terms of my personal health and whether I would be able to return to the job I love, working as a Surgeon in the NHS. We had just told the children of my diagnosis, fearful of their reaction and with the optimism of youth, they were not worried at all!

The appreciation for life also becomes more profound. Family and friends have passed last year and many new ones were born. The grief is intense on losing those who are close, and although people always tell you that time will heal, this is not understandable until you go through it yourself. The grief fades into the background but the memories become more striking with time. They become triggered by the most odd things: scents, foods, colours, words amongst so many things and the menories make you laugh or cry at the most insane moments.

And there are so many memories. I remember celebrating New Year’s Eve with my parents, brother and sister. We would all stay up until Big Ben chimed and then my parents would send us all to bed. As the years passed, we would have to try to keep our parents up until midnight with increasing difficulty.  We have done the same with our children. Watching the London fireworks has become a tradition as has phoning our nearest and dearest. Communication has enabled connections across the world in seconds compared to the old airmails that Mummy would send to India that would take several weeks. These are the times when I really miss Mummy and Daddy. They both continue to give me a drive for life and enable the success and health of others.

I cannot thank the NHS enough for my care last year. I would not be here, back to working, without the excellence of the team at Croydon University Hospital who diagnosed my acoustic neuroma or the skill of my neurosurgeon at the John Radcliffe in Oxford. The care I received was without reference to my background, wealth or culture. How many countries can boast such an altruistic system. It never crossed my mind to seek private healthcare as I knew I would get the best within the NHS.

I am proud to be working in the NHS. I see my colleagues, in all aspects of healthcare, working so hard with the scant resource, trying to ensure that patient care is delivered to the highest standard possible. Time is precious and there is no doubt that there is waste and inefficiency in the system but most of us spend our time firefighting, trying to manage the crisis caused by targets which do not allow longer term planning. Change is being forced centrally at pace and there is no time to evaluate whether this really will be to the benefit of the NHS and the patients it cares for.

The junior doctor dispute was bitter as was the decision to withdraw bursaries for those who wish to pursue roles within the NHS, often as a second career. It sent a clear message to the workers: those who manage the NHS do not value their staff, they are not thought to be integral to the NHS, as people who invest their careers in one company for a lifetime but rather as expendable workers. No wonder so many have left the NHS or changed their allegiance to a different country or even to Scotland or Wales. Brexit has added to these pressures as we have already sent out the message that we do not value our EU colleagues although they are the backbone of our NHS.

NHS-area-of-work.jpgThese decisions have culminated in a system where there are gaps at so many levels within the NHS. In an effort to make the money go further, there is a cap on locum and bank pay and spend for medical and administrative staff. The NHS needs to cap the salaries of non medical NHS staff in the same way to ensure parity. Those who are still working in the NHS are covering these gaps by working innovatively to ensure patient safety but this cover has now become a struggle.

Consultants are being asked to cover registrar shifts, trainees are missing training opportunities and the NHS has lost the ‘firm’ structure that ensured that we all worked in teams, allowing emotional support, debriefing and rapid feedback. Nurses are staying beyond their shift times to help support colleagues with sick patients and all staff within the NHS are contributing free hours as many of us are altruists and cannot see patient care being compromised.

There are limits to what can be achieved within the cash envelope which is NHS funding. The winter crisis of 2017/8 has been and continues to be difficult to cope with. The NHS does not do Christmas or New Year holidays, everyone keeps the ship running, with relentless targets for cancer and elective care needing to be met. There have been surges of emergencies for many Trusts, due to increasingly sick and frail people as well as those who have self-inflicted the need for NHS care. Mental Health provision is extremely challenged and ambulance services ensure these people find a safe provision of care which is often the acute sector, often at a time of crisis rather than semi elective care. GPs are on their knees and there are reasons that trainees are not choosing to follow this profession and decide on portfolio careers to allow a pressure valve when the NHS becomes too hard. The extra winter funding is a start but without funding for community care, this does not improve the flow through the acute sector. Most Trusts are in deficit and will not achieve the impossible financial control targets and even the John Radcliffe Hospital, a world-renowned centre of clinical excellence, is struggling financially. The NHS is spending millions on turnaround teams and consultancy firms, perhaps we should pay the internal staff better and allow them to get on with running the NHS well.

I am proud to be back in my job, working as a clinician and a manager. I see the skill of colleagues in clinical and managerial practice, trying to balance excellence with finance. We need to make a decision soon as to what we want. The NHS achievements over the last 70 years have been astounding but are costing more and we are all living longer and expecting more.

DSNcxJ1WkAAsPPK

From an aspiration of care delivered without cost at the patient face in 1948, the only cost implemented is that of prescription charges but even this has exceptions for those in need factored in. Do we now need to think about charging? Or just changing the way we respect the care that the NHS gives? The NHS gives freely, Grenfell, the Bridge attacks, Manchester. Each time the NHS has to deliver excellence, it does. Perhaps the public need to give excellence too.

Why do people fail to attend hospital appointments, even dates for surgery. Each of these episodes costs all of us already but we just don’t see it. Recently, I have witnessed bookers trying to persuade patients to take dates offered for surgery, to be told that these are not convenient as they have social plans. Really?

Each NHS user should be asking how they can do their bit to use the NHS resource as well as they can. Trainees sent out to accompany ambulance crews were shocked at the number of calls for inappropriate reasons but also as to the number of frail, elderly people or those with mental health problems, just about coping at home until that final straw breaks the unstable status quo. Have we stopped being a compassionate society where we looked in and knew the neighbour next door?

I am looking forward to working in an NHS to the end of my career and will continue to invest in it as it has in me. I have loyalty to the NHS as in the past it had loyalty to me. Our younger trainees and staff need to feel valued now as do the Senior Staff who are the memory and innovators of the NHS.

To allow it to succeed, the NHS needs to be unshackled from many of its targets that have become beasts that need to be fed. The fines that are applied for missing targets need to be reviewed: we should be learning not being penalised for processes that need improvement. The question of finance must be addressed this year and a cross party working group may enable how we can continue to deliver a NHS that we are all proud of.

I am looking forward to this year, looking forward to getting my strength and health back to normal. Learning to cope with my hearing loss and ensuring that I develop a new work life balance. I am looking forward to my 50 (again) birthday this year as well as the 70th birthday of the NHS on the 5th July.

I have had another chance at enjoying my family, my work and continuing to chase my dreams. Let’s work together to give the NHS that chance.

This is a series of blogs starting from the day I was diagnosed with an acoustic neuroma. If you want to start at the beginning then please follow this link: 

https://stellavig.blog/me-and-my-acoustic-neuroma/

December 25th 2017

December 25th 2017

It is Christmas Day and I so grateful to be celebrating this with my family. Our thoughts are not of religion but of family and love. We miss those who are no longer with us and celebrate the arrival of new bundles of joy. As we get older we realise that richness is not money but safety, health and well being. There is also great sadness realising that there are so many people who are not safe and have no access to healthcare.

Today of all days, just hug or talk to that someone special.

I want to say a special Merry Christmas to all of you. Thank you all for just being you!

With much love Stella