Hitting the target....but missing the point?

There has been much debate, discussion and speculation about the impact the Mid Staffordshire public enquiry and the subsequent Francis Report is having and will continue to have on health care delivery. Today I was invited to attend a presentation by Professor Ian Cumming, Chief Executive of Health Education England the new organisation who explain their role as:

"We are the NHS engine that will deliver a better health and healthcare workforce for England. We are responsible for the education, training and personal development of every member of staff, and recruiting for values. We are England’s health and healthcare people service."

Professor Cumming describes a culture in many organisations (and certainly found in the Mid Staffs culture) of documenting at all costs, even over caring for patients and went on to describe a few scenarios he had witnessed where service user need was secondary to process requirements and meeting targets. The issue of record keeping, documenting client care and statistics recording has always been important but perhaps has  become more so over the last 20 years?

Since the early 1990's with the advent of the Access to Health Records Act 1990 and the free market principles of the Purchaser/Provider split  and subsequent changes with successive governments there has been more accountability, more business culture within the NHS coupled with a social change of a shift in greater litigation culture. This has all had an impact on how we practice as occupational therapists and how we educate and train occupational therapists. As a manager in the early 1990s I remember numerous conversations with practitioners who bemoaned the fact that documentation and statistic recording was time consuming and took them away from patient care - the mantra at that time was "If you don't record, it hasn't happened. If it hasn't happened then we are not a viable or valuable service to patients or to the organisation". Perhaps sewing the seed for the position many seem to be in today of shifted priorities detrimental to patient care.

As an educator of occupational therapists, one of the areas I teach is Legal and Ethical issues in practice. Students' awareness is heightened during these sessions of what could constitute harm, neglect and breach of Code that may result in being struck off the HCPC register or taken to a civil court for breach of duty in common law. These sessions are intended to create best practice, adherence to COT Code of Conduct and HCPC Standards of Practice and to ensure that the ethical principles of autonomy, beneficence, non-maleficence, veracity and equity are considered in everyday practice. I still believe that this is vital for a student to understand before they go out onto their first placement (one week observation not included). However, I would like to pose a question.......

Are we in danger of hitting the target and missing the point? Do we as occupational therapists spend too long on process and administration to the detriment of client contact? Whilst most of the discussion in the arena is currently focusing on nursing and medics, allied health professionals will not be excluded and I would be interested to hear what your experience of hitting targets and missing the point may be.

COT Annual Conference ---- and Occubuzz

Today sees me trying to return to "normality" following 3 days in Glasgow for the COT annual conference. Sarah and I were in attendance having had a number of abstracts accepted for poster facilitations, a seminar and an innovative technology stand. At the time of submitting abstracts (usually September time) it feels such a long way away to the following June - however it crept up on us and with the usual last minute flurry of activity ensuring posters were designed and printed, presentations were ready and we had material to make our stand "stand out".

Highlights of the 3 days:

a) Meeting so many people in "real world" that we had met and connected with through our social media networking - in particular a number of our Post graduate students on our online MSc programme that we have never actually "met" before. Watching people move and hearing them speak is a fascination that never wanes - so now, when we return to virtual space we can have a more rounded picture of our connections. So if you came and found us to say hello - thanks - we loved meeting you.

b) Of course catching up with everyone was great.

c) Introducing Michael Iwama to Occubuzz and almost having a preview of his dance moves perfected for the evening's gala - Michael -we may not have been there to see them - but we now have eye witness accounts and photos - so we know it happened - and good reports have been filed :-)

d) Coming away with potential collaborations to explore further including being approached both by a publishing company to consider writing a book and a USA recruitment agency interested in our online training capacity and capability.

e)

OCCUBUZZ - the interest generated out-performed our expectations. We were swamped everytime we were on the stand by people wanting to talk about the app and it's potential. Our "sticky bee" stickers became cult with people coming to ask for one - however they had to listen to our spiel before we would give one out.
You can find out more about this on the Occubuzz tab at the top of the page. Please download the app and play with it - it is a prototype and there are some gremlins but your feedback is vital to our development of version 3 which we are then hoping to use in some research with practitioners and the general public. We hope to have a blog and a facebook page just for Occubuzz coming very soon......



f) Attending the Student presentations where 2 of our students were presenting their experiences of a volunteer project using occupation as the focus for a Carer Support group we have worked on with a local Trust. Sam Tozer and Louise Hesketh - you were great, professional, clear and extremely interesting in your reflections and what you shared -great experience for the CV. (Of course not forgetting Helen Hampson and Maria Lynch who were part of the project too). More information about this project can be found on our poster (Evaluating an Occupation Focused Group for carers of people with mental health conditions). Click here

g) Dare I mention the free food and drink copiously provided on the first evening back at the hotel by the recruitment agency that over-predicted numbers of delegates. Our gain I believe :-).

h) Making some headway in the development of social media guidelines for health and social care professionals. Our seminar on Professionalism in the Digital Age was well attended (even at 9am!) and we received some useful comments on the risks and challenges ahead that need to be addressed. Watch this space as we work with our national and international colleagues on this project.

At the moment this is about all I can remember. I return to be swamped in emails, admissions queries, marking and other bits that don't seem to care that I have been away - I will attempt to follow up with more info very soon - and yet again I make a resolution to be a better blogger.
Any hints and tips on how to be a more regular blogger would be well received. Thanks for your continued support.