First Impressions

I have now completed the first three days of my ‘orientation period' in the NHS. My first day was a corporate day spent at Pinewood House where I met with HR, Finance, Compliance, Equality and Diversity, Learning and Development and Business leads. It was interesting to see how these aspects of management interlink with each other and to gain an understanding as to the position of Oxleas as a trust. I found this day really useful toward understanding how the changes to the NHS are likely to impact on Oxleas as a trust and how Oxleas are planning for and coping with those changes.

I spent the next two days shadowing people in service delivery roles, both of which happened to provide care to people in the community. I found these experiences valuable on many levels and some of my initial thoughts related to both experiences.

On Thursday I spent the day shadowing an Advanced Primary Nurse who delivers care on a short term basis to the elderly who are experiencing an acute phase of an illness but are not well enough to get themselves to the GP. On Friday I spent the day shadowing the Bromley Early Intervention team who identify and care for people who have experienced their first episode of Psychosis. There are many elements to this role as the team must address the patient's entire lifestyle in order to have solid structures and support networks in place to enable recovery. These vary from helping them to organise accommodation and providing daily activities to assessing medication and working with the patient to produce a care plan that is realistic, fits with their lifestyle and how they want to cope with their psychosis.

Firstly, simply meeting patients and understanding their daily lives and the problems they face highlighted to me the core reality of the NHS and the importance of the fundamental services it provides. It brought home the importance for the focus to always be on patient care and patient experiences despite the other financial and structural issues we are facing.

Secondly, I began to see the vast differences that exist between people's individual circumstances i.e. the level of family support they have, the community they live in etc. and how they choose to cope with their illness. I saw the importance of the care provider understanding these circumstances in order to adjust and amend their levels of support accordingly to provide care that is relevant and appropriate for the individual. The care provider having this understanding enabled them to build a trusting and productive relationship with the patient and to see the patient as an individual with their own background, circumstances and opinions.

Thirdly I began to see some of the aspects of care being delivered in a community setting. Someone working in someone's home or meeting them in the community has to adapt and adjust to various environments on an almost hourly basis. They must take into account practical elements of delivering care in these settings and also maintain a professional but friendly attitude whilst in someone's private home.

These days also emphasised to me the importance of effective communication, especially when the patient may be vulnerable. I saw extra care being taken to ensure the nurse and patient had a mutual understanding of the care plan for the patient and the next steps. I also realised the importance of communication between service providers, family, the patient and management in order to achieve a seamless and well coordinated service.

Both these organisations had a focus on preventing the patient having to go to hospital rather than treating an illness in its acute phases. This seemed to involve helping the patient to manage their care and empowering them with information so that they can do so themselves with the support of others. To me, this approach seems entirely logical both on a personal and financial level.
My experiences over the three days underlined the importance of the services the NHS provides in people's day to day lives both on a medical and personal level. I have just recorded some of my initial reactions and thoughts of these first experiences.

This week I am based in Birmingham, starting the educational aspect of my scheme but will return to Oxleas the following week. Finally thank you to everyone who hosted me this week and I am looking forward to the upcoming days of my orientation period.