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LMC Chairman's Festive Blog

Friday 23 December 2016

***** ******* is coming to town!

Implementation is everything. As Santa Claus pokes round for that elusive can of WD40, and struggles to recall precisely how he applies Einstein's Special Theory of Relativity so he can do all he has to, the local Health and Social Care leadership are moving from the planning to the consultation and implementation phases of the STP. It's arguable who has the easier task. The main excitement at the STP Programme Oversight Group meeting this week was the surprise presence of ***** *******, recently appointed as the new Chair of the STP. Many of you will be aware of his/her national profile as ******* of *******, and of course his/her former role as ********** at ******. They are due to take on the role formally in January, but if their identity hasn't been formally announced by the time I hit the 'send' button on this missive, this paragraph will seem a load of ********. At least it will give you something to ponder as you peel the sprouts.

Primary Care representation at the highest level of the STP has caused much debate in recent months, and I was part of the interview panel (also involving representation from the CCG, SPH and the Primary Care workstream lead) on Tuesday to select somebody for this challenging role. Whilst the successful applicant won't have a mandate to represent all GPs, they will be responsible for promoting the STP and engaging a flagging and increasingly knackered workforce. There are undoubtedly opportunities that can help practices and their patients, and I'm confident that we've found somebody as well-suited as anybody could be for the job. Their name hasn't been announced yet? Sorry- maybe you could start on the Devils on Horseback while you think about this one....

I'm doing my best to get festive, and have managed to get myself outside four Christmas dinners to date, including our LMC party held at the racecourse (of course). I'm very lucky to work with such an excellent executive team, superbly supported by the girls in the office who keep the whole thing purring smoothly along like a, er, smoothly purring thing. We were distinctly recognisable from the other corporate hordes by our dancing, ably and energetically led by V-C Karen, and of course our stetsons (another day, another blog). Our tree at home appears more unevenly decorated than usual this year. At first I suspected management (festivities and decorations) had developed an unusual vertical sensory inattention, but the clue was a little pile of wire hanging loops in the dog’s bed. The puppy is now 8 months old, and having just realised there are certain expectations attached to being a labrador, started munching her way through the silver baubles from the lower branches. What goes in must come out, and on a positive note, poop-scooping in the gloaming has become easier of late- just head for anything sparkling in the moonlight. All that glitters is most definitely NOT gold.

If you're having to work over the Christmas period so that the rest of us don't have to- we thank you. It was 30 years ago when I spent Christmas day as the medical SHO on-call at Cheddon Road Hospital in Taunton. Whilst other colleagues on the medical rota stalked the wards in the original single-storey old building at Musgrove on the hunt for empty beds, I looked after an eclectic mix of specialties on the other side of Taunton, in a haphazardly assembled mixture of buildings.

Nobody thought to question the wisdom of having the acute chest unit 2 miles away from an ITU (or my staffing it), and there was also a geriatric ward, in-patient dermatology (don't laugh), and an infectious diseases ward. The latter was a colourful place to work, and populated variously by an inevitable Nigerian prince or two from Millfield, who deigned themselves too grand to need antimalarials, marines from Norton Manor Camp returning from exotic parts with all sorts of exciting souvenirs, and the occasional patient with HIV/AIDS, which in those days was effectively a terminal diagnosis. When on-call, we also covered the geriatric wards at the old Trinity Hospital behind East Reach, and also Blake Hospital in Bridgwater.

Tradition, or at least the scary senior sister, dictated that the duty SHO on Christmas Day dressed up in a nurse's uniform and carved the turkey in the middle of the geriatric ward. The sherry had evidently featured prominently with the lunchtime drug round, and the punters were noticeably more soporific than usual, although one of the male patients still managed a hemi-ballismic lunge at me as I passed him his lunch. At about 2pm I had a call from the duty SHO at Musgrove to say that there was a probable tension pneumothorax coming my way, which was nice of him, especially as she had already arrived on the ward, gasping. Luckily, the on-call radiographer was already in the hospital and we had X-ray confirmation of the diagnosis almost immediately, and certainly quickly enough that I had no time to change out of my frock before putting in a chest drain. Just as I was finishing there, a nurse asked me to see one of the COPD patients who had suddenly deteriorated. After a bit of sorting, I had a blood gas sample to analyse, which would then necessitate driving with the syringe of arterial blood, packed in ice in a polystyrene cup on the passenger seat of my car, to Musgrove for analysis in ITU.

Proceeding suspiciously slowly through the deserted town centre, so as to prevent a bloody mess in the front of my car, I was aware that there were only three people on the road that afternoon. I was in a clapped-out Polo, my tinsel-trimmed white coat barely covering a tight blue nurse's dress, riding up to reveal sheer black stockings that reached just above my knees. In the mirror, so close that they appeared to be sitting on my back seat, were two policeman in a Panda car, who followed me almost all the way to the hospital, before turning back to the police station. At the lights in Station Road I sensed they were thinking of pulling me over, but they were thankfully more interested in getting home for the Russ Abbott Christmas Special than having to confront a festive transvestite vampire.

I hope we all manage to relax and enjoy some time at home with our families over the next week or so. I sense that not many of us will look back to the mad, bad and occasionally sad 2016 with a huge amount of fondness, so here's to a better, happier and healthy 2017.

What could possibly go wrong?

Happy Christmas.

Saint Nick

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