IOM DHSC & MANX CARE

[Andy Onchan]

24 minutes ago, Roger Mexico said:

I assume there is an element of self-mockery there. 

It's a phrase that they frequently use in their Faceache posts.

[Jarndyce]

40 minutes ago, Roger Mexico said:

In this case I think it was an election pledge from Beecroft that she would try to do something about the case.

Yes!  I think I remember this, thank you!

[Dr. Grumpy]

2 hours ago, Roger Mexico said:

I assume there is an element of self-mockery there.  But it's worth pointing out that, unlike with a UK hospital, there would be no automatic publication of the report on the CQC website (and I can't even see it there now).  The report had been separately commissioned by the DHSC[1] and they could publish as much as they wanted or not at all.  So IOMN having a copy might well have triggered the cosy chats on Manx Radio and the rest.

[1]  Which in turn means there are no ratings for the various areas examined.

A friend from 'across' tells me that a similar report regarding the ED of a UK hospital would have resulted in 1. Immediate closure of the unit and 2. Resignations of CEO, MD and DoN.

Obviously we cannot close the only available A&E on island, but we can at least ask the bosses for their action plan to remedy the situation

[Apple]

1 hour ago, Dr. Grumpy said:

A friend from 'across' tells me that a similar report regarding the ED of a UK hospital would have resulted in 1. Immediate closure of the unit and 2. Resignations of CEO, MD and DoN.

And the rest I'm afraid.....

[cissolt]

2 hours ago, Dr. Grumpy said:

A friend from 'across' tells me that a similar report regarding the ED of a UK hospital would have resulted in 1. Immediate closure of the unit and 2. Resignations of CEO, MD and DoN.

Obviously we cannot close the only available A&E on island, but we can at least ask the bosses for their action plan to remedy the situation

Poor Theresa is still finding her way.  Did we need all these new directors? Or just a competent CEO?

[Roger Mexico]

Ashford's response is quite extraordinary isn't it?:

https://www.manxradio.com/news/isle-of-man-news/former-health-minister-not-surprised-by-cqc-report/

I suppose it's got to the stage where he's now the one who stupid enough to say out loud what the others are thinking.  He's claiming credit for having the idea of CQC inspections (despite others calling for them for many years) but doesn't explain why he didn't have any during all the time he was Minister, including two full years pre-pandemic.  Hooper and others also think they should be patted on the back for doing the bare minimum, but at least Hooper did it.

And Ashford seems to believe that it will take decades to change a corporate culture (presumably he just hopes everyone retires eventually).  Well it might if you do nothing to change it, but more likely it will just continue itself forever.  Such change needs decisive action from the top and the will for that seems lacking from the Board.

Of course such culture isn't just confined to Manx Care/DHSC and can't really be fixed just in there (though it would be a good place to start).  I quoted a paragraph from the report that summed up what is a symptomatic problem:

All grades and disciplines of staff told us the incident reporting system was seen as a tool to apportion blame. The system was described as ‘weaponised’. We were also told that reporting was discouraged. Some staff said they could not access the system, they had to request that someone else input any incidents on their behalf but this was frequently denied.

But we've only just seen the outrageous case of the four anaesthetists, where this was exactly what happened and the AG's Chambers seem to have driven that.  And we've never had an explanation or an apology for that disaster.

[WTF]

16 minutes ago, Roger Mexico said:

Ashford's response is quite extraordinary isn't it?:

 

And Ashford seems to believe that it will take decades to change a corporate culture (presumably he just hopes everyone retires eventually).  Well it might if you do nothing to change it, but more likely it will just continue itself forever.  Such change needs decisive action from the top and the will for that seems lacking from the Board.

 

it will always be a case of monkey see monkey do, time to fuck off all the monkeys and start again.

[cissolt]

The culture issue is across every government department at all levels.  Solutions are difficult as I am sure there are a few good people working hard.  

Cull everyone who has had more than 2 complaints made against them?

Didn't Murray have 18?

[GD4ELI]

56 minutes ago, Roger Mexico said:

Ashford's response is quite extraordinary isn't it?:

https://www.manxradio.com/news/isle-of-man-news/former-health-minister-not-surprised-by-cqc-report/

I suppose it's got to the stage where he's now the one who stupid enough to say out loud what the others are thinking.  He's claiming credit for having the idea of CQC inspections (despite others calling for them for many years) but doesn't explain why he didn't have any during all the time he was Minister, including two full years pre-pandemic.  Hooper and others also think they should be patted on the back for doing the bare minimum, but at least Hooper did it.

And Ashford seems to believe that it will take decades to change a corporate culture (presumably he just hopes everyone retires eventually).  Well it might if you do nothing to change it, but more likely it will just continue itself forever.  Such change needs decisive action from the top and the will for that seems lacking from the Board.

Of course such culture isn't just confined to Manx Care/DHSC and can't really be fixed just in there (though it would be a good place to start).  I quoted a paragraph from the report that summed up what is a symptomatic problem:

All grades and disciplines of staff told us the incident reporting system was seen as a tool to apportion blame. The system was described as ‘weaponised’. We were also told that reporting was discouraged. Some staff said they could not access the system, they had to request that someone else input any incidents on their behalf but this was frequently denied.

But we've only just seen the outrageous case of the four anaesthetists, where this was exactly what happened and the AG's Chambers seem to have driven that.  And we've never had an explanation or an apology for that disaster.

Not extraordinary, rather a very good reason why he should never be in charge of anything anywhere. This whole episode is shocking - I knew from friends that there were 'issues' but didn't know it was this bad.

Edited September 8, 2022 by GD4ELI

[Jarndyce]

https://www.manxradio.com/podcasts/manx-radios-mannin-line/episode/mannin-line-special-cqc-report-into-nobles-emergency-department/

I've just managed to listen to this podcast.   Leaving aside the disconnect of the Minister stating that staff should be able to flag up issues (against the background of an employment tribunal relating to whistleblowing): I thought Manx Care's Director of Nursing and Governance made interesting listening.   I assume Mr Moore was invited with the Minister, wearing his Governance hat.

If I have misheard, do please correct me - but I believe that I heard him:

- Attempt to redefine bullies as passionate and committed individuals who can maybe be perceived as abrasive;

- Downplay comments about patient safety in the report in favour of "risk" - then state that all healthcare is  inherently risky (to an extent, maybe - but shouldn't that risk be minimised - and shouldn't Mr Moore be able to assure the public that any risk has been minimised due to application of good governance principles?).   Is patient safety not a concept any more?

- Provide a self-serving picture of himself, putting on the uniform and working in ED, while downplaying the comments of more junior staff who told the CQC that they didn't see the chief nurse very often.

 

I've never met Mr Moore and he may be a very passionate and committed individual - but my first impressions, rather like the report, leave room for improvement.   I do not feel that I have been given "assurance".

[Two-lane]

5 hours ago, Roger Mexico said:

automatic publication of the report on the CQC website (and I can't even see it there now). 

The 5-point summary would be:

Is the service safe?
We found that this service was not always safe in accordance with CQC's inspection
framework

Is the service effective?
We found that this service was not always effective in accordance with CQC's
inspection framework

Is the service caring?
We found this service was caring in accordance with CQC's inspection framework

Is the service responsive?
We found this service was not always responsive in accordance with CQC's
inspection framework.

Is the service well-led?
We found this service was not always Well Led in accordance with CQC's inspection framework

In other words, one green  and the others orange/red. I don't know how to judge if the CQC would put a red marker against the failing areas if they had the authority to do that. There is certainly no green star (outstanding) anywhere there.

[Blade Runner]

8 hours ago, Boo Gay'n said:

Here we go.

There is a lazy myth that all nurses are angels and all doctors are demi-gods.  Flowing from this is a lazy assumption that they can't be criticised.

However, health and social care are full of really nasty people - some of whom don't care about the people that they are supposed to be looking after, and many of whom bully their colleagues relentlessly.  It is often the nasty ones who then form cliques, become union activists and throw out the concept of 'professional autonomy' to fend off any attempts by management to achieve good services that could be benchmarked against the best in the UK (as the CQC has tried to do).

Those cliques are canny too, and know how to get to the politicians.  This means that they are never challenged, and the politicians seek glory for awesome policies like little Finley getting his special medicine.

It can be changed through imposing standards etc. in law - which they are not in the Isle of Man, and obliging professionals contractually to deliver them.  Courage is needed from politicians and managers, but this would not be rocket science.

This.

Nobles has been on a downward spiral since the late 90's

That was one of the main reason I took myself and family back to The UK. Well that and the crab attitude for private enterprise.

Ramsey Cottage Hospital was good when I was on the rock and reading here looks like it still is too. Nurses openly told us that they were going private in the UK rather than going to Nobles......

P.S. Re Bone Doctors on island.

I would not send my dog up there.

My daughter broke a leg in the early 00'S and was put in a whole leg cast. After a couple of weeks it was apparent she had her foot pointing the wrong way. Had to be rebroken and reset. The resetting was only done after threat of litigation.............

I really would trust the many Vets on the island for better service than Nobles.

[GD4ELI]

9 minutes ago, Blade Runner said:

This.

Nobles has been on a downward spiral since the late 90's

That was one of the main reason I took myself and family back to The UK. Well that and the crab attitude for private enterprise.

Ramsey Cottage Hospital was good when I was on the rock and reading here looks like it still is too. Nurses openly told us that they were going private in the UK rather than going to Nobles......

P.S. Re Bone Doctors on island.

I would not send my dog up there.

My daughter broke a leg in the early 00'S and was put in a whole leg cast. After a couple of weeks it was apparent she had her foot pointing the wrong way. Had to be rebroken and reset. The resetting was only done after threat of litigation.............

I really would trust the many Vets on the island for better service than Nobles.

When deciding where to move to in 2014 I seriously considered the island, but Nobles and rural internet were two showstoppers. Quite a few ex-Nobles staff in Cornwall, some as Manx as the hills who would never go back.

The rot firmly took hold when Tony Brown was CM, do you remember a tv program where he said there's not much for the CM to do as the Island runs itself (paraphrasing here)?

Restoring Nobles is almost impossible.

[Newsdesk]

1 hour ago, GD4ELI said:

Not extraordinary, rather a very good reason why he should never be in charge of anything anywhere. This whole episode is shocking - I knew from friends that there were 'issues' but didn't know it was this bad.

Ashford should never even have been put in charge of a bar when he was bar manager. He’s basically just an incompetent bullshitter who well overshot his own basic level of competency thanks to HQs backing. 

[Roger Mexico]

4 hours ago, Dr. Grumpy said:

A friend from 'across' tells me that a similar report regarding the ED of a UK hospital would have resulted in 1. Immediate closure of the unit and 2. Resignations of CEO, MD and DoN.

Obviously we cannot close the only available A&E on island, but we can at least ask the bosses for their action plan to remedy the situation

I've only just listened to the end of the Manx Radio podcast, and Hooper complains that they had to come up to be interviewed "off the hoof" and had to "move their timeline" to respond.  Clearly they intended to bury this report until it was leaked to the newspapers and pretend the next one was the real one. 

Given that that inspection will be taking place quite shortly, I am puzzled about their confidence that things will have improved a lot by then, only about four months after the first one.  If it's the usual civil service way of coping, they're presumably hoping they can bully the staff into silence.