Emilie Couchman is an academic GP, currently undertaking a PhD with the Mesothelioma UK Research Centre at the University of Sheffield and working as a GP on a part-time basis in Northumberland. Her Twitter handle is @DrEmilieCouch
The front-line role of reception and administrative staff cannot be overlooked. In my view, they have as much responsibility to care for patients as clinicians do. Of course, we should not expect clinical support from them, but the reassurance, or lack thereof, provided by reception staff can make or break an individual’s healthcare experience.
When I was pregnant with our first child, my husband was often working away. Our first NHS scan fell on a date a week before his planned return. I remember feeling sick as a dog, while working 8 clinical sessions a week. I phoned the antenatal ultrasound clinic, expecting a compassionate voice on the other end, given their job revolves around newly-pregnant women. ‘Computer says no…’ was the essence of the response I received. No audible compassion, no time taken to listen to my context of having miscarried before, no consideration of my social situation given I would need to attend without my husband; just, ‘You must have your scan on this date according to our protocol’. I completely understand what it is like working within the confines of a system that has significant limitations; my gripe in this context is the lack of acknowledgement of the frustration this causes the service user.
Our NHS … is brittle, and snaps under any remote pressure that isn’t in line with its bureaucratic procedures.
Our NHS isn’t flexible. It doesn’t bend sufficiently to meet our needs. It is brittle, and snaps under any remote pressure that isn’t in line with its bureaucratic procedures. Talking of brittle, I fractured my elbow this week. The first bone I’ve broken (if you don’t count my ambiguous scaphoid injury after a night out dressed as a PacMan at medical school). The pain was unimaginable, and I vaguely remember saying something about preferring to have two more Caesarean sections to the kind, comforting radiographer as I passed out mid-X-ray. The administrative staff were courteous but gave no hint of wanting to connect on a human level. They were intent on processing my details and did this job very well. What more did I want? Perhaps an ‘ouch, that sounds painful!’, indicating that they noticed my beaded brow and outright fear of any kind of movement that might move the broken pieces of bone in my arm. Nevertheless, I understand the pressures outside the direct control of individuals working within the healthcare service, so my overwhelming feeling is of gratitude that people show up and provide a service that enabled me to receive a diagnosis and the appropriate treatment.
Is the ‘human touch’ aspect of care necessary? Perhaps not. But does it change patient experience? For sure. And does it take much time? No.
Is the ‘human touch’ aspect of care necessary? Perhaps not. But does it change patient experience? For sure. And does it take much time? No. I refuse to believe it would add delays and hinder efficiency. Do I understand that some frontline staff are unable to provide it? I do. Burnout can present in this way; losing the will to connect with fellow humans and gritting your teeth to get through another shift. Fisher and McDermott recently wrote of the ‘importance of enabling relationships and connection at work’ with patients, clinical colleagues, and management. They suggest that improving wellbeing of staff by nurturing therapeutic relationships within the workplace is fundamental to change culture for the better, increasing job satisfaction and retention of healthcare professionals.1 There is no clearer sign than the impending (at time of writing) nursing and junior doctor strikes that a drastic change in culture at both national and local levels is needed. We all need to be open to change and challenge; clinging on to ‘The way we do things around here’ will cause the system, and those working within it, to snap.
Fisher, R, McDermott, A. The battle to retain GPs: why practice culture is critical. British Medical Journal. 2023;380:p344