An Uncertain Future by Ken Donaldson

Well, that’s been an interesting few months, hasn’t it!! We all watched with fascination as Covid spread across the Globe – China first then Italy and Spain – before it hit our shores and started creeping towards Dumfries and Galloway.  Everything changed. We were told to stay at home, avoid loved ones we didn’t live with, only go out if necessary and our work was transformed. Many people had to ‘Shield’ at home and could no longer work. Those still coming in found their working day turned on its head; perhaps completely new duties or sitting in front of a screen all day. But there was one thing I am pretty sure was felt by everyone; fear.

I was terrified. Terrified of how many people were going to get sick, terrified of how many may die, terrified for our frontline staff who were putting their lives at risk. I was also terrified for my own family and loved ones and, whilst this may sound selfish, I was terrified that I would fail in my job. This felt like a big test of leadership. Was I up to the task? Was D&G at risk because I was about to fail.  Many sleepless nights followed.

However it all looks different now. We have survived the first peak of Covid and, in general, we have gotten off fairly lightly. Our colleagues in the Critical Care Unit and Care Homes may disagree as those two areas have experienced a significant impact from the disease but, as a region, the numbers were nowhere near what we expected and whilst this may be down to our rurality it also reflects how all of us have adhered to social distancing and isolation and stopped the spread.

So what happens now? Lockdown restrictions will start to ease, people will be out an about and there is the strong possibility of a second wave. However there is no doubt that we are much more prepared for that and have systems in place to deal with it should it come. But social distancing is here for some time and we all need to think how we are going to deliver our services for the people of D&G in this uncertain future.

Things have changed and one message I would like to share today is that we cannot go back to what we had before. It quite simply wasn’t working and if we have demonstrated anything in the past 3 months it is that we can deliver healthcare in 2020 in a very different and more efficient way. We don’t need face to face consultations all the time, we don’t need to admit so many people to hospital, we don’t need lots of different steps before a patient interacts with the professional they need to.

There was one other noticeable change when all this kicked off; we all pulled together like never before. Many petty differences which had prevented progress vanished. People reached out to help each other (virtually or 2m apart, of course!) and it was obvious that we genuinely cared about our colleagues. There was really no need to use the phrase ‘We are all in this together’ because we all inherently knew that was the case.

So while the dust settles and we look around at the ‘New Normal’ let us not go back to what we did before. Let us embrace new ways of working and talk to our colleagues about how we do it together. Let us do the right thing for our population.

“A crisis can create an opportunity to learn and build a better way forward. The system that will emerge on the other side of the crisis is shaped by those leaders who are able to harness the potential in the moment and galvanise others to act.”

John Sturrock 2019

Ken Donaldson is Executive Board Medical Director for NHS Dumfries and Galloway

With thanks to Charles Mackesy for the image.

 

 

 

Enough Love by Ken Donaldson

I was out for a run the other morning (yes, despite the physique I do run. I also eat) and was listening to a random music selection. An oldie by Genesis, Land of Confusion, came on. I smiled wryly as I listened to the lyrics. Lines such as ‘Too many problems’ and ‘losing control by the hour’ certainly resonated.

The past few weeks have been simply unbelievable. The initial adrenaline rush brought on by the Covid 19 crisis has started to dissipate and the realisation of what is coming and how this will affect us is sinking in. The purpose of this blog is not to discuss all the plans we are working through and what needs to happen over the next few days and weeks to make us as ready for this as we can be. The purpose of this blog is to talk about us. When I say us I was thinking NHS D&G but in reality I realise I mean everyone working together with the NHS through these difficult times; social workers, carers, police, council, fire and safety, third sector etc etc. Actually what I now realise is that I mean the People of Dumfries and Galloway. All of us.

What I have witnessed over the past few weeks has been a simply astonishing response to this impending crisis. Those in the critical areas; Primary and Community Care, Emergency Dept, Combined Assessment Unit, Critical Care Unit have stepped forward with plans to significantly alter services and ensure they can cope. Those in other areas less critical stepping forward to offer their skills and time to support services in any way they can.

All this is amazing and, I can’t deny, that when I have been feeling particularly stressed, it has made me feel emotional. But its the small things that have brought on the tears; the catering assistant when I was paying for my lunch who gently laid her hand on my arm and asked if I was ok (I know, she shouldn’t have, infection control etc but it was a lovely gesture), the colleague making a point of stopping me to ask if I was all right, another who offered a hug. I mention these for a specific reason.

Whilst I may be feeling a little stressed just now in a few weeks we are all going to be facing simply unprecedented pressures. Quite a few of us will be sick with this virus, we will have friends and family suffering and work will be relentless. We need to cling on to these small gestures. Simple acts of kindness are going to help keep us going through the dark times.

I was at a meeting with Valerie White, Interim Director of Public Health, and she said words to this effect “This is going to be really hard and we all need to work together but I can say without any shadow of a doubt that there is nowhere else I would rather face this than Dumfries and Galloway. The commitment I am seeing from everyone and the willingness to work together is amazing.” I can only echo Valerie.

Returning to that song, Land of Confusion, there was another line that stuck out; “There’s not enough love to go round”. Now this is one I totally disagree with, in Dumfries and Galloway I think there is enough love to go round, and then some.

Take care everyone. We can do this together.

Ken Donaldson is Medical Director at NHS Dumfries and Galloway

*Image taken from “The Boy, the mole, the fox and the horse” by Charlie Mackesy