I got rushed to hospital on the 13 April 2016, with terrible pain and loss of vision in my right eye. My retina had detached. And following, the surgery l also developed complications with an infection and had an eight-day admission. I'm still on a course of steroids and different eye drops plus l have developed cataracts.

These experiences have reminded me how care quality and a care quality strategy would make a massive difference to my quality of life. It would turn my life upside down.

Despite this, I would hate it. I beg you, don’t do it! My life, my livelihood depends on things staying just how they are.

Let me explain. I earn a reasonable living out of people falling between the cracks that exist between services and getting hurt as they are buffeted by poor quality of services. I am part of a community interest company called Community Navigator Services that provides training, consultancy and so on, papering over the cracks knowing that however hard we work those cracks will reappear tomorrow.

An implemented, integrated care quality strategy would change all that. We would be out of work tomorrow. I would probably have to hand back my MBE. I would have to spend more time with my family. Life would be unbearable.

Fortunately, I don’t expect it to happen. Let me tell you a story about a subject that has become very important to me – my complicated feet!  

Every month, I have to go to the podiatrist because of my diabetes, and the lack of circulation in my feet – and every month I get to relive what I call my "monthly falling down and blowing up the building site moment".

Do you remember Michael Douglas in the film, "Falling Down"? So worn down by the petty insults and trivial absurdities of daily life that he ends up taking a rocket launcher and accidentally blowing up a building site before finally committing suicide by cop? That's how I feel every month when I visit the foot clinic.

Every month I phone the clinic. I explain that I need one of the rooms with wheelchair access. And I explain that I have been told by the podiatrist that I have remarkably complicated feet, because of my diabetes, and the lack of circulation in my feet and I must book longer than the normal fifteen minutes. And every month, I am assured that I am not to worry, everything has been noted, everything will be fine.

And every month, when I get to the clinic, everyone is really friendly and helpful and caring and professional. I am dispatched to the room without wheelchair access and the podiatrist takes one look at my feet and says, "you'll have to book another appointment, we won't get all this done in fifteen minutes."

And then the podiatrist looks at me in a very caring, empathetic manner, and says, “has no one told you that you have very complicated feet?!” And every month, this image floats in front of me of Michael Douglas wrestling with his rocket launcher.

Now, of course, these are little incidents. Petty irritations, and I try hard not to get irritated. Those who know me will agree that I try really hard not to blow up building sites unless it’s really necessary.

The real risk is that I will give up hope, that the routine of petty humiliations will eat away at my resilience, at my ability to lead an ordinary life. Which is all I am trying to do.

And I feel these little incidents, these small moments of being ignored and not listened to, are snowballing. The way I see it, being valued or not valued is not rocket science. It’s often just a matter of listening or not listening and showing that you have been heard.

We have here a receptionist, a manager, and a podiatrist: three people, based in two locations, with three different definitions of quality and perhaps half a dozen opportunities for a people and processes to fail the integration quality test. If we can’t get this right, what real chance is there of national integration of quality? My job will outlive me.

And it is not just “people like me” who are affected. We have seen social workers and other professionals, providers in tears as they describe the pressures they are under to deliver any quality of service. Every day, we hear of professionals leaving, or thinking of leaving, the vocations they embarked upon with such optimism and passion.

For me to be out of a job, three things would have to happen.

  1. There would have to be a common definition of quality. My definition would be based around fundamental concepts such as warmth, respect, and compassion, dignity and being person-centred. But that would need a common understanding and agreement.
  2. There would have to be an understanding that quality is based on behaviours not rules and processes.
  3. There would have to be rules and processes that supported not blocked those behaviours and definitions.

But I will be honest with you, I don’t see it happening. If people like you talk to people like me about things like implementation of integrated quality strategy, we tend to be very cynical. The phrase “same old, same old” springs to our lips. We expect that there will be a lot of money spent on IT systems that may or may not work and that our everyday lives will remain dependent on random acts of kindness while juggernaut of healthcare continue to prioritise processes over people.

If you want to measure something, measure warmth and respect, dignity and being person-centered.

If you want to cost something, cost compassion. How much does it cost to say to someone, “I can see you are scared and feel vulnerable”?

If you want a key performance indicator, look at the consistency of services, at people doing what they said they would do.

A simple, clear, human system that prioritised warmth, respect, compassion and doing what it said it would do. If that happened, it would truly make a massive difference to my quality of life. It would truly turn my life upside down.

I would have to look for a new job — and you know what, I would be absolutely delighted.  I would like to leave you with this thought - quality is remembered long after service is forgotten.


To find out more about Clenton's work and Community Navigation services, visit www.communitynavigatorservices.org

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