We talk a lot in healthcare about demand, efficiencies and cost, only occasionally amid the headlines of delayed discharges, A&E waiting times, GPs under pressure, cancelled operations, unavailable medications and doctor's strikes do we look seriously at the quality of care.
Our NHS does many amazing things every single day. Indeed you might argue just surviving this long as a free-at-the-point-of-use healthcare system as various governments have tinkered around the edges with it is, in itself, a bit of a miracle.
But real quality of care, the sort that seems on the face of it to be very basic but in reality is utterly transformative, is rarely mentioned. In this blog I want to remedy that in my own small way.
Regular followers of mine on social media, or readers of my D4Dementia blog, will know that I became a mum in November 2015. Overall, we had some wonderful care from the NHS during our transition into parenthood, but one experience more than any other has remained with me long past the contractions and blood pressure monitoring.
— Beth Britton (@bethyb1886) 4 December 2015
I've been a breastfeeding mum for over a year now. Not very remarkable you might think, but according to a study published in January 2016 only 0.5 percent of UK mothers continue to breastfeed after their baby reaches its first birthday, the worst rate in the world. But it could have been so, so different.
Our daughter was born in hospital, and during our stay there (only 24 hours), three different midwives all confirmed that her and I had taken to breastfeeding like ducks to water. Only by day three after the birth, I knew something wasn't right. Thankfully we'd opted to have our postpartum care with the amazing birthing centre midwife who'd cared for us in the last weeks of my pregnancy and the early hours of our birthing experience.
She took one look at our breastfeeding technique, changed everything, and my daughter and I have sailed along with feeding ever since. Even when I got mastitis in the early weeks, I avoided antibiotics with some self-help techniques shown to me by another of the birthing centre midwives. Up until that point I thought cabbage leaves were just something you ate, but ladies, they have other uses too!
Going back to those early days though, how four midwives in the same NHS Trust - three in the hospital and one in the birthing centre - could view our feeding technique so differently is a mystery to me, but perhaps explains why so many women struggle with breastfeeding. The birthing centre have a UNICEF Global Baby Friendly Award, which might explain their additional knowledge, plus they had the time to help. In modern healthcare, giving time can be a bit of a wonder treatment in itself.
But where do my experiences leave our under-pressure, creaking at the seams NHS? Of course all healthcare is subject to the natural differences in aptitude and application that we all show as human beings. No two midwives, nurses or doctors will see things in quite the same way, but as patients this variation in care and support has consequences that aren't always positive.
If there is one thing I've learnt time and again, from the experiences of caring for my dad during his 19 years with dementia all the way through to my experiences as a mum, the choices we make as patients about where we have our care and who provides that care (as much as it's possible to choose) are absolutely critical. We have to be more savvy about our healthcare: yes demand better, more consistent care and support, but also seek out, as much as we can, those services and professionals who can give us what we need.
And when we find a great service or healthcare professional, shout about it. I wrote to the Secretary of State for Health with a detailed account of our birthing experiences, imploring him to visit our amazing birthing centre and see what can be learnt from what they do (a small, local service, expert and dedicated staff, home-from-home facilities) that could be replicated across NHS maternity services and throughout healthcare for the whole life course.
As the NHS experiences growing demand for maternity services, whilst at the other end of the age spectrum an increasing number of older people needing care, more patients than ever before will be affected by variations in the quality of care they receive. It may not be as headline-grabbing as delayed discharges and A and E waiting times, but it has real, human consequences, and arguably is the most crucial factor in keeping people well and away from our overburdened NHS services in the future.