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Mark Radcliffe

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‘Protocols and pathways do not guarantee quality care’

So I’m standing with two other men looking at my broken car. One of them, a dour chap from the AA, is speaking in some kind of code. ‘Gasket’ he says. The other one, my brother-in-law, is nodding and saying ‘head gasket’. Finally they shrug, make a car joke and tell me I’ll need a lorry to get me home.

The man from the AA says the lorry will be along in 90 minutes. That’s not bad, I think, and I make the mistake of saying so. I think there is a lesson about modern life here and it is ‘never be impressed’.

Thirty minutes later I receive a phone call saying the lorry will be two hours. ‘Thanks for letting me know,’ I say foolishly. Twenty minutes later someone else calls to say the lorry will be three and a half hours. I simply say: ‘But it will be a lorry, won’t it? You got that bit right, didn’t you?’

‘We’re very busy sir,’ she says, and of course everyone is.

The lorry arrived and we set off. But not before the nice man from the AA said that he wasn’t able to take us all the way from Manchester to Hove because of driving regulations. He would have to stop in Wolverhampton for a 45-minute break (health and safety) then he could take us to Oxford where we would be met by another AA man who would take us home.

‘Should have you there just after midnight,’ he said. It was 6.30pm.

To cut a long story short, we arrived home at 2am. Might have been quicker had the lorry meeting us at Oxford not gone to Reading but there you go. Everyone was nice and did pretty much everything they were meant to, if we assume that what they were meant to do was in isolation from the overall aim of getting me and the girls home within 10 hours of being asked to do so.

And there is the modern world for you. In lots of ways it’s great – I love the interweb. But in other ways it’s rubbish.

For example, I am waiting for a scan result from four weeks ago. The scan was done on the NHS of course but not by the NHS. It was franchised out to a building society or greengrocer or someone, who said, and I quote: ‘You should hear from whoever referred you in a month or so. If you don’t, you should phone someone.’

And with that they opened the door and I fell out of the mobile MRI scanning caravan into the car park. I probably will hear from someone eventually – it’s probably a rule somewhere – and, when I do, they will probably be very nice and everyone will pretty much do everything they were meant to. But is that really the best we can do?

All jobs, it seems, are governed by protocols these days. But this removes the people involved – whether they be roadside rescuers, nurses or health service managers – from the purpose of what it is they are supposed to be doing. We are swimming in systems and care pathways. Doesn’t necessarily equate to care though.

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