Standards of Care

The first thing to say is that

"If the NHS is a post code lottery then I have won it".

Living in the same borough as The Royal Marsden is a positive boon.

I should start by saying that I have never received poor health care from the National Health Service.  In the main, I can impart good experiences.  Where I have had gripes it is with how places are run rather than lack of care by medical staff.  Having said that I can't say that my wife has always been as fortunate as I have.

Regardless of past experiences what I can say is that the care provided by the Marsden seems to be on a different level to anything that I have encountered before. It is clear that they receive a healthy sized chunk of the pie from the NHS but there is also clear evidence of investment in the process and that the investment is being appropriated responsibly and thoughtfully to make the patient experience better.  There are many things that I can talk about regarding structure, processes and facilities but the overriding sense of the place is well run and, whilst "happy" would be an inappropriate word to use, in the context of the illnesses that the patients are suffreing, "contented" might not seem out of place.

In any organisation of such size I am sure that there are lots of problems behind the scenes, and my experience is not without its flaws, but here is a bullet point list of some of the good things that I have encountered.  Some of the points are quite general but others are little things that I believe improve the patient's experience.  Some of the points (such as pastoral care) are not as relevant in other aspects of medicine

• The hospitals are clean
• Cleanliness procedures seem to be followed as you would expect (no slapdash behaviour)
• You can see that an effort has been made to keep areas uncluttered (it helps them look physically sterile)
• Your case is handled by a team (all of whom seem to be well briefed)
• You have a case nurse who acts as a coordinator and reference point
• Staff are polite, well, informed, direct, honest in their appraisal and they LISTEN
• Care across different departments is coordinated removing duplication where possible
• Pastoral care is available as an integral part of your care should you feel that you would benefit
• You are advised if clinics are running late ( a large notice board in outpatients is a simple but very useful tool for keeping you at ease)

When you have cancer the psychological difficulties are as great as the medical process that you have to go through.  As a patient you soon get past the word because you are thrown in to an arena of rapidly progressing treatment.  Each case is individual and each cancer is unique, so the technology, medical and palliative care that you receive plays a huge part in whether or not you make it through.  However, it is a much easier journey with good support and understanding around you.  I am lucky to receive good support not only on a medical, family friends and work basis.  The removal of worries outside the medical arena makes it much easier to focus on the journey ahead.

Since I have been back to my GP I have also had great support from the head of the practice who has provided me with an "ear" outside the Marsden an has also done some research into the clinical trial that has been offered.  She has suggested some incisive questions for me to pose.  The area of clinical trials is perhaps the one aspect of my consultations which has left me less satisfied.  There is a need to perform trials to advance care for all patients but, after the initial consultation I was left with feeling that a more vulnerable patient might have subscribed immediately without thought.  I also feel that some relevant information wasn't provided.  I will be discussing the issues with the team before making any decisions and will post my thoughts here later.

I have spoke with "annstonefamily" today and it is encouraging to get advice from people who are coming out of the other end of the "sausage machine".  I have had a chance to ask about some of the challenges of the chemotherapy and the surgery from someone who has experienced it.  I very much hope that they get the "all clear" in a few weeks time.