It’s Tuesday, for me the most ordinary day of the week because Monday is always a challenge, Wednesday is mid-week and Thursday is next to Friday. It’s a very quiet morning, it’s 5am and I’m in a hotel room needing motivation to finish reading some meeting papers. I’m sitting looking at the iPad with a cup of coffee. Thinking...

Thinking is good, isn’t it? We don’t do enough of it, spending time in uninterrupted thought...

I check-out and walk to my place of business. In the distance I can hear the faint whisper of traffic. Somewhere out there is a workman with a hammer. I wonder what he’s building, repairing or demolishing?
It’s cold and the fabulously blue sky has one wisp of cloud. An airplane rumbles high above. I’m walking and thinking. I’m thinking about the lack of thinking there is. In the news there is mention of medication errors and there are the usual knee jerk responses but no thought. The maelstrom of the day and pressure rob us of any chance to think.

There are think-tanks and investigative reporters. They are good at doing the mental heavy lifting and raising awareness. But I’m thinking about another sort of thinking. I’m thinking about being thoughtful.

Sad to say, most of the time we are thoughtless. Thoughtless in the way we focus on outcomes. Thoughtless in the ways we approach improving quality and performance. Casual thinkers declare: ‘Sort out the NHS’; ‘It has to be changed’ or ‘transformed’ or ‘modernised’; ‘Medication errors shouldn’t happen’; ‘Errors are a crime’. That’s stinkin’ thinkin’.

The secret key?

Most of the work of pharmacy is thoughtful work. Thoughtful in the way we talk to people at their most vulnerable, deal with them at the ragged edge of their lives.

How do you innovate thoughtfulness? How do you improve it? Can you buy more thoughtfulness through bigger wage packets?

There’s the thoughtfulness of a handwritten note. There’s the thoughtful pharmacy that changes the front doormat to pink because people with dementia would otherwise see a black hole; those providing free deliveries to the needy and most vulnerable. There’s the thoughtful pharmacy assistant who is trained to give back independence to those robbed of health by disease, and the thoughtful pharmacists who ring ‘just to see how you’re doing’.

It’s not just pharmacists and their teams who can be thoughtful, but everyone in the NHS. These thoughtful people can make our days seem shorter.

Thoughtfulness is at the heart of patient relationships, at the heart of workforce relations, staff retention and supplier relationships. Thoughtfulness speeds things up, slows things down, makes the wheels turn.

Thoughtfulness is the oil in the machine, the wind in the sails, the spring in a step.

Thoughtfulness makes you feel good and the people around you feel good. Maybe it’s the secret key to efficiency and innovation?

Master of deception

Thinking stops foolish thought. You don’t proclaim your innocence by imposing guilt on others. Pharmacists are being blamed for the dispensing errors all over the news. Jeremy Hunt is a master of deception, calling for an environment in the NHS in which healthcare professionals can immediately admit errors and advise
colleagues what went wrong so that others can learn from their mistakes.He ignores the fact that there is an increase in vexatious complaints across the NHS, even when there aren’t winter pressures, and that the current system encourages these with the rise and rise of legal firms who urge people to make claims.

A study referred to by Mr Hunt and widely reported has revealed an estimated 237 million medication errors occur in the NHS in England every year, and avoidable adverse drug reactions cause hundreds of deaths.

ADRs could be a contributory factor to between 1,700 and 22,303 deaths a year, we are told.

Of the total estimated 237 million medication errors that occur, the researchers found that almost three in four are unlikely to result in harm to patients.

Now I appreciate just one error can lead to an unnecessary death and tarnishes the safety of dispensing the other 99.996%. But let’s think, what other profession can be slated for having such a high accuracy rating?

Hunt, the NHS and those within pharmacy who didn’t defend the facts or the stats, have failed the profession and patients because they chose to deflect away from the real failures: an underfunded, inefficient NHS; the worst reforms in history damaging community care; no national scheme to collate errors; and above all, swingeing cuts in community pharmacy funding. An ageing and ever-growing population will only add to long-term pressures.

So, we either stop stinkin’ thinkin’ or start getting used to the norm being more dispensing errors, patients dying on trollies in hospital corridors and further NHS litigation. One thing I do know is imposing guilt on others for your own failings is never a solution. 

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