Monday, 7 June 2010

What does “world-class” anything mean in the NHS?

If you live and work in the NHS you will be aware that language changes as it does in the real world. There is nothing new with new terms coming in like CT or CAT scan (computerised tomography/computerised axial tomomgraphy) or MRI (magnetic resonance imaging) scans.

More recently the term MI (Myocardial Infarction or heart attack in old money) has been replaced by NSTEMI (Non ST elevation MI) and STEMI (ST elevation MI) which refer to changes in the appearance of the ECG which determine what is the best treatment for anyone suffering a heart attack.

Certain terms create confusion for example what is the meaning of STI? For some it stands for Sexual Transmitted Infection. It appeared a few years ago in A&E computer generated letters and took a while to work out what it was which is a Soft Tissue Injury.

Another is the abbreviation PID which could mean to a gynaecologist Pelvic Inflammatory Disease (the clap) but to an orthopaedic surgeon could mean a Prolapsed Intervertebral Disc (slipped disc).

So what does the NHS managers buzz world “world-class” mean when put in front of anything?

It certainly does not refer to anything from the first world. When we speak to colleagues Stateside and tell them of local “world-class” commissioning initiatives they fall about laughing and ask how we avoid being sued and how come we are so many years behind them?

It certainly does not refer to the second world which we think may now mean North Korea and possibly China.

The migration of people from Eastern Europe to the UK mean some of our biggest critics are patients from the former Eastern Bloc who can go home on a weeks holiday, get a scan and an operation done to cure them quicker than they can see a totally useless complimentary therapist in this country at a fraction of the cost. They also are better as a result of a trip to the former Soviet Union but still are waiting for NHS “world-class” care when they return.

It can not refer to the third world as patients of ours who have been unfortunate enough to fall ill overseas have all commented on how much better things there are in terms of resources and treatment and remember they have paid their National Insurance and Taxes and are getting their first world treatment from their travel insurance not their own country.

One in particular had in 2.5 hours a MRI scan, a consult with an orthopaedic surgeon and was seen by a physio quicker than their child was seen with a broken wrist in their local “world-class” A&E department.

So which world is the “world-class” world of the NHS and its managers?

Praise be to the Party for giving us the term “world-class”.

Is it the same as kids in the seventies cutting out Rolls Royce insignia and sticking it on their Choppers to make them look better than they actually are?

In fact the Chopper riding kids are now the managers . . . but they haven’t grown up yet or realized how p*ss poor and backward they still are. (With apologies for the more than usual grunt words).

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