Cherish learning moments, want to replicate exposure back home
Five trainees on an exposure and training trip to National Health Services (NHS) UK bring back the amazement and learning to Kashmir and attempt to replicate it here.
A group of doctors spent two weeks visiting in-patient wards and community mental health teams as part of an international program of training to find out what life is like in 21st Century NHS.
The doctors were exposed to a variety of services and facilities such as those for dementia, drug and alcohol, child, and community mental health teams in Grantham, UK and also inpatient and rehabilitation units in Lincoln UK.
The doctors were ‘amazed’ to find the vast difference in mental health services in India and Lincolnshire Partnership NHS Foundation Trust (LPFT) services. The training was part of the World Health Organisation’s mental health Global Action Programme (mhGAP), in agreement between the Royal College of Psychiatrists’ and the government of Jammu in Kashmir.
LPFT locum psychiatrist Dr Sayed Aqeel Hussain, who hails from Kashmir, along with Trust Medical Director Dr Sue Elcock organised the trip.
The amount of respect to privacy and consent is something that impressed Dr Syed Bushra Imtiyaz, a team member. “I like the fact how everything is fully discussed with the patients and their families at LPFT. It’s amazing how much importance patient consent is given when it comes to choosing the drugs or procedures. Everyone is involved with regards to the management and treatment options on offer,” she said. She added “The drugs and their possible side-effects are also fully explained to the patients at LPFT which results in a better delivery of services for patient care.”
She was also touched by the fool proof referral system. “The amazing GP referral system, under which the NHS users would only go to the respective GPs of their area who would assess them and then accordingly refer them to the specialist doctors as the need be,” she said. She found this a total contrast to system in Kashmir wherein a single patient could present to as many doctors as they wished. This results in an increased influx of patients in the hospitals and decreases the amount of time to be given per patient, leading to a decline in the quality of patient care and over burdening of doctors, the doctor believes.
Dr Sukhpreet Kour, another member of the team found the substance abuse help system an inspiration that she feels could help many lives if it could be replicated here. “In the UK you have lots of specialties such as drug and alcohol and child and adolescent services, we don’t have that kind of set up back home. I would really like to see more programs like this in the future so people from developing countries can come and learn and take that learning to other countries which will help change things,” she said. On the same note, the effective and intensive documentation and records system has also impressed doctors. “I like the fact that you have detailed documentation of everything here – it saves a lot of time. Back home patients have to provide their own medical history each time they see a doctor so if it’s recorded in a single compact manner it saves an awful lot of time,” Dr Khuram Maqbool a visiting team member said.
The patient load and the degree of probing and explaining that the doctor can get into in the given scenario has also been seen as a concern and something that needed to get replicated in a better manner here. “Because of the patient load back home the amount of time we have with patients is about five minutes. Here, every consultant spends longer with their patients so I am going to take this approach back with me to see if I can implement it on my return to give the patients a bit more time” said Dr Hena Mustafa. The staff shortage at many levels and its cumulative effect on patient care was seen as a constraint and doctors found it in total contrast in NHS.
“You have many more health professionals involved in patient care – nurses deliver around 90 per cent of the mental health care whereas back home it’s all doctors – every burden and all the workload is on them. At home the nurses know very little about psychiatry, they are just there to give injections,” Dr Suhail Saifullah said.