Posted by: Tony Copperfield2 April 2014
I had a patient with a mental health crisis the other day. So I thought, I know, I’ll phone the mental health crisis support unit. Obviously, I expected this to be an exercise in futility: that they’d all be away on an ‘improving communication’ study day, or that they’d create a crisis instead of alleviating one.
But this is what happened. ‘I have a patient with mental health issues,’ I said. ‘And he’s having a crisis.’
‘Well, we’re the mental health crisis support unit,’ said the voice at the other end. ‘This sounds like a job for us.’
And they solved the problem. Or rather, they solved my problem, in that I heard no more – so the potential disintegration of my day was averted, despite the psychotic wobbly thrown by my patient. How marvellous and, let’s face it, unprecedented.
And, bugger me, the next day a near-identical thing happened. I had a patient who required, as they say nowadays, ‘end-of-life care’. ‘He’s on a stairway to heaven,’ I explained on the phone to the relevant team member. ‘Or maybe it’s a highway to hell. No, hang on. It’s a pathway. And I believe you’re the end-of-life pathway people.’
‘We are,’ she said. ‘We’ll sort him out.’
And, just like the mental health crisis support unit, they did. Nursing care, DNACPR form, PRN meds. The lot. I just sat back in disbelief and drank some coffee.
Blimey, I hear you say. A success for primary care teamwork! Hurrah for primary care teams and all who play in them.
No. Wrong. Stop right there. This is not teamwork. This is network. The mental health crisis support unit and the end-of-life pathway people are big organisations which, like many others, I sometimes overlap and interact with. I probably won’t need them for another year. I can happily let them get on with their job and they can let me get on with mine, secure in the knowledge that we’re all available on the end of a phone when required.
So what? So listen, those of you who bang on evangelically about teams. Teams are everywhere. We’re teeming with teams. And for every team, there’s a team meeting. That’s the problem. Extended primary care team meetings. Multidisciplinary team meetings. Admissions avoidance team meetings. QOF palliative care case review team meetings. And now the very latest idea locally: federation-based teams including community pharmacy, community matrons, social workers, mental health workers, health visitors, midwives and health trainers (and presumably various other forms of health footwear). All of which will involve – yes, you’re ahead of me – massive numbers of team meetings.
It’s not as if meetings ever achieve anything, other than a nice plate of biscuits, a load of minutes no one reads, and more sodding meetings. So please, those of you who are literally setting the agenda: remember that all these people might be my mates – especially when I need their help – but they’re not my team mates. If you’re a team dynamic junkie, go ahead. But leave me out of it, I’m busy.