Facing the unfixable
The third of the Reith lectures by surgeon Dr Atul Gawande addresses the two “unfixable problems in life and healthcare – ageing and death”. Despite the inevitability of both ageing and dying, health and social care systems continue to struggle to support individuals facing them. Dr Gawande calls for a new approach, focusing on quality rather than length of life.
It’s an unhappy fact that the most common week for surgery is the last week of a person’s life. There are two implications to draw from this. One that the surgery may be of questionable value to the patient, the second that it increases the likelihood of them spending their last days in hospital.
Dr Gawande believes that the current system and expectations of a society focused on the “fixable”, can end up increasing the suffering of patients nearing the end of their life. He believes healthcare professionals and patients should be more easily able to discuss what treatment options are appropriate and if treatment is actually appropriate at all.
The wellbeing imperative
This is not about withdrawing care. It’s about shifting focus to where we can add quality to life. That means doing all we can to support the independence and vitality of people as they get older and accepting that while the problem may be unfixable, the way they experience it is not. The challenges are less about “what” and more about “how”.
We are currently planning for our next regional Partnership Day event which will take place in the summer. It will focus on improving care for, and wellbeing of, older people. Kent, Surrey and Sussex has the oldest population in the country. A sustainable healthcare system for the region must address their needs as a priority.
Across the region there is broad consensus about the needs to:
- Maximise proactive care
- Minimise the crises in care (and associated upward trend in emergency admissions), and
- Enable the 35% of older people who want to die at home to do so and not die in hospital.
We’ll announce details in the coming weeks about how to register for our summer event and help shape the region’s response to our most significant priority.