Chris Birch, Patient Governor

July 2011

I am proud to be a Governor of this hospital, and one reason is its outstanding record in the fight against HIV. Two close friends were killed by HIV and the lives of some of my HIV positive friends were saved by this hospital's doctors. So I jumped at an opportunity to visit all our HIV and sexual health clinics.

I was lucky to have Jane Bruton, Clinical Nurse Lead for HIV, as my guide. We first visited the John Hunter Clinic in the St Stephen's Centre, next door to the hospital. HIV tests, with results in a few minutes, are provided plus pregnancy testing, contraception, Hepatitis B and C screening and Hepatitis B vaccinations. About 26,000 men and women a year attend.

Then it was on to the Kobler Clinic on the Ground Floor of the St Stephen's Centre, an outpatient clinic, which sees about 4,500 patients a year. Here I met an old friend from my days working as a volunteer at London Lighthouse, waiting to see his consultant, Dr Mark Nelson. They very kindly agreed to my sitting in on the consultation.

Next—to the HIV Day Care Unit on the hospital's 2nd Floor, which provides a Rapid Review clinic for HIV patients with an urgent problem. There I met Dr Anton Pozniak. Then to the Thomas Macaulay Ward, next door to the Day Care Unit.

Our next stop was the West London Centre for Sexual Health located in Charing Cross Hospital's South Wing. The centre has about 29,000 attendances a year and a high proportion of those are of Black African or Black Caribbean origin. There is also a walk-in clinic for patients aged between 16 and 24.

Our final destination was our two-year-old 56 Dean Street centre, run by Dr Alan McOwan in Soho, now the busiest clinic of its kind in London, with about 53,000 attendances a year, mainly gay men. Outreach work is done in the local Chinese community where there is a lot of Hepatitis. The clinic has about 1,800 HIV positive individuals and is open until 7pm on Mondays, Tuesdays and Thursdays and from 11am to 4pm on Saturdays, which is a big advantage for patients who are working.

Chelsea and Westminster provides a friendly, confidential and free world-class sexual health and HIV service, in three separate centres, of which we can be extremely proud. The ambiance is welcoming and the waiting areas, particularly at 56 Dean Street, are like those of a five-star hotel, so different from those of many sexual health clinics a few years ago.

I was extremely impressed by the enthusiasm of the staff I met and I was surprised to learn that stigma is still a big issue 30 years after the start of the HIV pandemic.

I am extremely grateful to Jane Bruton, Clinical Nurse Lead for HIV, for taking me on a four-and-a-half-hour Grand Tour of all our sexual health and HIV clinics.

April 2011

Chris Birch, Patient Governor

One of the perks of editing a weekly news magazine, which I did for 13 years, is that you get to do a lot of expenses-paid entertaining, and I have had many interesting lunchtime discussions with a wide variety of people.

But never before my shadowing visit with Consultant Gastroenterologist Dr Marcus Harbord at Chelsea and Westminster Hospital had I spent my lunch hour listening to a discussion of other people's bowels.

I had been invited to meet Dr Harbord, one of six consultant gastroenterologists, for a sandwich lunch but I had not realised that I would be attending an inflammatory bowel disease multi-disciplinary team meeting, or IBD MDT for short.

Dr Harbord was in the chair and there was also a surgeon, a surgical registrar, a radiographer, two stoma nurses and an IBD nurse. And while we munched away, we watched and discussed pictures of patients' colons on a large screen.

Inevitably, much of what was said was way above my head but I was impressed by certain things. When I was a young man, long, long ago, doctors treated their patients as cases. Their patients had technical problems which they would solve without becoming emotionally involved. But the cases that were discussed by the IBD MDT were not just 'cases'. They were human beings whom the team knew as individuals with individual problems.

"This patient is a young man in his early 30s with his whole life ahead of him so we must bear that in mind."

"This gentleman in his 80s lives alone, if we do this or that how will he cope?"

The team's compassion for their patients was obvious.

I was also struck by a certain understandable defensiveness. "We ought to do this and this, because if the outcome is that and the finger is pointed at us, we would then be able to say so and so."

After lunch Dr Harbord took off his gastroenterology hat and put on his other hat as a general physician responsible for the 28-bed Edgar Horne Ward. Another MDT meeting with Dr Harbord in charge and attended by Consultant Hepatologist Dr Matthew Foxton, a registrar, two junior doctors, two sisters, two occupational therapists, two physiotherapists, the discharge team co-ordinator and a social worker from the Royal Borough of Kensington and Chelsea.

A total of 11 patients were discussed in detail and I was again struck by the detailed knowledge that the team had of their patients.

We then did a ward round and I was impressed by the fact that, if a patient was asleep, Dr Harbord did not wake them. When I was an inpatient last April, I was continually being woken up for a variety of reasons and so Dr Harbord scored several brownie points in my book when he allowed a patient to continue sleeping.
Dr Foxton then took me to the Intensive Care Unit to visit one of his hepatitis patients, a young man in considerable pain. The unit has 10 beds which are used flexibly, depending on the level of care needed by the patient.

Finally, a quick visit to Thomas Macaulay Ward and then home, exhausted, in time to catch Neighbours.

I am extremely grateful for having had this opportunity to do and see what I did. I was greatly impressed by the high standards, quality and compassion of the doctors, nurses, therapists and others I met.

November 2010

Chris Birch, Patient Governor

18 years ago I put up a memorial in Westminster Abbey (to a woman who had been dead for 615 years), and I get quite a buzz from owning a very small part of that magnificent church.

Three years ago I was elected a Governor of this hospital, and I get a similar buzz from being a very small part of the governance of this wonderful hospital.

Before I was elected, I had thought that the Council of Governors (as it is now called) was probably a rubber-stamping body without any power. My first big surprise was to find that we have very real and important powers.

The most important of these is, perhaps, choosing and appointing someone to chair both the Council of Governors and the Board of Directors because a rubbish Chairman is likely to lead to a rubbish hospital. Happily, we were a very good hospital before we appointed Professor Sir Christopher Edwards, and we are an excellent one now.

We also decide how much the Chairman should be paid and if, at any time, he should be removed. And we do the same for the other five Non-Executive Directors.

The Board of Directors runs the hospital and the Governors are their 'critical friends', holding the Directors to account for the hospital's performance. We seek to represent the views of patients, staff and the community and bring these to bear on strategic decisions about the hospital's future.

My second big surprise was the amount of paper involved and the difficulty of keeping it under control. The papers for the Council of Governors meeting on 21 April 2010 weighed 1 lb 13 oz, and it cost the hospital £2.18 to post them to me. And that was just one meeting. It was a lot to read and I am not a slow reader.

However, most of the papers for the various sub-committees are distributed by email and I have spent a small fortune in the past three years printing them out. By ruthlessly throwing out any paper that I don't think I will need again, I manage to contain my hospital papers in five box files. But it's quite an effort, and I quite often throw away something I wish I hadn't.

One of the best things about being a Governor is all the new friends I have made.

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Chris Birch, Patient Governor