Learning from those we care for

One of the first female ethnic minority chief executives in the NHS examines why medical professionals, as authority figures, need to be open to patient feedback to ensure the safety and improvement of prescribed medicines:

I was recently listening to the radio while driving on the motorway in the rain. I find these are conditions when something I hear can be really touching and painful.

There was a report about Epilim (Sodium Valproate), a drug which saves lives but also can have a devastating impact on the unborn child when taken by pregnant women.

These facts were hidden from women for a long time, the true extent of which was only just emerging.

It was very uncomfortable for me to know that I to belong to a paternalistic system where caring and lack of care can be so closely linked.

I was reminded of a colleague, long since retired, a strong woman, passionate about how we treat women.

There was a time when Sodium Valproate was used increasingly in the treatment of bipolar disorder.

As part of a good comprehensive plan of support, we were beginning to help many lead more fulfilling lives by using this treatment. Or at least, we hoped so…

In spite of this my colleague spoke up to change what we thought was working. She campaigned tirelessly and with patience to change practice in the organisation, when the impact of taking the drug on women wasn’t seen as a major issue; when others felt that we had more pressing safety concerns to address.

She led what was initially a one woman campaign to make us all understand the importance of this matter and then to change our practice. She influenced many. Gradually practice changed.

I was a consultant adolescent psychiatrist at the time and recall how this work influenced decisions we made together with young women in our care. These decisions would have an impact on their children of the future.

It changed the way I thought about these young women. It made me understand that decisions I made would have an impact long after I ceased to be involved in their lives.

This change required considerable effort on the part of clinicians, those of us with some sort of perceived power over those who are more vulnerable and have less of this perceived power. It wasn’t too difficult once we got going and in the end we all gained something.

I learnt that I want to be part of a system which will continue to challenge the way in which we care for women, within and outside our organisation.

Small things we do will make a difference for good. Alternatively, small things we do can perpetuate harm and impede progress. When we hold women back, we hold families and communities back. And that is not good for any of us. This bothers me.

Listening to real, lived experiences, in the enclosed space of my warm, comfortable car, in the pouring rain; getting in touch with the voices of those affected. Learning…

Navina Evans

Dr Navina Evans MBBS, DCH, MRCPsych is one of the first female, ethnic minority chief executives in the NHS and was appointed CEO at East London NHS Foundation Trust in August 2016.

She led it to “Trust of the Year” in 2016-17 and to be rated “Outstanding” by the Care Quality Commission.

She was previously the Trust’s Director of Operations & Deputy CEO, and before that Director for Mental Health.

Navina was formerly Lead Clinician for Newham CAMHS and then Clinical Director Child and Adolescent Mental Health Services, East London Foundation Trust.

She has involvement in Medical Education at Barts and The London Medical School as Honorary Senior Lecturer, Associate Dean, and Academic Year Tutor.

Her extensive clinical experience is in CAMHS Psychiatry and Paediatrics. Her interests include leadership, improving the way healthcare is delivered and learning from sources beyond healthcare.

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  1. Olivera Markovic says:

    I worked closely on NHS England patient empowerment yet was disempowered by the hospital when my mother was admitted.