EastEnders – we must be thankful for our world-leading burns care

Like millions of other people, I’ve been following EastEnders closely these last couple of weeks.

My interest was sparked – if you’ll forgive the pun – by news that there was to be a terrible fire at the Moons’ place, after Alfie sets a bin alight in the belief he can remedy his financial woes through an insurance claim not realising that his partner, Kat, was asleep upstairs.

Kat sees her reflection in the mirror

One of the images we’ve been sharing on social media to raise awareness of our work

In a classic villain-turned-hero tale, Alfie rushes into the burning house to rescue Kat, whom we see bandaged up in subsequent episodes in Walford General Hospital.

Kat’s bandages come off in tonight’s episode, and I’ll be watching again to see just how accurately the treatment reflects the modern reality.

I’m not doing this to pick holes – in fact, I think EastEnders has given an excellent and informed picture of what getting burned is like, so far. But I do what to see how the story progresses. EastEnders has an opportunity to celebrate the world-leading NHS burns care on which we can all rely.

Some might expect me to talk of my own experience of sustaining burns in a car fire, but I’ve held off from that. What happened to me was more than forty years ago and today’s care of an acutely injured patient with severe burns is totally different.

Indeed, the EastEnders storyline has brought home to me just how far burns care has come, especially in recent years, and I believe much of this is down to the persistence of the team at Changing Faces.

We’ve worked closely with the NHS and Department of Health over the last decade to develop the world-leading national standards for burns care that are now in place nationwide. You can read below our Position Statement on burn care across the UK.

So, as you’re watching EastEnders and musing on Kat’s injuries and treatment, please do have concern for her situation but be thankful too for just how far we’ve come.

In many ways the missing link is the psychosocial care that follows – and that’s why Changing Faces is needed here. Here to help Kat, here to help anyone in that daunting, frightening situation. And here to help her family too; Alfie and all.

Will that become obvious in the story, I wonder?

Use the comments field below to tell me what you think.

CHANGING FACES’ POSITION ON THE PROVISION OF BURN CARE ACROSS THE UK 

Background

Changing Faces (CF) has been lobbying for improved treatment and routine psycho-social care for burns patients and their families for many years.

The charity has advised on many developments and informed practice in many areas including:

  • Burn Care Clinical Reference Group: Patient public engagement representation on this advisory group to NHS England. CF contributes information about patient experience and advises on how to improve psycho-social elements of treatment and care.
  • London and South East Burns Network commissioned CF to produce training for all staff in burns units. This training manual is now delivered in many specialist centres in England.
  • COBIS (Burns Network in Scotland) – are currently implementing the CF training pack across specialist units in Scotland.
  • The former National Network for Burn Care in England and Wales reviewed and revised the national standards for burns treatment and a Quality Dashboard to which CF played an active role.

The structure of burn care in England/Wales

Specialist Burn Care is provided in approximately 13 hospitals for the most severe burns. Other burns are treated in the community at A and E departments, GP surgeries and local hospitals.

The specialist services usually have psychologists but there is frequently no psycho-social provision beyond specialist care.

Recent policy/guidance developments

  • Development of “key quality indicators” in England and Wales for burns specialist treatment – to include psychological assessment of patients
  • Revised National Standards currently being revised for England and Wales. CF is delighted that psycho-social care is integral to the description of care pathways which includes support on discharge and when patients are back in the community. The discharge plan should address psycho-social needs but the provision depends on local availability and patients say that it is still often lacking.

Changing Faces considers that further developments are needed

Changing Faces would like to see further developments and improvements in the following areas:

  • At many local hospitals there is a need for more training of staff to be able to assess the needs (medical and psychological) of burns patients
  • At present compliance with the revised national standards will be based on self assessments in the specialist centres. CF would like to see a more robust system for ensuring compliance. E.g. part of CQC assessment.
  • Post-discharge from specialist units care becomes fragmented and patients say that medical and psycho-social support cannot be relied upon. They describe a post code lottery in local provision.
  • Psycho-social support in the community needs to focus both on dealing with the aftermath of burns/injuries AND with the challenge of integrating back into daily life. CF can support patients and professionals in this area and has self-help resources to assist with this but more resource is needed.
  • Improved support for carers and members of the patient’s family – both emotional and practical at all stages of treatment – should be provided to help families cope with the challenges of having a relative who may have a permanently altered appearance and undergo long periods of hospitalisation as well as face challenges reintegrating into daily life. (This is provided in some specialist units).
  • Patients have identified the need for improved communication and information sharing. Patient experience mechanisms needs to be strengthened and gaps in provision need to be improved upon.

A week of connections

I love Round Britain Quiz but frustratingly rarely get all the connections.

Here’s a conundrum for you:

“What links a sculptor from Oxford, a speaker at a conference in Gdańsk, an actor in EastEnders and Dr Scroggy?”

The answer is…

Last weekend, I met Martin Jennings who sculpted Sir Archibald McIndoe’s statue in East Grinstead to commemorate his outstanding work with the Guinea Pigs – and I was struck by the similarities of those who sculpt and plastic surgeons. In Greek, ‘plastos’ means ‘to mould’ and that is indeed what sculptors do.

Years ago, a plastic surgeon called Brian Morgan instigated courses for surgeons to learn the sculptor’s art – and there are now regular courses. The Guinea Pigs came from all around the world – and on Wednesday evening last week in Gdańsk in Poland, I met Peter Neligan, now a Professor of Surgery in Seattle, who used to be a surgeon in Toronto and was the co-ordinator of the Canadian chapter of the Guinea Pigs.

Peter and I were in Gdańsk to speak at a fascinating symposium on vascular anomalies – and I left England on Tuesday to get there, which meant that I missed the EastEnders episode which so traumatised the viewers. Kat was caught in a house fire and sustained major burns.

This is an important storyline because it could open up questions of how patients and their families are treated in the British burn care system – including to address their emotional and social needs – and how Kat will be received back in Albert Square, Walford… and the nation may have to witness how prejudiced and uncomfortable we are towards people who look different.

Going back to McIndoe: he was famous not just for his surgery on the fighter pilots of the Battle of Britain but for speaking up for the fair treatment of his patients with all their scars and disfigurements in the pubs, clubs and shops of East Grinstead. A public health doctor par excellence and one of the first to support face equality, like race equality.

I learned a lot in Poland and I heard from Peter Neligan of his latest edition of the six-volume tome Plastic Surgery, the state of the art book that stems back to the version in 1964. The history of facial surgery goes back the First World War and the work of Harold Gillies and his seminal textbook Plastic Surgery of the Face published in 1920.

And I have two more weeks to see the latest play about Gillies: Dr Scroggy’s War.

Bring on this week!