It is Saturday morning, I am on call and working at my desk on lingering clinical work after the ward round, awaiting blood results, blood pressure data, etc.

My mobile rings. The screen shows 'unknown caller'. Not a stalker offering free deep breathing exercises. That one is almost only ever the hospital.

Switchboard - "Dr Moghal, I have the mother of a patient on the line. Do you take calls from patients or parents?" "Yes I do."

I talked to the mother about her daughter's care at her local hospital where she is an in-patient. The interaction, the communication, the listening, the advice and the confidence returned to a concerned mother was critical. I then shared her concerns with the local service. Note to the policy wonks: A tertiary service, working with a local service, keeping care local to the family - no PbR tariff for that relationship, the work and patient outcome.

We have an SHO on call. We have a SpR on call. For my service, we have a nurse specialist on call. So, I could have diverted the call. The SHO would probably not have known the patient, understood the context of the local service admission and been blind to my relationship with the local service to manage the local admission. The same would have been equally true with the SpR. Both would have been busy with immediate on-site clinical needs. Both would have called me for advice, and the resulting fragmented communication would have been potentially unsafe, ineffective and not what the parent deserved as an experience; the mother would have remained anxious for longer. I know that the nurse specialist on call would have achieved a more successful interaction than the trainees and very possibly better than me, but the quickest, most efficient and most appropriate action was for me to take the call. Granted, the trainees missed a learning opportunity.

It is telling that the switchboard operator felt that she had to ask "Do you take calls from patients or parents?" Perhaps what works in a small service may not work in a large service, perhaps paediatrics is different. But do we know that for certain?

I do healthcare. I do customer care.

Am I any good at it? I am learning, every day.

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