There he is.
Morning, Karen. Take your coat off
and I'll give you the ten penny tour.
Nah, it's OK, Mum showed me round last week.
Oh, right, but did she show you where we hide all the good stuff,
like the biscuits?
Now, that is information I do need to know.
You know, it's not like working at the Mill here. It's...
People come in with different challenges.
They're students -
you know, hangovers, exam stress, morning after pill.
I get it. It's easy.
Well, not all students are the same.
A surgery's a surgery.
Whatever comes through those doors, I can deal with it.
OK.
Mr Confident.
SCRATCHING SOUND
HE SIGHS DEEPLY
Seriously, these are the last boxes.
Apart from the ones in the kitchen.
OK, so I don't like to throw anything away.
Be careful, you're a hoarder in the making.
OK, you're going to have to explain this.
Er, Fred Bear got me through some difficult times -
chicken pox, first day at school.
He was always there for me. Ah!
SQUEAKY VOICE: Have you missed me, Jamie?
You must have had a favourite toy.
Yes. Er, Bugsy Rabbit.
But when I was ten, he, er, he went to the charity shop -
exactly the same place that Fred Bear's going to go.
No way. Say goodbye.
Give him here. Give him here. Jamie, no!
I told you... I'd tell you to get a room, but you've got a whole house.
Oh, hello! Er...
Don't tell me - you were just passing?
I'm Marisa - Jamie's mum.
You must be Luca.
Er... Hi.
Hi.
Jamie's told me all about you.
So, what are you studying?
I'm in my first year -
fine Art. Ah, nice.
And what's brought you here today?
I've got a project to deliver, end of the week,
but I'm nowhere near finished.
And that's because...?
I can't sleep.
I'm awake all night, then exhausted during the day.
Mm. I'm meant to be on my way to work now, but I can't face it.
Where's that?
Supermarket, just in the warehouse.
I can't do customers.
Mm. I see.
OK, so how can I help you today?
I need something to help me get off to sleep.
Benzodiazepine - that will do it.
And how long have you been experiencing insomnia for?
Month or so. Any idea what's causing it?
Does it matter?
Sometimes it's better to tackle the cause rather than the symptom.
I've been on benzos before, I know they'll work.
We don't have any details of your family doctor back home.
So?
If you give us permission, we can access your medical records.
Are you going to give me a prescription or not?
Look, Ben, it's...
There are some questions I need to ask first.
No. I came here for help, not an interrogation.
Ben, please, sit down.
Forget this!
Bye-bye!
Everything OK?
Yeah. No problem.
Hmm.
I mean, you could have labelled all the boxes,
you know, just little hints - like, kitchen, bathroom.
Thank you, Captain Hindsight.
I'm just saying.
You always pack the kettle last,
then it's easy to find.
I'll check the boxes in the hall.
So, what do you think, Luca, full sun or semi shade?
Er, I'm not really known for my green thumb.
What is it? It's a lucky bamboo.
It's meant to symbolise good luck
for anyone entering a new chapter in their life.
Oh! How very appropriate!
It's all down to the number of stalks.
Only I can never remember, is it three for love
or for a long and happy life?
Mm.
Now he's met you, Jamie's doesn't need to worry
about his love life, does he? Hmm. No.
How long have you been together exactly?
Er... Um... A couple of months, off and on.
Off and on?
Er...
I think I saw a coffee shop on my way here.
Why don't I save us some time and pop round?
What can I get you, a flat white? A latte?
Oh, I'll sniff out his kettle.
Jamie couldn't find his backside with both hands and a sat nav.
I heard that, Mother! You were meant to!
Try the boxes by the back door.
I am so sorry.
I feel like you could have warned me. Well, I didn't know
she was going to gate-crash.
I've got to go, anyway. I've got that meeting.
Thought that wasn't for another hour?
SQUEAKY VOICE: I know she can be a bit much,
but won't you stay? For me?
OK. He definitely doesn't talk like that!
Ta-da!
Oh, no. You can't go now,
not when we're just getting to know each other.
MOBILE RINGS
Mr Hancock.
I'm on my way now.
Yeah, I know. Sorry.
Yes, should have phoned in. Sorry.
Won't happen again, promise.
I'm going to sort this out.
Here you go.
Thank you.
Wh...why are you moving it?
It's much better there, don't you think?
Mum! What?
As you're both having so much fun, I'll make another pot.
Jamie says you've been travelling. Yeah. It was amazing.
And now you're ready to settle down?
Well, given the shortage of nurses in the NHS,
I don't think I'll be going anywhere for the foreseeable.
Have you been in many long-term relationships?
I think what you're asking is - am I going to mess Jamie around?
He's still my baby boy.
You don't need to worry.
Thank you.
Sorry about earlier.
I know you were only trying to help.
That's fine.
That's what I'm here for.
I'm stressed.
I'm not just talking about stressing about exams
or a bit of angst over social media. Mm.
What I have is with me every hour or every day.
My GP back home said it was a form of anxiety.
She prescribed benzodiazepine.
And you've run out of your prescription? Not exactly.
When I came here, I decided to wean myself off.
Without medical supervision?
Yeah. I know that was risky.
It was dangerous. What's happened to make you change your mind?
The attacks have been getting worse.
Sometimes I'm so worried about having a panic attack that...
..it triggers a panic attack.
It's paralysing.
It's affecting my studies, my job.
If I lose that, I can't afford the rent,
food, I might have to drop out.
OK. Let's just take it back a step, just for a second.
Do you know what the diagnosis was?
GAD.
Generalised anxiety disorder.
And, when the panic attacks became more frequent,
they started treating me for panic disorder.
Both serious conditions.
Did having a medical explanation help?
It meant that it wasn't my fault that this was happening to me.
I needed to go to uni.
I couldn't wait to get away from that small town,
where everyone knew about my...problem.
And when you came to Letherbridge,
you were looking forward to a fresh start?
New people. New place.
I thought maybe I could leave my anxiety back home.
And that's when you decided to stop taking your medication?
And it worked. I was on top of it. Everything felt great...
..for a while.
A new start can be liberating, but there's also a lot of stress
involved with so many life changes all coming at once.
Let's see what we and the university can best support you.
Um, that's going to be a bit difficult.
Why?
They don't know about my condition.
They don't?
Middle?
Yeah.
Perfect. Perfect.
Next.
Is that the time? It's a couple of minutes fast.
I can't be late for this meeting.
Special diet?
Pardon? Are you vegan? Gluten intolerant?
No, nothing like that.
Why? I want to make you both dinner.
When are you free? Mum! We'll talk about it later.
That'll be really, really nice of you. Just let me know when.
Wonderful. I've got to go. Bye.
Letherbridge Uni was my first choice -
I didn't want anything to jeopardise my chances of getting in.
OK. That's understandable.
So, filling out the application form,
when it came to, "Do you have a medical condition?"
I ticked, "No". Why? I thought they might reject me,
especially when they found out I had a mental health condition.
I just don't think the university would be prejudiced like that.
On the uni's website, they big up their welfare department,
but I've heard students talking about how hard it is
to get an appointment. That's why I have to deal with this myself.
But you're not on your own, Ben.
Look, I'll give you a prescription, but only enough for a week.
Book an appointment and we can have a chat about your other options.
OK. Thanks.
In the meantime, why don't you give some thought to being open
with the uni about your condition? What's the point if they can't help?
Maybe you shouldn't write them off
before you've actually put them to the test. OK.
I could have a word, put your case to them.
And get labelled for the next three years? No, thanks.
So, next on the agenda is stock control.
What? We went through all that in your last meeting.
Medical supplies, yes. The clinicians are aware of waste
and over-ordering,
but there is the question of administrative stock.
Can we all just be careful of how much stationery we're using, please?
Well, personally, I already count every staple and paperclip
and I'll email you my data.
It may just be pennies, but it all adds up.
Thank you, Bear. I think we've got the message.
So, moving on,
I've got some exciting news.
Er, I'm not quite finished.
You can do "any other business" at the end.
You really are going to want to hear this.
You too, Al.
Ooh, sounds intriguing.
I want to bring something new to The Mill -
peer review.
Ugh...
Really?
Mm, don't look at me. This is the first I'm hearing of this.
Each clinician will be matched with another
to evaluate their performance.
Oh. Will this include the receptionists? Or the nursing staff?
No. It's just for the doctors.
OK. Great. Well, I'm all in favour.
Yeah. Me, too.
Mm, nothing like change for change's sake.
OK. Hang on. What exactly is this going to entail?
I'm glad you asked me that, Emma.
Yes, I know how hard you've been working -
we all have.
I'm not saying you can't take your sabbatical,
I'm just asking to postpone it until Dale comes back.
If you could give me another two weeks.
Oh, thank you.
I will make this up to you.
Bye.
KNOCK ON DOOR
Yes?
Student Welfare?
Yes. You're in the right place.
Liz Stanton. How can I help?
Dr Suni Bulsara.
I don't think we've met.
Which department are you in?
I'm not on the university staff.
I'm from the campus surgery.
I thought it would be useful to introduce myself. Indeed.
But now's not a good time.
If you can make an appointment...
Are you free in the next couple of days?
Sorry. We're so short-staffed at the moment.
How's...end of next week?
This isn't a random call.
Oh?
I've just spoken to one of your students
and I don't think his issues are going to wait a week.
Clinical peer review is
a tried and trusted way to uphold standards and improve quality.
"Tried and trusted", "improve quality" -
congratulations, you've a full house on your buzz-word bingo card.
Got to ask - how...?
Does it work?
Excellent question, Al.
And it's easy.
You will be paired up with another doctor
who you will observe during consultations
and then you will give constructive verbal feedback.
That sounds like an absolute minefield.
There are some forms here that will help you.
Of course. Forms to be filled, boxes to be ticked.
On these your colleagues will score your performance
based on quality of work,
communication skills and a few other criteria -
all simply marked out of three.
It could cause a bit of a bad feeling
if somebody gives you a one out of three.
If there are areas that need improvement,
isn't it better to find out from an internal, supportive process
rather than waiting for the patients to complain?
All right. OK. When does this start?
Don't look at me. This is all Nina's idea.
We've done this at all of my previous surgeries
and the results were excellent, informative and team-building.
I'm sorry, did she just say the T-word?
She sure did! What's wrong with team-building?
Sometimes, it can turn into a bit of team-breaking in this place.
I thought I was a good GP.
I couldn't see that I was too resistant
to refer my patients to specialists.
I didn't realise that by over-running my consultations
I was putting pressure on my colleagues.
Peer review made me a better doctor.
I promise you it works.
You've given us plenty of food for thought,
so maybe we can pick this up in the next meeting
when Daniel and Zara are here.
Actually, I've already mentioned it to them
and they seemed happy with the idea.
I'm ready to roll this out now.
Er... Hands up everyone who wants to improve the patient experience.
You see, this is not how this works.
But if the service we give our patients can be improved now,
why wait? Yeah. Yeah! Bring it on.
Well, he's in his first year
and his studies are already being affected.
Because of a medical condition he hasn't disclosed to us?
He's afraid of being labelled because of his mental health issues.
But we would never do that. And that's what I said,
but I'm not sure I convinced him.
What do you expect me to do?
What it says on the door -
to look after the welfare of one of your students.
Are you trying to tell me how to do my job?
No. But before I came here, I had a look at the social media.
I'm not sure if you're aware, but a lot of students have posted
quite a lot of negative comments about your department.
Which give an unbalanced picture
because they rarely post about the good experiences.
It was still enough to deter my patient from contacting you.
We're doing our best but we're stretched.
Aren't we all? How long have you worked at the campus?
I know most of the doctors there.
This isn't about me, this is about my patient.
But if you won't give me his name... That has to be his decision.
Then how am I supposed to help?!
Shall we start again?
Good idea.
I've already designed the forms
that need to be completed at the end of each consultation.
It sounds like a lot of extra work.
Five minutes,
less time than it takes to boil a kettle.
But it will need some organisation.
A little rearranging of the staff rota, yes,
but that would be child's play for you, Bear.
So, are we all in?
Yes. Can't wait. As long as it doesn't affect reception.
Yes, or create any bad feeling.
This isn't about picking fault.
Ha-ha.
All I can say is that it worked for me.
It could work for you, too.
Well, you're going to be one doctor down
because I'm not taking part in your little experiment.
Al! Spoilsport!
Shame.
Oh, thanks.
We had a mulish doctor like him at my previous practice,
but he came round when he saw the benefits.
I'm ready to launch when you are.
The university keeps taking on more students.
At the same time,
welfare departments have never been under closer scrutiny
because of a few high-profile failings in other institutions.
I've read the stories, parents who thought
their vulnerable children were being let down by their universities.
Yes, we have a duty of care to all our students,
but they are adults who want to try and live independent lives.
And then you have people like my patient,
who are not disclosing pre-existing medical conditions.
Actually, the real problem we have is the opposite.
How so?
In general, students have never been more open about their mental health,
but there's no increase in resources across higher education
or the NHS to support the increased referral rates.
We've also got more cases where students don't reveal
they're struggling until they reach crisis point.
So, you need them to speak out earlier?
Then we can be proactive from the start -
give them the help they need before things become a problem.
So, what kind of help are we talking about here?
It can just be about having
safe and confidential spaces to come to, if that's what they need.
We can also ensure accommodation take account of their condition.
And if someone has anxiety or panic attacks, you can make sure
that they don't share with too many people?
We can also make adjustments to how timetables are balanced
and help negotiate extra time to complete assessments.
Sounds really good, Liz.
We are here to help, but we can't do anything unless they ask.
Mm.
And how are you?
What? Sorry, is that such a strange question?
It's...been a while since I've heard it.
Well, where do you turn to when you need help?
I...I really do have work to do.
Of course.
The campus surgery is there for staff as well as students, you know?
It's good to see the students have got a new advocate -
I'll be sure to refer them in your direction.
Thank you, Liz. You take care.
MOBILE RINGS
KNOCK ON DOOR
Yes?
You wanted to see me?
This won't take a minute.
OK. I just wanted to say, the next time you have a proposal,
you need to run it by me and the partners
BEFORE you make it a public announcement, OK?
Now, Bear, there's no need to work yourself up.
Oh, no. You see, I'm...I'm not worked up.
You've got enough on your plate.
Let the rest of us take some of the burden,
that's why I'm here.
It's not a burden, it's...
One of my responsibilities is to make sure that
we're always on the same page and that WE don't undermine each other.
I'm sorry if you think I stepped on your toes -
that's the last thing I wanted.
My trouble is, when I see a simple way of improving things,
I want to make it happen so that everyone can feel the benefits.
We're always open to new ideas, but there is a proper procedure.
And I didn't follow it.
I can see that now and it won't happen again.
Liz. Hi.
Hi.
Do you want to come on through?
Don't overwater it. I won't.
And remember, I want a date for that dinner -
you and Luca.
You couldn't wait, could you?
After you kept telling me about this wonderful new man in your life,
of course I had to meet him.
And?
And what?
What do I think of him?
It starts when I wake up,
my heart races, I feel sick.
I can't remember the last time I slept through.
My head's too full of the problems
that are waiting for me when I get into work.
I start early, finish late,
it's still isn't enough to do everything I need to.
Is there anyone else you can talk to about this?
My partner used to listen,
but she's got her own problems at work.
Colleagues? They're as stressed out as I am.
The worse thing is, I love my job.
Working with the students is so stimulating,
but I just don't know how long I can go on.
Surely you can take some time off work?
I can't put any more pressure on my colleagues or abandon the students
who need me. You can't expect yourself to care for others
when you don't look after yourself.
Sorry. Um...
I'm normally on your side of the desk.
And if you were, what would you say?
That's it's time to let someone help.
And, you know, while we work on what we can do best, personally, for you,
how about setting up a meeting with my bosses - see if there's any way
we can take off some of the workload from your department?
What were you thinking?
A publicity push.
Now, I've had a look through
and, you know, despite all the positive messages,
it's not, essentially, very clear where to...where to go,
how to delineate from your services and the surgery's,
and I think that's something we should work on, concentrate on,
especially with mental health.
That would be really helpful. I'm glad.
I'm glad it's just you doctors, though.
Can you imagine if I had to peer review Karen?
No, that would not go down well.
I'm sorry, I can only give you a one for your patient interactions,
but you get a big, fat three for your death stare.
Yes, well, you may not be involved in the peer review,
but imagine how stressed the doctors are going to get having to do it.
And when the doctors are stressed...
Yeah, we get it in the neck. Exactly.
Anything you can share?
Er, Jamie just texted.
His mum ambushed us when we were trying to unpack.
Is that a euphemism? I hope you were on your best behaviour.
"Lovely young man. Perfect manners.
"Definitely a keeper."
Oh, he did make a good impression.
Yeah, three out of three for "good boyfriend material".
Yeah. I can't really blame her for wanting to check
that I'm good enough for her precious son.
I was terrible when Chris used to bring people home.
I had to know everything,
but then that's mothers for you.
I thought I'd be offended.
You know, Jamie's an adult.
What's our relationship got to do with her?
But it was actually a bit of a laugh.
Ben.
I thought that was you.
I was actually going to give you a call tomorrow.
About what? I've got my meds.
I've spoken to the Student Welfare Department. You what?
It's all right. I didn't give your name.
I explained your fears about being labelled. They want to help. How?
Well, it isn't too late to disclose your condition
and, if you did, they could establish whether your mental health
might impact your overall grades and performance. OK.
The campus surgery and the Welfare Department are going to be
making more of an effort to work together.
What does that actually mean?
In your case, we want to ensure that you have enough support so that
your condition doesn't adversely affect the next three years, right?
I still don't want them knowing about my anxiety disorder.
But if it could help you...?
I can come to you if I need to, can't I?
Of course you can... Then that's enough, OK?
If that's what you want.
You still need to make an appointment. In a week.
Then you'll give me another prescription?
I still want to look at other alternatives to medication.
Yeah?
I do have somewhere to be.
A little bird told me that these are your favourites.
Yeah, but...
Consider it a peace offering.
Do you want them,
or should I give them to somebody else? No, I do. Thanks.
But I am going to pay you back.
This is me saying that I know that I went about it the wrong way,
but that doesn't mean that my idea is bad.
Well, I'm just sure that Daniel and Zara are going to want to hear
all of the details. I've already sent it to them
and I've had a few thoughts about who to match up with who.
I thought these would be the most effective pairings.
What do you think?
Oh, yes. Er...
This...
This is going to be interesting.
Oh! Good! Good!
Hi, I'm Dr Clay.
Oh, are you, now?
Of where, exactly?
Damien was talking about me and my wife.
Honestly, just forget I said anything.
Us, in our old man pyjamas,
telling the dog off for jumping up with his paws.
I keep expecting a call with a formal complaint.
I need a Welsh consultant.
A Welsh consultant?