Much has happened in the past few weeks. Firstly and probably least importantly CCGs have been authorised as new organisations. We are now the real thing. I am no longer an interim, shadow or designate. I am in charge and that is both exciting and frightening. More importantly the Francis Report has thrown a public spot light on the cultural issues within the NHS was all know are there and have talked about in hushed conversations between friends. A bullying culture…top down pressure to make the money work.. jobs on the line..
How could we ever have thought that it was okay to accept that at the top of the NHS somehow believing it didn’t affect anything important, only mattered to those in receipt of the pressure, when of course we all knew somewhere inside ourselves that it affected everything..
And I wonder how to change it. I am now a senior leader. It is my job to play my part in making the NHS a better place to work and a better care giver for patients.
So much of it is SO good. There are so many who work really hard to give a fantastic service to patients, often unsung, unthanked they just get on with it because it is the right thing to do. In all of this soul searching it is important we remember that. It is about growing a culture that supports the good and challenges the less than good to be better, to aspire to the best rather than accepting poor standards.
Leadership is key. WE need compassionate leaders, who lead by example. It isn’t possible to have one culture of leadership at the top of the NHS and expect that not to filter right down to the front line. If we want compassion and caring for patients then we need a leadership style throughout the NHS that delivers that at every level. WE need to understand that being caring doesn’t mean being soft. It doesn’t mean tolerating poor performance, laziness and lack of progress. It means we manage people as we would like to be managed with clarity, sensitivity, openness. WE need to be clear about our expectations of each other and we need to remember to praise people for the effort they put in and the successes they achieve.
AS a GP I have always tried to deliver the standard of care to patients that I would want for myself and my family. I am intolerant of poor care and I say so. I am sure that there have been times in my career when I have delivered less than best care. I am human after all. There are times when it feels so busy that I am concerned I cant give the person on front of me everything they need. I reflect on those moments, worry about them, and do my best to make changes to stop them happening again in the future. As a leader I try to do that same. I don’t get in right all the time but I am learning fast.
Collectively we have to have a strong shared belief that we can make a difference. That the culture in the NHS, even though it ia a huge organisation, can change. Bringing clinicians into management helps I think ( well I am bound to say that aren’t I?) Brining patients and the public into decision making in a real way is also vital. Developing an openness where we share our plans , our successes and failures is also key. And that isn’t about just having board meetings in public it is about talking at those meetings openly about the issues and challenges we face rather than just going through the motions ,and it is about getting out there and sharing with our public the really big and difficult issues we face and for which there are no simple answers. Should we fund IVF? If so where does the money come from? How do we decide between the many competing priorities for investment we receive, when there is no new money?
In the end rather than try to fix the big picture I will focus on trying to get it right here, in our little locality. That is a big enough challenge. If we are all doing that, all over the country there is hope that it will feed up into the centre from all the roots of the NHS…So it is about doing stuff differently and challenging the old ways… interesting that when I started writing this I wondered if it might been seen as critical by people above me in the NHS tree and then I wondered why that would matter if we truly are an open organisation happy to question ourselves and admit our faults….
So is this the begining of a quiet revolution?
How could we ever have thought that it was okay to accept that at the top of the NHS somehow believing it didn’t affect anything important, only mattered to those in receipt of the pressure, when of course we all knew somewhere inside ourselves that it affected everything..
And I wonder how to change it. I am now a senior leader. It is my job to play my part in making the NHS a better place to work and a better care giver for patients.
So much of it is SO good. There are so many who work really hard to give a fantastic service to patients, often unsung, unthanked they just get on with it because it is the right thing to do. In all of this soul searching it is important we remember that. It is about growing a culture that supports the good and challenges the less than good to be better, to aspire to the best rather than accepting poor standards.
Leadership is key. WE need compassionate leaders, who lead by example. It isn’t possible to have one culture of leadership at the top of the NHS and expect that not to filter right down to the front line. If we want compassion and caring for patients then we need a leadership style throughout the NHS that delivers that at every level. WE need to understand that being caring doesn’t mean being soft. It doesn’t mean tolerating poor performance, laziness and lack of progress. It means we manage people as we would like to be managed with clarity, sensitivity, openness. WE need to be clear about our expectations of each other and we need to remember to praise people for the effort they put in and the successes they achieve.
AS a GP I have always tried to deliver the standard of care to patients that I would want for myself and my family. I am intolerant of poor care and I say so. I am sure that there have been times in my career when I have delivered less than best care. I am human after all. There are times when it feels so busy that I am concerned I cant give the person on front of me everything they need. I reflect on those moments, worry about them, and do my best to make changes to stop them happening again in the future. As a leader I try to do that same. I don’t get in right all the time but I am learning fast.
Collectively we have to have a strong shared belief that we can make a difference. That the culture in the NHS, even though it ia a huge organisation, can change. Bringing clinicians into management helps I think ( well I am bound to say that aren’t I?) Brining patients and the public into decision making in a real way is also vital. Developing an openness where we share our plans , our successes and failures is also key. And that isn’t about just having board meetings in public it is about talking at those meetings openly about the issues and challenges we face rather than just going through the motions ,and it is about getting out there and sharing with our public the really big and difficult issues we face and for which there are no simple answers. Should we fund IVF? If so where does the money come from? How do we decide between the many competing priorities for investment we receive, when there is no new money?
In the end rather than try to fix the big picture I will focus on trying to get it right here, in our little locality. That is a big enough challenge. If we are all doing that, all over the country there is hope that it will feed up into the centre from all the roots of the NHS…So it is about doing stuff differently and challenging the old ways… interesting that when I started writing this I wondered if it might been seen as critical by people above me in the NHS tree and then I wondered why that would matter if we truly are an open organisation happy to question ourselves and admit our faults….
So is this the begining of a quiet revolution?
