What a difference a day makes

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It hasn’t been a particularly good couple of weeks in the land of CCGS.. nothing big really but lots of hassle that makes doing the job difficult and  increases stress… no amount of zumba can take away the stresses of not being able to get on with the job because we don’t have phones or emails  and it is amazing how much time you can lose trying to retrieve lost diaries…

But.. then we had Tuesday and an “open  space” event… about care for older people.. I have never been to one of these before and  it was new to most of us and a bit daunting… no sitting  quietly in the back of the meeting planning quietly what you are going to cook for tea.. no this was all about full on participation .. listening and contributing…It was part of a piece of public engagement we are running called “fit 4 the future” and  involved all our local stakeholders.. public.. private ..voluntary… it was great . 70 people came and there was so much energy and  positivity in the room. And I thought that I wish our  public could see this.. see how passionate the people  who work in our many services are. How much they want to make things better, that despite cut backs  and staff shortages and  so much negative coverage in the media about older peoples services these people really care.

People had lots of ideas…some new…some a little off the wall…So much  of what we talked about was about how we work together  across the organisational boundaries that divide us to do the right things and make it better…accepting that there will always been boundaries somewhere and  it is easy to use these as excuses to do nothing…

And we talked about how many times we have all been here before.. said the same things before… can it really be different this time?

Well.. yes I hope so.. and I told my  story about the patient who came to see me for help giving up smoking.. they said sheepishly… well I have tried 4 times before and FAILED… and my reply was as it always is.. they were not failures they were rehearsals…. So lets hope that just like the smoker desperate to give up… we desperate to get it right this time can learn from all those many rehearsals we have all participated in before. .learn from why they didn’t work and  get it right ( or at least most of  it) this time…

So I went away from that day feeling tired but so much more positive.. buoyed by the commitment of so many people who just want to get it right and who despite everything care so much…

All Change!

So here we are… finally the real thing. Lots of people have asked  me “How does it feel?”…. Well the answer is for me personally .. not very different really in that we have been doing the job for the last 18 months or so.. but now I guess the buck stops here….with me, and that feels big!

What has been interesting though has been to watch the architecture of the commissioning ( buying services) part of  NHS  be taken apart and  rebuilt  gradually over the  last few  months picking up speed towards the deadline….and  how complex and difficult that has been. Now we have gone past the date when it all had to be rebuilt and ready for habitation… we have discovered  we need bits we cant find and  bits that we have that aren’t ours but don’t seem to fit anywhere else.... like one of those old jigsaw puzzles you find in a dusty cupboard … some pieces missing and some pieces that just don’t seem to fit anywhere…

Just to make life even more interesting many organisations have recently moved home ( we have moved from old PCT building to share  with our local authority) and along with that comes phone and IT chaos lasting weeks ( no landlines for 2 weeks, slow or absent internet access) …. And then .. just to top it all for some reason someone decided that Aprils Fools day would be a great day to migrate  all staff from one email system to a new one… with new addresses.. less functionality… marvellous!

And the day job has to go on.. despite lack of computers of telephones contracts must be signed, plans made, savings made.. the clock is ticking..

It has not just been us that have been confused… We  received a letter from a patient who was appealing against a decision made early this year by our PCT individual case funding panel and ,because of  reorganisations, her case is now being dealt with by a new and much more remote part of NHS England, involving a whole new set of people. And she is confused and I don’t blame her.

And I ask myself… surely we could have done this better…such big organisational change  means new jobs, new  roles, new colleagues, new challenges feels difficult.. painful.. confusing…uncertain… Surely the NHS -which does this so regularly-should be getting better at learning the lessons and at least do the structural bits efficiently and swiftly, which might lessen the pain.  Maybe the problem  is we lose so many good  people each  time we shake everything in the snow globe up again , and there are few  people left with the memory of the past and  those who are left worry about being seen to be  overly  negative..

It will get better, and in a whole this will seem like a distant memory we can laugh about…Lets hope there are enough of us left next time ……