Friends

I see there’s been another shuffle in the acronym department.

The DHSC+NHSE have secured the future of their top brass. (Their latest organigramme is below).

Here’s a list of their ‘top management’ who won’t be worrying about their futures.

Unlike the thousands who have come to work this morning, not knowing if they’ll have a job by Christmas or perhaps next April, because…

… as far as I know, the enabling legislation to demolish NHSE is not yet in the drafting stage…

… plus the consultation that’s required in law…

… plus the terms and conditions for civil servants are different to the public servants’ conditions of the NHS.

People will continue in limbo.

Perhaps it’s worth pointing out;

‘…UK government borrowing in August hit the highest level for the month, in five years… £18bn… tax and NI receipts… outstripped by higher spending on public services, benefits and debt interest…’

That’s Treasury speak for… there ain’t no money.

What do we do? Pause the chaotic reorganisation? Dump the ten year nonsense? Too much pride invested in all that… but we could recalibrate, pause, reflect and…

… think about the Five Ps.

1. Prepare for change

Things change all the time. Often in little ways. Sometimes for the better, sometimes not. Every once in a while a big change arrives…

… game changers, like electricity. It wasn’t until the 1930’s it became commonplace in every home…

… step changes, in 1994 the general public started to access the Web and…

… wow changes, 1999 when Apple released their first mass-market consumer products with built-in Wi-Fi.

Change can be like a chaotic, noisy nightclub… flashing lights and a thumping beat. The only way to make sense of it is to join in and dance!

Our big bang change is machine learning, bound with natural language computing to give us the beginnings of artificial intelligence…

Goodbye routine, repetitive work.

Administration, swept into the bin, alongside lamp-lighters and chimney-sweeps.

Decision-support redefining work, what work, whose work, how is work done, but…

… artificial intelligence is smart enough to know; clever, qualified people will always be in demand. As will caring people, with insight, skill and compassion.

For the NHS, a predominantly hands-on service, it means investing in people. The extent to which we do will define the health services of the future. Which brings us to…

2. People.

Great things will be done by machines but greater things will be done by people.

The NHS is our biggest employer and should be a trendsetter. Alas, it is brutal. It exploits its monopoly of jobs for clinicians and medics and the fact it’s the biggest workplace in most of our communities…

… 75% of NHS staff are women.

That often means they are the principal carers in their families. Recognising that should mean the NHS is a female-friendly employer.

I’m pretty sure we get nowhere near it.

We need to ask what do we have to do to make the NHS the workplace of choice. Which makes me think of P number 3…

3. Principles.

Integrity and good old-fashioned honesty… the glue, fuel and foundation of any organisation.

The NHS is an intricate place filled with huge risks. More than a million people come through the doors of hospitals every day. GPs see that many and more. It’s foolish to think each patient will have a good experience.

Something is bound to go wrong, for somebody.

A brutal regulatory framework means mistakes get buried and we don’t learn from them. Regulations grow like weeds. People are frightened of the consequences of owning up, terrified if they don’t and petrified to speak out.

A no-blame culture seems a long way off.

4. Perspective.

Life is about perspective. How we look at things creates the framework for the decisions we make and an understanding of the unintended impact they might have.

For instance, the league table fiasco…

… excellent Trusts plunged into a third-rate listing because in a demand-led service, they’ve done more work than they’re funded for and run into financial trouble.

The tables are nothing to do with the public. They’re everything to do with NHSE clawing back deficits.

This narrow perspective, prioritising financial metrics has created tables that undermine confidence in Trusts as an employer, as a service provider which impacts donors to hospital trust-funds.

Reputational signals do matter. Skewed data representing Trusts as poorly performing creates a double hit; first reputation and second if that reputation implies a poorly run organisation, it makes it harder to galvanise local giving. It’s called evaluability bias. What influences charity giving?

Finally…

5. People we serve.

The NHS is a tangled web of vested interests, people and organisations with their own angle, their own drum to beat.

Suppliers who claim millions in savings if only we’d buy their stuff.

Trade organisations who dare not say what’s true for fear of ‘not being in the tent’.

Royal Colleges who cost a fortune and say little of value.

Regulators whose main aim is to show how tough they are.

Think tanks who seem to have stopped thinking and,

Lobbyists who will tell you anything…

… it’s easy to forget, the purpose of them all is to serve the people who, one way or another, pay for it all…

… the patient, their families and friends.

News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at thetrainingnet.com by kind permission of Roy Lilley.