Covid 19

Learn from

Covid seems a long time ago…

… but for many, it will still be a vivid memory of loss, pain and anguish.

Hearing, yesterday, first-hand, from the then Prime Minister, at the Covid Inquiry about the inner machinations of mid-March 2020…

… how decisions we’re made, balancing public health, the economy, the potential failure of the bond-markets and the legal ramifications of ordering the closure of UK plc…

… it was clear, there were cruel choices. An appalling balancing act.

Whatever we might think of Boris Johnson, as a person, never mind Prime Minister, however irritating his haircut and demeanour, what we are seeing is what it was like to prioritise, make big decisions that have huge ramifications for people who were, often, the least resilient and least able to cope.

‘The nation was being overwhelmed by something that we were clearly not prepared for and had underestimated.

At the time, people made the best decisions they could, in a system not designed for such an emergency and somehow muddled through.’

Just 40 words that are really what this expensive piece of theatre is all about.

Forty words that could be a one page, one paragraph report. So far spending on the Inquiry has topped £85m.

It has struck me that the players in this national drama, each of whom has complained they were not listen to or their advice and views, at some stage or other, ignored is a graphic example of how balancing competing priorities is never easy.

Particularly when the choices have life changing implications for millions, curtailing liberty and freedom.

‘Priority’ is a word that should not come in a plural form…

… alas, I fear that is a loosing argument…

… but where you see the word printed or spoken in the plural, take it as an indicator of confusion and the inability of mangers and leaders to think clearly and do their job.

Anyone who has more than one ‘priority’ is someone who really shouldn’t be in-charge of anything.

Is government any different? The big departments of state, of course, will each have their priority. Defending the nation, maintaining a safe currency, educating the next generation.

All of those were swept aside by the arrival of Covid.

The principal ambition then becomes alignment, everyone working to the same goal.

All NHS organisations have a system for managing competing priorities… they are called Boards. They often find it too difficult.

In government it’s the Cabinet.

It is the job of the Board or Cabinet to define the ‘North Star’, looking beyond the competing priorities to the direction of travel for the whole organisation.

The interdependencies as they exist between health and social care is a good example of the failure to priorities.

One cannot work properly without the other… that is why there are ambulances queueing and wards congested.

The relationship and structures are a priority to resolve, that’s consistently ignored. There is no ‘North Star’… the care of people. Just two misaligned organisations muddling through.

Aligning resources to focus on a priority… for government the answer is easy. Print more money… not without consequence but very convenient.

For organisations, like the NHS, it’s not so easy.

NHSE has been obliged to end the departmental IT priority for the NHS to manage its systems more efficiently and safely with the use of technology and has taken money earmarked for IT development… to keep the system running and paying the bills. A priority.

As always when priorities are juggled communication becomes a word we cannot ignore. People need to know why and to trust the reasoning.

During Covid the three wise monkey approach, the five o’clock briefings from No10, on the telly lost their clout as messages were delivered by different people.

Consistency in messaging is in large measure dependent on who delivers the message. How we view them and trust them.

Politicians rate poorly yet night after night a succession of them popped up on the box.

Government was in survival mode, trapped between making the best decisions they could to keep people well and the economy alive.

Yesterday, we learned in the end, the battle with covid supplanted everything else, as it should have from day one. We lost time and lives trying to ‘prioritise’ more than one thing.

HMG thought there were two priorities, the economy and health.

There only ever could have been one.

If this Covid drama is to teach us anything, it must be; making a wrong decision, or delaying making a decision is a mistake.

In my view there is no great sin in making a mistake.

The sin would be covering it up or not making a priority to learn from it.

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.