Last Wednesday I travelled up to
Gateshead. Not to enjoy the scenery but invited by the local CCG
to discuss diabetes care. They had read about our local model and wanted to
know more…so off I went with my slides which went through our local journey
since 2009. The story of negotiations, the story of umpteen meetings, the new
changing NHS resulting in changing personnel, need to engage, shake off the
image of the Consultant stuck in their “ivory tower”, those long hours away fro
the family, the nights of self-doubt gnawing at one’s impenetrable self
confidence…nearly 4 years later, the results are starting to trickle in. And so
far, so good. Cautious optimism is probably the way to describe it best…the
usual cavalier version of Partha Kar would love to say “told you so”..the
slowly ageing, a bit more battle hardened version wishes that the leap of
faith taken was not in vain. Innovators fail…but the present NHS provides no
time for that. No time or even forgiveness for failure.
We did our introductions around the table- and I was fascinated by the mixture of people there…there was the finance person and general manager from Medicine, there was the acute Trust Consultant, there was the
CCG lead, the CSU staff, the Commissioning development manager…they
were all there….in one room. And what struck me was the sheer will to try and
“make the necessary change”. We discussed ideas, I answered all the questions-
then someone seemed to have a light bulb moment within the finance team…and
looked like something had unlocked. The meeting concluded with a lot of
positivity, set times to take things forward and I left passing my best wishes
on. The hardest task begins thereafter….trying to convince the vast swath of
primary care to work differently, the specialist team to be open to the idea of
virtual support, the need to show hard outcomes but it was a start. There was
hardly any animosity in the room, yes, the usual banter amongst Trusts and
CCGs/ CSU…but little malice. These guys wanted to
make it work.
It is amazing how far apart that world is from the constant talk of failure, obstinacy and obstruction one hears, whether it be on social media or in conferences. There seems to be an abundance of folks who want to do the right thing, but somehow struggling to do it. Conferences specialise in speakers having sound bytes, policies specialise in stating the blinding obvious…but somehow there is no doing. Somehow everyone wants to wait for the system ot the model to be “perfect”..I say…No…sometimes it takes a leap of faith. Go and do it. Talk less. Just do. Try and use the “N” in the NHS and learn from each other. We somehow need to learn to separate the ideology from the reality. Somehow you get the feel that ideological passion from some quarters wants either everything to work perfectly (didn't we tell you privatisation was good?) or pretty much nothing to work smoothly (told you privatisation was evil). You know what? There are plenty of people who aren't polarised in their views, they occupy the middle ground, look at the ideological rhetoric with a healthy degree of cynicism and just want to do some good for the patient. Just because you want something to work in the “new” NHS doesn't make you an anti socialist, there is also the off chance that person is keen to make it work in spite of the pressure on the system.
So ladies and gentlemen, give it a try. Look after the patient who sits in front of you or in the bed in front of you, look after the staff you work with or for, smile a little bit more- and try and make the best of what you have. It’s going to get tighter but “no chance of improving patient care”? Don’t sell me that line. The British, I was always told had an inner sense of self criticism, stoicism, the black humour element…all of which are in abundance over social media- but I was also brought up being told that they had a spirit to stand up against adversity, any adversity. We have attended enough meetings, heard enough about integration, collaboration, coordination…now is the time to do something. A little less chest beating about how’s its all going to go up in smoke.
By all means, support the NHA party if you wish, by all means sign up petitions if you wish- but also go find a manager or a GP or a counterpart in your trust- and see what you can do to get patient care just that bit better...over a cup of coffee or even a friendly beer if you wish. Either way, just do something. Why not use the time a bit differently rather than blame the "system"?
To quote Castro “It does not matter how small you are, if you have faith..and action”. So very true.