Sunday, March 30, 2014

Awards..why do you bother?

"Awards..why do you bother?" I get asked this question a few times ..or at least I used to but it seems to have ceded a bit nowadays. When we started off on our model of care, plenty of  scepticism, plenty of comments about how this was all about spin, showcasing things a bit better...but I suppose 3 years and a bit later, the support and public backing of our CCGs, colleagues across 80 surgeries along with acknowledgement from NHS England etc...there has been a degree of perhaps grudging admiration from the old guard....when you have continuous and daily requests from CCGs across the country, you know we did something perhaps different, something perhaps a bit bold. We created a name for it "The Super Six model"..while in reality, all it was was changing the definition of a specialist, using their role as an educator, providing support for primary care- as and when they needed it, on their terms, not ours. That was all- and for that, as I have always said, I am eternally grateful for colleagues in the department, in primary care and commissioning roles taking that leap of faith, believing that this cocky, long haired, unconventional fellow wasn't trying to make more silos but was fuelled by a genuine desire to get back to those golden days when a GP was a friend with a different skill set, nothing more and nothing less.

Which brings me to the awards. Over the last few years, we have won,as a department a slew of awards...local, national...you name it, we have been there....HSJ, BMJ, QIC, Guardian Awards...some amazing nights with our team..driving down in a limo with the team and enjoying a fabulous night out. So the question is why? Has it just been about the prestige of winning an award? All about showing off? Well, let me let you in a little secret. One of the main reasons for it can be summed up in 1 word....Morale. The NHS has gone through an absolute battering and some of it has perhaps been justified but a few rotten apples don't make the whole barrel bad. And however much your passion to improve care, your drive to get things better..at some point, at some stage, even the best amongst us will wilt..especially when you are told incessantly that your best isn't good enough. As Consultants, don't get me wrong, but we have plenty to fall back on when the going gets tough..for starters, the salary ain't bad, neither is the pension in the future, neither are the opportunities for CEA awards, private work etc...

However, to a nurse or an HCA or an administration person within your department, it really ain't so. Morale is a key element to make things tick..and what awards do, is help recognise that you do indeed do a good job. What recognition on a national level does is show to themselves that the work you do is comparable to the best in the business. I say so as a lead of the department for over 5 years now..morale shoots up in leaps and bounds...you only need to see the beaming smiles to appreciate what the impact can be. Its uplifting, throws some sunshine on the work you do....and the resultant impact of that..a galvanised workforce striving to take things to the next level. The NHS has always believed that excellence is the norm and thus nothing to shout about...unfortunately the flip of that is that when you have detractors are keen to expose the darkness of failures, you must, absolutely must, have the chutzpah, evidence and strength to counter that with the light of successes.

Other bits? Recognition amongst your peers and even the Trust. You get to be recognised and known, as well as respected as a blue riband service- if you don't think that's important, look at trusts or areas where services have been disbanded because there is no evidence of it being "good enough" or "it's need". It's not the most clinical or politically convenient decision to disband a team which attracts kudos for the trust or is feted in the national arena as a pocket of "excellence". All subtle but important bits to recognise if you are trying to improve patient care. You can shout yourself hoarse about patient care- but you can't provide much without the existence of a well staffed or well motivated team- it's as simple as that. Over the last few years, with the blessing of our local CCGs and our trust,we have blossomed and the fact is that we actually do not have a staffing issue. 

Which brings me to the reason as to why for the nest few years, we,as a team, are likely to stay away from awards. Why? Because the purpose of morale, recognition and building a team has been served. With the cocky confidence that has been my trademark, my calling card and my nemesis, after 5 years as Clinical Director of Diabetes...let me unsheathe that sword from the scabbard one more time to say this....if you haven't heard about the work the diabetes team in Portsmouth are doing, then with the greatest respect, you aren't or shouldn't be involved in diabetes care.
Now its time to consolidate, now its time to get down to the business of making diabetes care for patients the best possible. If in spite of all the resources, we can't deliver, then the fault is mine as the spearhead of the department. If as a leader you are ready to pick up the bouquets, build the case for a well stocked workforce then you must be ready to take the brickbats too if you can't deliver- as simple as that. And I have been incredibly enthused by how the nursing staff and colleagues have responded to that...each area is working on doing things differently...the Hypoglycaemia Hotline has been one, the future developments of the adolescent service an exciting area...the renal service plans etc...I have been amazed by the ideas and drive. 

And THAT'S what awards do. You won't probably see the merry band from Portsmouth much at the ceremonies in the next few years...but when the time is right, we will be back. Till then, we have a job to do for our local diabetes populace.

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