Sunday, March 23, 2014

Blog 100...#whatyoudone

As I sit down to write blog number 100 over a lovely cup of coffee, you go back to that first blog, done while sitting in a cafe on the Champ Elysée...thinking it would just be my personal reflections, a space to vent...and over the years, it has been just that and perhaps a bit more, perhaps even got one person to think and reflect..who knows..perhaps but it has indeed been cathartic if not anything else.

Anyway, today's blog is more about what I have noticed ever since I have been a Consultant, no- let me take it back..ever since I have been a trainee- and I have smiled wryly at times, sometimes shaken my head and walked away, sometimes even made some sarcastic comments in close quarters..nothing more. But today, let me put this in a blog.

The NHS is full of leaders, full of people who love giving talks, love preaching, love exhorting others to work differently- which is a good thing indeed- what's wrong with that, I hear you say? Well nothing much, except that I have a certain allergy to hearing those speak or preach whose own track records are not much to shout about. I have no problem in listening to the enthusiasm of youth who have started early and are keen to sweep you away, inspire you in their wave of enthusiasm to improve patient care (cue the Natalie Silveys of this world) neither do I have any issue in listening to the experience of age attached to the flag of a shining track record and a slew of patient care focussed achievements behind them (cue Don Berwicks of this world)...the problem is the NHS either spend a lot of time blocking the flush of youth or have few of the seocnd group. 
We have plenty of leaders- the very same folks who get recycled, who have been a part and parcel of the system they keep exhorting the rest to change, keep encouraging others to work differently but when you actually try and look at their achievements or what they have done, then it all looks a bit..how shall I put it...sparse. 

Let's look at an example..Medical Modernising Careers- universally feted as revolutionary idea which would transform medical training, now also accepted as a disaster which destroyed many a career. The pioneers of that radical idea? Still around, perhaps a few CEA points richer...still advising about education..the circle of life goes on undeterred. How about our own speciality? Universally now accepted that diabetes care could be better..if you don't like data or don't believe what the National Diabetes Audit says, go to social media and listen to what patients say. Big "national" voices now exhorting us to "move in the community" when I have sat in meetings in years past and listened to them snigger at the "poor care" primary care provides. I still recall the denigration and snide remarks when we set up our model of care...how it would compromise patients...and today you can wryly smile when their own CCGs ask us for opinions, the same power houses laud us for our innovation. Having respect for primary care isn't innovation, folks, its simple courtesy.

You know why I say this now? Because I am tired of every sphere of healthcare being infested with individuals who specialise in lecturing but have no track record to boost. So I have now decided that in every meeting I go, if the speaker/exhorter/leader isn't someone young who is simply trying to infuse you with enthusiasm (always time for that!) then I will ask "tell me what you have achieved for patients".Tell me one thing that the system or patients thank you for...heck since we now have a hashtag for everything, even start something up like #whatyoudone.

And I exhort each one of you, whether you are a patient, a doctor, nurse, manager- anyone who is passionate to improve patient care- to do the same. 
If the person who is asking you to do things differently has never done so before or even left a trail of past failures, you need to ask whether that's someone to follow, whether your own idea, innovation and enterprise is better served by following your own heart and belief. Ask them #whatyoudone. Something, anything outcome based, anything patients liked, felt it improved their care....

In the words of Peter Drucker.."Effective leadership is not about making speeches or being liked; leadership is defined by results not attributes". The NHS, in these times of uncertainty, needs that sort of leader, not ones who are using the tag as a strap line to justify their existence.


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