Tuesday, May 19, 2015

Priority

Those who know me can vouch for one thing. I don't do pessimism...very rarely....mischievous? yes..wind up people?...always with a smile...but pessimism? Nope...its all about the art of what can be done. I am not even going to try and do mock modesty but backed by supportive CCGs, primary care colleagues and just a ridiculously good team, we have achieved changes in diabetes care- which others have looked at with admiration or jealousy..depending on the personality. And we have carried on regardless...

But you know what..in spite of the obvious blazing confidence, in the heart of hearts, you know whats coming over the hill is making that all-confident smile get tinged with a bit of wryness, a bit of grimace is probably starting to set in. And it's not the politicians or the media who I am sceptical of..they are doing, what their ideology drives them to...that's life, thats the harshness of what we live with. Have said before, a change in political colour would have made no difference to where we stand  now..so its not about petty politics, its not about ideology- though some may choose to differ..the fact remains that no one and i mean no one had the foggiest idea or bravery to set out a discussion with the public that maybe, just maybe we can't deliver everything anymore. Just start the discussion that the NHS has had a great ride, its been amazing but its now time to be realistic and its no longer everything for everybody. At nearly 67 years, the time to dial things down may indeed be here.

My annoyance and pessimism is centred on those leaders within different quangos who post elections have continued to say it will be fine if we work differently. Don't ..just stop saying that. ..stop using words like "transformational change" without saying we need to change contracts; don't use terms such "boat-rocking" without saying that "we need cheaper alternatives". Be honest...be open...stop using studies to counteract views of each other...of course be positive but with a dose of realism too.

People talk about efficiency drive...what does that mean..would you give up a backroom staff of your organisation? Patient centric...well...have you actually involved the patient? Have you been honest to say that somethings can't be delivered? Come on ladies and gentlemen, good to pick up awards, attend glossy award ceremonies (I have attended a few) but at least come back to your staff and be honest. Don't sit in the echo chamber of Twitter and say "we simply need to work differently".

The dishonesty about it all is now starting to grate a fair bit- especially on twitter. There are few folks in the NHS who genuinely believe this will survive as things are. 7 day GP working is coming- whether with support for Physicians associates or not. 7 day hospital service is coming- rightly too...but let's be honest to say what will now stop. We must otherwise we are colluding and misleading patients who believe we can still provide all.

I wil finish with giving an example of diabetes. Overall, the quality of care in this country is average- due to a combination of factors..can we improve it? Possibly not everything but we may have to prioritise and decide what to aim for. I strongly suggest in your own areas you all start thinking of what needs to stop. There will be some who will want to provide all..as "that's what we do". Just one thing...when you burn out, even the few who would have benefitted from you, don't any more.

Time to think, time to challenge clever word play, time to be honest. Time to think whats high priority and focus resources on that, maybe not everything

2 comments:

  1. Partha, agree completely. Believe that health delivery colleagues would also agree. However, the group which could sway public opinion and which continues to promote the nostalgic view is the great British press.... Change their position and then realism may start to permeate.

    ReplyDelete
  2. Partha, agree completely. Believe that health delivery colleagues would also agree. However, the group which could sway public opinion and which continues to promote the nostalgic view is the great British press.... Change their position and then realism may start to permeate.

    ReplyDelete