I have a thousand other things to do. As you do. I shouldn't be doing this. You probably shouldn't be reading this either. So many other things. This is a waste of…
After thirty odd years (very odd) in healthcare, I have realised that there is only one thing that we all need to ensure the NHS survives, that will help patients and carers to be true partners in health and healthcare, that could aid collaborative working, the building of a wonderful new world where we all work together to change things.
I have read hundreds of articles, books and learned reports on improvement, change, organisational development, transformation and improvement. Slick words, PowerPoint presentations, infographics… I have absorbed thousands of principles, concepts, frameworks, speeches and pontification. And I have added my penny’s worth to the engagement industry. I have forgotten most of it.
I have run Board seminars, training events, conferences, open spaces and fancy interactive workshops. I have worked with people with mental health problems and other life-changing illness, injury or disabilities, with clinicians and admin staff, with leaders up the top of local, national and international organisations. Yes, this sounds like a boast. Maybe it is, but that’s not the point really.
I’ve learned loads. I know it mostly boils down to relationships and being kind. I know also that I’ve never met a deliberately unkind professional or patient. Everyone is doing their best. I know there are one or two nasty people out there – plagiarists and spoilers. But usually there is a reason behind their nastiness that is more about their own stuff. I know. I’ve spoiled things too.
I know that in the middle of most events I run. In the middle of most books I read. In the centre of people’s consciousness at work – at the heart of being a wonderful professional, in the midst of a conversation about better ways to work together to improve…. There is that moment, when somebody says or writes the words, recognises the key to it all, when there are nods in the room, when there is a nervous and slightly hysterical (but usually suppressed) moment of group cohesion. When somebody says…
“But we don't have time”
And then we skate over it. We carry on making plans, we carry on winging it, we write reports based on insufficient data, speed up rather than slow down, go back to the thousands of emails that have been building up, make those phone calls, sort out the crises. And carry on as we did before.
We try to hang on to the words, the leadership frameworks, the ideas that came from the conferences, the intention to do more work together to improve stuff. But just like returning from holiday, the memory of the blue sky fades. The rush takes over.
We don’t really talk about lack of time to do stuff. There is no time to talk about the lack of time. To deliver. To improve. To change. Creativity depends on the pause. Ask any poet. Without quietness, reflection and time 'to be', we are (the NHS is) lost.
Unless improvement methodologists, patient and staff partners, change merchants (like me) recognise this and do something about it – I am not sure what – then all the good will in the world will wither away.
I am sure now, after two years working as a Patient Director in the Sussex MSK Partnership, that this is the ONLY barrier to my work. Busy professionals, clinical and admin staff, patient and carer partners, in our organisation and the CCG and more widely don’t have enough time in their busy days to do more than they are doing, let alone take part in my worthy endeavours to add to their responsibilities – their ‘burdens’ – to be even more patient-centred.
That’s one reason I always say my work is predicated on the principle that ‘patients and carers can help’. But most of them now accept that. They have seen our fab patient partners make a difference during redesign work, in governance groups, etc. When there is a tiny slice of time to come together.
We all want to be better. We all know that, together, we could improve things. Yes, we need more money, more ‘capacity’, more ‘capability’. But mostly we need that thing we are perennially short of. More time would bring the other stuff as a consequence.
No more nervous chuckles of recognition. No more passing over the difficult issue.
I am a big fan of the ‘slow food movement’ and believe there is the rising of a ‘slow health movement’. It's time to take time seriously. As in our lives, we need to slow down. As in my life, I need to take time to avoid another breakdown.
Can the NHS avoid its own nervous breakdown? Can you? Now, back to what I was supposed to be doing. Oh shit. Ten more emails….
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© David Gilbert 20117