I think if a left wing trouble maker like me was the Health
Minister and I had to appoint someone to review the culture in the NHS with a
view to protecting patients from the kind of treatment they received at
Stafford Hospital in the Mid-Staffs NHS Trust, I’d probably appoint the most
critical person I could find.
In my case it wouldn’t necessarily be an American,
free-market neo-con fiscal conservative, fundamentally opposed to ‘socialised
medicine’, but I’d be looking for a real critic.
Seriously, it’s time for criticism and then changing things.
In fact, Professor Berwick (President Obama’s healthcare
advisor) is clearly sympathetic to and supportive of our NHS. I love where he’s
coming from but I fear he’s just a bit too
sympathetic.
Perhaps that’s why a conservative health minister who has
failed to follow the important recommendations of the Francis enquiry appointed
him.
This is from his letters to Clinicians, Managers and Staff:
“For the
nearly three decades that I have been able to observe and work with the NHS,
nothing has impressed me more than you – the workforce of 1.3 million people
who are trying to make real a vision of a vital, universal health care system,
accessible to all, and free at the point of service. Your nation’s commitment to
health care as a human right and to healing as a shared mission is second to
none in the world. And all of that is possible through you; only through you.”
This is from his letter to the Government and includes the
ideals he wants to see governing policy;
“A culture
of learning can….. and the likelihood of such a culture’s thriving in the NHS
depends, more than on anything else, on how you, the senior leaders, behave,
speak, and invest.
These are
four guiding principles that, I suggest, should inform every step you take in
these matters – in what you think, say, and do:
● Place the
quality and safety of patient care above all other aims for the NHS. (This, by
the way, is your safest and best route to lower cost.)
● Engage,
empower, and hear patients and carers throughout the entire system, and at all
times
● Foster
wholeheartedly the growth and development of all staff, especially with regard
to their ability and opportunity to improve the processes within which they
work.
● Insist
upon, and model in your own work, thorough and unequivocal transparency, in the
service of accountability, trust, and the growth of knowledge.
Time and
again in our Group’s deliberations, every member used the word “culture” to
diagnose both the faults of and the possibilities for the NHS. I urge you to
focus on the culture that you want to nurture: buoyant, curious, sharing,
open-minded, and ambitious to do even better for patients, carers, communities,
and staff pride and joy. If you read our recommendations carefully, and act on
them, I believe that you will have set your compass right.”
This is from his letter to the people of England;
“What you
do have in the NHS is something that most other nations in the world don’t
have: a unified system of care that is completely capable of identifying its
problems, admitting them, and acting to correct them.
That is the
process now underway; that is the process that led your leaders to convene our
Advisory Group; and that is the process that can and, I believe, will help the
English NHS to emerge over time as one of the safest health care systems in the
world.
That is not
easy. And it gets even harder if the staff of the NHS experience a culture of
fear, blame, recrimination, and demoralization. I hope that you resist such
general negativity, in yourself and anyone else, and instead clearly point the
way with energy and optimism toward the care that you and I want, and that the
vast majority of people who work in the NHS want to offer.”
And this is what he wants us to be doing in future;
“patients,
carers, and citizens – have a vital and exciting role to play. Your voice is
key to the future. I hope that this report will give you more confidence in
speaking up everywhere and all the time in a vital NHS, and will give those who
care for you and want to help you the confidence and skills to invite you, hear
you, and welcome you into authentic partnership.”
When I hear references to ‘culture’ in the NHS, I just hear
an echo of Sir David Nicholson’s voice going on and on about ‘NHS culture’. That’s
something you can read for yourself in his Blog and his interviews. I’ve been
following his progress as he’s been winding down (yawn), doing a valedictory
tour (thank you, thank you), cementing his legacy (groan).
Frankly it’s not just about culture but I’ll come on to that
later.
Neil Harris
(a don’t stop till you drop production)
Home: helpmesortoutthenhs.blogspot.com
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