The people at the top of the NHS, it is widely thought, have it so easy. If they just had the sense to engage with the public and front line staff then they could make things better, cheaper and more efficient.
The people on the front lines of the NHS such as junior doctors, nurses and physiotherapists also have a widely held belief – that they can’t make change happen. Patients are mostly the same as well. “What can I do?” they say.
If only patients and staff could yell at the people at the top and tell them how hard they have got it, the thinking goes, then maybe change would happen.
How can staff and patients possibly create change when no one listens to them? When they don’t have any money? When they’re just a tiny cog in the system? When speak of innovation and creativity is often met with fear and disdain?
If this is the case then only the people at the top must be able to create change, they say.
The fact is that the people at the top realise that they have a budget where they have a whopping 1% devoted for software and 0% for innovation and creating change. If the people at the top decide to innovate and blow some of their budget on something new, then it better have a big impact, it better be nationally scalable from the get-go and it better deliver on all the outcomes promised. If they don’t deliver on this impossible promise then it’s their head on a pike!
You see, the people at the top are paralysed. They can’t do anything because they know too much about the wrong kind of things and they are risking their livelihood if they put their name on something that doesn’t work.
The patients and front line staff, the ones that pick themselves to make meaningful work are the people who will create change. The problems and barriers we face are not nearly as big as what the people at the top face. This is a lie that front line staff and patients tell themselves, as taking responsibility for something much bigger than their role is a tough pill to swallow.
When I was a Junior Doctor at St James’ Hospital in Leeds, I had the great pleasure of working with the late Dr Kate Granger. She started the “Hello My Name Is….” campaign. The reason she started the campaign was because she had terrible experiences of doctors not introducing themselves during her illness. On one occasion the doctor that told her that her cancer had spread left her “psychologically scarred”.
She went on to say at a speech:
“I had been moaning to Chris (Kate’s husband) about the lack of introductions from the healthcare staff looking after me. Being the practical optimist that Chris is, he simply told me to ‘stop whinging darling and if it is that important to you do something about it.’ So we did.”
It wasn’t Kate’s responsibility to do the campaign. No one gave her authority to start a campaign. She simply didn’t have to do it. But at that moment, she picked herself and decided to make change happen.
She didn’t know that her campaign would end up being endorsed by the then Prime Minister, celebrities, about half a million NHS employees and result in her being awarded a MBE.
The reason why the NHS is so broken is because there aren’t enough people like Kate who pick themselves. But anyone can pick themselves. And it’s as simple as saying “I am going to make change happen”.