09 September 2016
This Monday I commenced my 40th year working for and with the NHS and I have been reflecting on the previous 39 years (don’t worry I am not going to take you through them all in this note, that would be very boring!). However, my reflection is that the last 3 to 4 years has been, and is still, the most challenging period of my career to date and I guess many leaders will say the same. The question you may ask is why?
We cannot shy away from the reality over NHS funding levels, which reportedly are lower than the levels of funding in Greece. Austerity is really biting and the expectation is that we still provide the same services to the population for less.
The policy framework in my opinion is confusing. We have Sustainability and Transformation Plans (STPs), systems working together to solve system problems (which I think is exactly the right thing to do), and then we have individual organisational objectives that in many cases are incompatible with the STP aspirations and ambitions. We need to work together but the regulation system tears us apart.
You might argue, and I would agree, that leaders have a responsibility to make sense of this for their staff, but sometimes it is difficult to explain the inconsistences in a way that makes sense. You might also think this is a plea to others to “give us a break”, it isn’t – but it is about being clear on the reality we work in, deluding ourselves that everything is okay in the NHS leads us in the wrong direction. This is why teams are so important.
Last night I caught up with the second part of ‘Still out of their league’ – a TV documentary about Salford City owned by five former Manchester United stars. This demonstrated why the team was important. The team was going through a blip in form so after spending a few weeks berating the players for poor performance, the coaches decided to take a more softly, softly approach; encouraging people to do their best, to have no regrets and leave everything on the pitch. It worked and the team got promotion for the second season. What we learn from this is that even when the challenge is great (they had to win their remaining five games and two play-off matches to gain promotion) the team achieved because of a different style of coaching and the fact they worked for each other. The NHS can and should learn from this. We need to encourage our workforce to keep going but we must also work as a team even if it sometimes feels like the policy frameworks don’t help us do this.