It’s time we made a difference and folk stood up and made a bit of a stir. We need to stand up for each other and ask for better support in the workplace, more courageous leadership and honesty and transparency about decision making. Leadership in health care isn’t just about responsibility it is also about power and authority. Power and authority can be scary but it can be used for good and to change the status quo. It might be scary to have a room full of people hang on your every word but don’t give up that power – I have seen it dissipated in one sentence – a throw away comment that means that purpose and intention is not deeply rooted. A breeze might blow and the seedlings of intention are unable to survive. We need to time to establish purpose and meaning – it needs deep roots and nourishment in order to thrive and flourish. It is important to be sure as to why we are seeking new ways of working and that we are not simply disengaging with the mainstream because it is too uncomfortable. We need connection – in health care I see way too many very good people investing time and emotion into trying to right the wrongs but it all feels fragmented and superficial.

I believe we need to ask some difficult questions and examine the whole system – from how we prepare health care practitioners in our Universities to how we provide information to people using health care services. My recent observations suggest that there are too many assumptions, too much taken for granted and an ideology fuelling current policy that is testing many people’s loyalty. I believe that arguments about maintenance of the NHS are distracting and that it is taking the eye off the quality of care. It all seems like a huge problem but there is magical thinking everywhere I go – someone else will sort it out – a strong leadership is needed and if we have that in place then it will be very different.

NO it is about personal responsibility – looking after your own patch and making sure you attend to what is yours to attend to – not passing the buck or blaming folk – a combination of game playing and magical thinking is stopping progress and it needs to stop sooner rather than later. People need to be more self aware and examine the way they interact with others in the workplace and analyse taken for granted ways of communication and see if we can learn from this. Find out what works well and keep that, establish a way forward and ask lots of questions. Persist it asking difficult questions and repeat Why? many times – when we stop we don’t improve – complacency and  contentment are dangerous bedfellows in the pursuit of excellence and if folk are happy to just make do then we need to make it uncomfortable for them.

War metaphors seem to abound at the moment but I am sticking to my map making imagery – we need to explore it more and see if it helps us understand both where we have been and where we might go next. Fighting to improve care does not feel right to me and we need a gentler and more considered approach. Anger fuelling righteous indignation just seems to create competition and adversity – it shouldn’t be about competition – it should be about cooperation and collaboration. Let’s start being honest about our scars, wounds and vulnerabilities instead of appearing fearless and perfect. We need to find ways of working together and then we can make a difference – north and south, patients and professionals, to me communication and clarity are key and I intend to start now.


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