Friday, June 21, 2013

The bubble



I have come to a finite conclusion. I live in a bubble. A bubble full of weirdos, unnatural people, a bubble where utopia is only but a stones throw away. A bubble where things aren't all in meltdown, a bubble where people are..happy, proud to be doing their job, come to work with a smile. and this world is magical where everyday brings new challenges, challenges to which answers are actively sought, resolve one and move on to the next.

Magical, isn't it? Did I also hear you say unbelievable? Did I hear you even mutter something about this state only possibly being induced by pharmacological intervention? Heck I have even heard about folks doubting those who shy away from the cynicism, that they cannot be taken seriously, they have no sense of realism. And perhaps all that is true, perhaps I DO wear rose tinted glasses but everyday I walk into work and do enter into that bubble...in the diabetes department. I have wondered for long why that has been the case. many theories, many conjectures...all the PowerPoint bullet points about an effective happy team followed to the T..maybe it's that...but there's something else.

Recently I went to a national meeting..where a significant amount was dedicated to bashing the previous managers within the PCTs and now in the Clinical Support Units. They evidently "knew nothing". It was laced with comments about the CCG leads too..why didn't the GPs go back and look after their patients rather than try and devise pathways?On the train back, I went on twitter and saw how "CCG leads etc were clueless" and as is the wont armchair critics continue to have a field day. Anyone to actually step up and do the job rather than criticise? Nope...so much easier to criticise Rooney for missing a free kick while munching on a pasty, isn't it?

Let me now take you back to this amazing bubble. In this bubble, I have met umpteen managers and clinicians for whom I have nothing but respect for at least stepping up to the plate in the most challenging times the NHS has faced. In this bubble, they have been fabulously supportive, been with me, the model of care outlined,all along the way. GPs who haven't pretended to know everything, but have listened,reasoned and helped deliver a care pathway which we inherently believed would help patients, was the future, was the way ahead..specialists supporting primary care, not isolated in silos. Majority of the country still talk about integration, attend meetings, take notes....South East Hampshire and Portsmouth CCGs went ahead and did it. and what about the managers? Those dastardly lot we doctors love to hate..the ones who once sacked will solve the financial crisis of the NHS, the ones who are the soft targets of the politicians. Firstly I have news for you..without good managers, you cannot deliver a good clinical service. If you think you can, that's naivety and disrespect for individuals whose job pressures you do not understand. Secondly, come back to my bubble for some news.

In this bubble, these managers have been as much committed to making things happen, helping deliver clinical care..and this week reinforced that. Any clinician worth his or her salt will tell you how many obstacles are there or put in your path to deliver good clinical care..and this week, I needed the commissioners to help. And you know what? They did..bang on the money. I have stayed away from saying this previously but beyond the clinical engagement of the GP Commissioners ( without whom the bubble wouldn't have existed), a significant credit goes to the managers for delivering....so thank you Melissa, Sarah, Lyn et al. Thank you for keeping the bubble alive.

 I know some will read this and feel me possibly having a "plan" and thus talking up the local commissioners. the reality is that I don't actually..as I have got what I have asked for at every juncture. In the NHS, we don't say thank you enough and that's what perhaps sucks the morale of all, up against daily challenges. And I am tired of  smart asses criticising especially when neither have they shown a willingness or strength Rostand up and do it themselves. You may disagree with the Health Act, you may disagree with the politics but you must at the very least say thank you to those who have shown the strength of character to at least attempt to steer the system rather than it descend into total anarchy. In my romantic comic book fuelled analogy driven world, what would Batman ever do without a Commissioner Gordon to help him?

So that probably answers a part of the bubble issue. Why does it exist? Why are people happy in the diabetes department? Because every single staff can deliver what they want without fearing about politics, resources, jobs....that bit I handle..and deliver due to some fabulous folks in the local CCG and CSU. I hear all the cynicism, all the chest beating..to those who tire of it, come spend a day with us, with the nurses, administration staff and medics of the Portsmouth diabetes team...I promise you...you will like the bubble.

For one day, we promise you a day of smiles,optimism and positivity. Take some of it away and infuse it somewhere else. The NHS needs a bit of sunshine, like never before.

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