Friday, December 26, 2014

Mastering the fire

It's been a magical year..so many highs..so many to look back and smile..  but inevitably the major highs have been the ones linked with friends and family..the times spent together, the holidays with friends, the special weekends with all in London, surprise birthday parties in Southsea, celebrating my daughters 13th...it's all been linked with family..there's been a theme there, hasn't it? 

From a team perspective, its been another year of progress, battling the perceptions of diabetes being a Cinderella service, trying to focus on patient care, trying to avoid harm and as recognition arrived - whether it be via the Kings Fund report or Diabetes UK, realisation started to dawn that we may just have done something which has the potential to be special. It's been a personal vindication being asked by other CCGs to share what we have done- sniffy comments from many seem to have turned to a bit more of a grudging admiration. You look, listen and smile. Getting old,you see, to remind all of the past negativity towards changes made by the team..

Lots of highs...doing the Mary Mackinnon lecture- what an honour - what a privilege- hope I did some justice to that great woman; rolling out 7 day service for diabetes care; HSJ honour for acute services;moving out of general medicine to prioritise diabetes care; a mention as a social media pioneer..all good recognition for a hard working crew- and as ever, the need to "make things happen" has caused frictions.
There has always been a key question for me...Improve patient care and sacrifice a few things for need of haste or take your time, try and get all on board and spend a bit more time when so many suffer while you wait for egos to settle, politics to take a back-seat...do you worry more about the relations with your colleagues or does the hurt you see when you see an insulin error enough to make you stand up and growl one more time? In a culture where it appears that relation maintenance are of a higher priority than patient care, clashes are inevitable. Avoidance of that takes time and patience...do our patients have that time while we as patient advocates have yet another meeting? Tough questions for all of us, aren't they?

It's difficult to do so..and thereby lies the crux. You want to do things swiftly in an era of silos, vested interests..you will rub off people the wrong way. The decision is whether patients can afford the time you tale or not- and for 5 years and a bit, that has not even been a question or debate in my head. A simple rule in life...not here to win a popularity contest...here to improve diabetes care...but how long do you keep pushing the edges?

There have been lows too- perhaps not so much individually apart from personal ailments (touch wood) but also a growing realisation that social media has its more mischievous sides- apart from the realisation that it can do plenty of good- it has also given avenues for some to build up reputations without actually doing much. A change of stance, a new buzzword, a new hash-tag, different titles- and the personality of self has grown- with little changing for patients.It irked..but strangely, in a cathartic moment..it has stopped irking me. Personalities such as that will always exist- they always have..social media is just another forum for the ones who have to justify their existence.It involved a Kings Fund meeting - Mark Newbold and Vijayanath- and something they said...it certainly is time to prioritise

As has happened many a times in my life, by luck or default, on a personal have arrived at a position where there perhaps isn't many more battles to fight locally..the chips are in place- the time is now for delivery- and we have some awesome staff to do so. It has indeed been a long goodbye trying to step down from the department role- but I think we are finally, hopefully, there . It is time for family, a time for a calmer soul..a time for perhaps a more charming side, rather than an angry side. The plan was always to blitzkrieg the local system for the first 5 years with energy, passion and drive...6 years in..its time for the next phase.

What will that bring? I know exactly what it is- it was always part of the bigger plan..what does need adding to it is the need for family time, a bit more laughing and jousting at home. This Christmas day was one of the best I ever had...main factor? We were together- all day- as a family.

Wish you all a fabulous 2015...I know it will be...Let the next phase begin. The fire still rages..mastering it will be fun. Will the softening of the edginess dilute the impact or is the firebrand reputation strong enough to allow things to progress? Let's touch base again in 1 year, shall we? 


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