Sunday, December 27, 2015

An interesting year

Another year. Gone. Just like that. Whoosh. Whistled past while we all wrestled with life. And it's pretty obligatory to have a look back. Look back as time fizzed by and hair greyed just a tad.

And I will be honest...personally, it's actually been a satisfying big things per se but the aim was to keep 2015 as one of the job one is supposed to do and try to do it as best as possible. NHS work was good - job satisfaction was high and as ever it boiled down to the colleagues or should I say, friends I work with. I work about 8 weekends a year, I work with an amazing team, have good relations with local primary care and Commissioners...sometimes it's not a bad idea to stand back and take stock. Sometimes its easy to forget the bigger picture.
Taking stock suggests it's not a bad place to be in- about 7.5 years after being a Consultant. Tips for anyone interested as regards a good working condition? Find a good team to work in...and invest a heck of a lot of time in building relations. Keep it casual, keep it simple, don't forget your sense of humour...and cardinally? Learn to laugh at yourself..believing your own hype is always a slippery road.

Nationally or in general the NHS got itself in the throes of an odd mix.
On one hand, if you looked hard enough, there were some good ideas out there. I am a believer in the principle of Vanguards - I like the concept, I like the direction as regards system leadership, need to measure outcomes of systems...and that is exactly how healthcare should be delivered and measured.
It's a sad indictment of the times that all of this is somehow hamstrung by the tentacles of politics. Money talks as ever..and whichever way you turn, the sums don't add up. We talk about a transformation fund, we talk about innovation...whilst also talking about financial balance. John Appleby is not someone to turn your nose up at....if he says we are in trouble, we actually are.
Money did come as per the ask of Simon Stevens but without public health and social care support, all it has the potential to be is an expensive sticking plaster at best. Politics doesn't allow thoughts for the future, it only lives in the present, learning nothing from the past.

Patient safety continued to be a focus..and one of the highlights of the year was meeting James Titcombe. You can disagree with his views but you certainly can't fault him for his drive to ensure no one else goes through what he has. Jeremy Hunt tried positioning himself as someone devoted to patient safety- and then proceeded to hand the initiative to his detractors by withholding safe staffing guidelines for nurses. If that was a faux pax, he then managed to embroil himself in a quagmire by not only embarking on an ill advised battle with junior doctors but also converting them into a lightening rod for all factions within the NHS to unite. One of the smoothest operators in politics somehow, against all odds, walked himself into a cul de sac.

Finally, there was something different in 2015..and if there was an award for the showstoppers of 2015, it had to go to the junior doctors. Whether it be their sterling work forcing a government to back track or the Christmas number 1, the rebel alliance have found their Luke Skywalker to rally behind. The NHS - a factional beast on so many levels..GPs, specialists, Nurses, pharmacists...finally..managed to look a bit more than the usual rag-tag bunch. Managed to learn the importance of unity. That should act as a message for ALL political parties...a united staff is a powerful beast..and the public is now pretty aware the NHS is in a spot of bother. Closest thing to a religion as someone said...the Tories would do well to keep an eye on this ticking time bomb on their hands. So..much kudos to the junior doctors for teaching many an old dog some new tricks.

2016 is nearly here...and I will finish with something which has been a personal belief. I rarely join "campaigns" but this year I did join NHS Survival. Why? Because, beyond the political slants, beliefs or whatever, the NHS does need a review of its funding...the sticking plasters applied depending on what political pressure the ruling party is under, doesn't serve anyone. Some have said other such reviews such as Wanless haven't worked, so why another commission? One fundamental difference..a pre agreed cross party agreement to abide by the findings. 

A commission comprising of patients, safety advocates, the main political parties, think tanks....wishful thinking? We shall thing is for one else have much of a solution. The mood- bar a few quarters of shiny chirpiness on social media- is actually hostile...and we run the risk of actually not letting Vanguards place to breathe and flourish. The key for that does indeed lie with the government...whether to spend 2016 (and post that even closer to the next election cycle) in fractious battles with the staff...or take the gauntlet properly.

Here's hoping. Wish you all a fabulous 2016.

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