Sunday, April 17, 2016

Mend the Morale

What exactly have we lost sight of in the NHS? Targets? Patients? Safety? Difficult to pinpoint it down but above all, we certainly have lost sight of one thing..the importance of looking after the staff. In an environment when you don't have extra money to attract staff, don't have a amazing work life balance to dangle as a carrot...in a more complicated and complex healthcare atmosphere, you need one thing as a leader...faith from the workforce in you...and most importantly, a positive morale. When you are asking a nurse, doctor or admin to go that extra mile with nothing but an arm around the shoulder, you need that zing factor as a leader.

Crack a whip? They walk away. Shout? They shrug their shoulders. What can you do as a leader in that scenario? Nothing really as without the staff, in healthcare, you are paralysed..safety gets compromised, targets drop...it's inevitable. A person on the street when they get ill are not wanting to see the latest swashbuckling leader, they want to be seen by someone competent...someone who is there to help them...someone who may have stayed on more than their scheduled time. Can you put a price on that? I don't know but I do know shouting does not achieve that.

It's also time healthcare professionals stop being embarrassed by what they earn. It's a job, a well trained job and you should be rewarded for that. It gets slightly annoying when leaders on big salaries or who have spent considerable time reaping benefits of the system start pontificating about others. That brings forth derision, not discussion.
Let's face it..7 day services need improving- forget the science and data, a weekend isn't the same as a weekday. Anyone who works on a weekend knows that..there isn't enough staff for that. We absolutely needed a debate on that..we needed brave leaders to step forward and say we need this as a priority but don't have the money for it...so we may need to stop something else. But we didn't..we tried all sorts of smoke and mirrors, lost the whole argument, and now are on the verge of losing those on whom we depend to run hospitals. Newsflash..a hospital without junior doctors or ward nurses isn't a hospital, it's someone's utopian fantasy of a world where patients just use Apps and get themselves better. Factor this in- do you know which one is the safest hospital? The one which has no patients. The error rate is about 0%

So to all leaders, please, get a voice and stop focussing on models, strategies, flow charts or graphs. It doesn't matter what you call it..without the staff helping to deliver it- above and beyond what you pay them- it won't work. The NHS is littered with such examples and yet we learn nothing, we try yet more models and organisations.
Whatever we have achieved locally, whatever notoriety we have achieved was never down to models or pathways, it was down to one thing-  working with the staff to ensure we didn't let the morale dip down where people stopped caring. Morale is the one thing that matters...get it right, the rest will follow. Today, in my new role, one thing I can promise is never to come out and tell the staff how bad they are..if I do want to improve diabetes care, then it's the staff one needs to deliver it..patients are the most important bit of the jigsaw but a fundamental cog are staff and we must, absolutely must look after them.

So a final appeal to all parties engaged in their present death stare match regards junior doctors...BMA and NHS Employers...please...resolve it. Go have a hug, get some beers, forget about establishing who was wrong so far...forget that, but go and sort it. I don't care how you do it or who needs to be the "bigger person" but please do get going. Apart from confused patients and public, there are a lot of demoralised, angry, upset and confused bright young minds caught in the middle of this- and as seniors within the system, we owe it to them to forget ego and hubris.
The NHS needs these sparkling group of people firing on all cylinders, working with a smile, giving that bit extra...and we seniors have got a role too...to support them, guide them, have an arm around the shoulders, say a few more thank yous and try our best with whatever leverage we have to convince the power brokers to end this fight to the finish.

Naive? Idealistic? Maybe but I do this job to improve care and there is no hope in hell of improving that without a motivated crew of junior doctors next to me. As I have said before, I am not a member of the BMA, you call me left wing, my college political adversaries will choke on their cornflakes, I don't have a dog in this fight...except that I have a fierce allergy against junior doctors being taken advantage of- and they already have enough of that from many within the NHS a already.

On Friday, I went to offer the junior doctors doing a sit-in some morale support and I have some news...I didn't see some loony left wingers. I saw 2 bright young people, worried and anxious...keen to end this dispute. I want the, smiling, I want them back doing what they do best, looking after patients..ready to give that extra bit when needed. And we, the rest of the NHS owe them that.
Mend the morale folks...this is no way to help patients get better. 

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