What is the one thing we could all do with at the moment regards the NHS? Hope would be a good starting point, I suspect.
And it's a difficult one to give, isn't it? Despair has gradually progressed to cynicism, hysterical laughters, wisecracks and blogs as to how it's all going Pete Tong. It's a fine balance too...those who stand up and say "it's all ok, don't worry"….gives you images of that Iraqi general claiming victory while the U.S. tanks rolled in the background...remember that farcical piece of history?
So what does one do...and more importantly why would one try get involved in anything to do with leadership roles within NHS at the moment? To narrow it down, the number of emails asking me "why bother" from some senior colleagues has been surprising, yet understandable I suppose. Let's take a sense check. Am a Consultant on a very decent salary, actually scrap that, a very good salary in a public sector job, good pensions, the gobby, cheeky-chappy type who would do well in advisory roles...simply on the dint of the fact we live in a world where the show matters, substance comes second, its pretty easy to say “I am ok Jack”....so why bother indeed?
Many reasons ...if I am very honest, ego is one of them. I have a pretty big ego (there's a newsflash) but I suspect it's also an inherent sense of self belief. I was asked by Bruce Keogh, a man I intrinsically like & trust (whatever your views are on him, I respect - but would appreciate you respect mine too!) and frankly, given all the noises I make about leaders who talk the talk..it would be incredibly hollow not to take up the offer of at least trying to change things.
Which brings me to the issue of hope. I travel a lot, I make friends, I make enemies...I can be affable and I can rub people up the wrong way quickly. I have a lack of political correctness about me and have always struggled to suffer fools gladly. It's a character foible but that's who I am and that's what you get with me- and I have absolutely no intention of changing that. I don’t believe in the need for having leaders of a certain mould- variety is the spice of life and all that.
But one thing I have also picked up is the lack of hope. The lack of belief that things can improve. On the flip side, have also met some absolutely amazing people whose dedication to improving diabetes care has simply been astounding. Problem? We don't hear enough about them...it's easy for me to do so about our work in Portsmouth (it’s that gobby thing again) but in general, people in the NHS are stoic, they are polite, they are humble and they see excellence as part of their job. As a result, we hear little and the masses out there feel the lack of hope.
So I suspect that's what I am trying...trying to join up those people together. Join up patients, joining up professionals...maybe showcase some of the work and see how it goes. I know some of you will go all Tom Cruise on me "Show me the money" (what a film, eh..."you had me at hello"..sorry - do like romcoms a fair bit) and all I can say is watch this space.
But let me also put back to you that money itself will solve absolutely NOTHING. More GPs won't improve diabetes care unless we as specialists learn to work differently..you know, try those things like phones and emails etc to answer and guide a colleague when needed..NOT "do a referral and will see in X weeks"; more practice nurses won't help unless they are given appropriate support/training...as I have said many a times before, does diabetes care per se need a huge investment to improve things? No, not really. Let me give you one simple example...self-administration of insulin in hospitals- why isn't that a standard national thing? What amount of money will sort that? Or is it the lack of will, the lack of belief that patients can't manage their own stuff and "we know better?"
It’s been a fascinating few weeks- and If you are someone who has diabetes, lives with someone who has diabetes or indeed works in this arena, I can only offer you hope for now. And there’s plenty of that around- it’s just not visible enough.
The initial trend seems good-big patient organisations, specialist bodies seem to be getting closer- a distinct palpable urge to work together...and that's a great thing. I can't account for the whole of the NHS but take it from me, these are good times for diabetes care....there's a window we must use if we want to improve care.
I can’t promise that diabetes care will magically improve- but whether it be pathways, markers, long term outcome based work, inpatient diabetes or access to technology- there is a furious amount of work being done by a lot of folks- so keep the faith. There’s much to look forward to but needs a collective belief…hope drives many a things forward- stick with me on this one and we shall see what we can be done.