Saturday, September 2, 2017

Care & Quality

Where do you start? What do you do when a Care & Quality Commission report lands reporting on your trust which is difficult reading? Its perhaps slightly weird having done a blog on this before- back in June 2016. The report would suggest a further regression- and there are always many emotions that emerge out of that.

I think the NHS has now been through enough of the fallacy that is of its view of the CQC. Reports became something to be shared widely and celebrated if it was a good one and ignored with disdain if it was negative. It is but a natural phenomena to look at bad data or results and conveniently label it as a cock up or a conspiracy. I know it- I have done it many times before in my career- I recall the days of poor amputation data- surely couldn't be us, could it? 

And as much as some would perhaps want it, this blog isn't a forum to go through the whys and hows of where we are. Its about what happens next. The report is what it is- and as an organisation, its time to say there are many instances where we have fallen short. The Trust has a new CEO and MD in place- and I will be honest- so far, their presence, visibility and most importantly, the frankness of accepting the report as it is- has been welcome- if not endearing. Sometimes you just have to- and rebuild again. History nowadays seem to have a very interesting way of viewing leaders- we appear to remember them more by their foibles and failings rather than their successes. Maybe take an example of British prime ministers over the years- would history have judged Churchill as kindly as they have in an era of 24 hour news, social media etc? I very much doubt so. Our NHS leaders are no different I suspect- its easy to look back at predecessors amongst Portsmouth Execs and point fingers at them- quickly forgetting the achievements too. I worked in pretty dire wards back in 2002- today we have sparkly new building- much more open, much more clean….individual leaders are rarely to blame- its more about who they take along with them in my experience.

So- to the now and future. What has been noticeable has been an attempt to redraw the lines and start again at the top tiers. A fresh start without denigrating the past- which to me, is good. And I will tell you this- I have been part of this Trust for nearly 15 years now- as a junior doctor, research fellow and now a Consultant- and it buzzes with people who are keen to help, keen to make a difference- the key as ever will sit in listening- and time will tell. The initial indications? Very positive - so lets see where it takes us. In my book, leaders should be judged by outcomes- and thats where the bottom line lies. Have you improved care for patients under your stewardship? If the answer is yes, you have succeeded- and the barometer for that, in the present system, whether we like it or not, is indeed the CQC. Use that as your appraisal, use that as your indicator- the aim is simple- make the next CQC report better.

I have said this before and I will say it again. I work in a fantastic Trust- and I could close my eyes and reel off umpteen names -doctor, nurse, physiology, pharmacist, manager etc- who are some of the best staff I have ever worked with. The trick as ever is to harness that. Individually? Always here to do ones job-mixing up generalism & specialism, try best to ensure staff stay motivated within my own sphere- and advice always at hand if deemed to be relevant or worth listening to with wider system experience accrued over time.

In Mark Cubbon, we have someone new-a new man at the helm- attempting to bring back the glory days. I hear he supports Liverpool football club too- somewhere there's a freudian analogy there indeed. 
It would be thus impolite not to finish with a quote from Klopp himself… "I have only one understanding of development and making success -and thats by going step by step". 
Wise words indeed.