“May you live in interesting times”…. is a phrase whose derivation is one that is contested. Some believe it’s a Chinese curse played out with irony on those whose lives are subsequently of disorder, chaos and destruction. Others suggest it is … Continue reading
One of my colleagues from Leeds, John Walsh, does joint blogs with people from across the system. I was privileged that he agreed to write one with me. Here it is. Happy Christmas.
“ Blessed is the season which engages the whole world in a conspiracy of love.” – Hamilton Wright Mabie
Last Christmas a worker at a NHS health centre for the homeless rushed through the streets of the city centre loaded down with carrier bags. In the bags were Christmas gifts and tins of chocolates. She had hoped her colleague would accompany her but the colleague was drawn away to clinical duties due the demands on the service.
The destination was the local refugee drop-in. The idea was for the refugee children to each receive a small present – a colouring book and pens – and gifts of chocolates for everyone there. The money was raised, the gifts bought, donated and duly wrapped. The clock was running fast so the worker decided the best bet was to walk across town.
The city centre bustled with people and shoppers. Halfway through the journey the handle on one of the bags burst. Our friend sighed, grabbed the bag by its body and ventured on. She was stressed – she had so much work on back at the centre and was behind with things too. She arrived at the drop in centre – flustered and out of breath. She was happy to put the bags down.
The refugee drop-in was full – adults and children filled the centre and sat around tables. People who had endured unimaginable experiences a short time before in the war torn areas of Syria were here and were safe. She started to distribute the chocolates on the tables and gave the presents to the children. The children opened the gifts and got down to the colouring and drawing. Colleagues from the local authority arrived with presents too.
As our friend stood there she started to fill with emotion and well up with tears. Something was unfolding before her – something very simple yet incredibly significant. It was an experience that touched her heart. She stayed a short while and then returned to the busy, never ending world of NHS healthcare.
On her way back she reflected on what she had seen. For a short time at the drop in centre, she had stopped her rush-a-day work life and been given a clear message. There were three parts to this.
The first was she recognised in that little church hall what really matters. It’s people who matter. Seeing the joy in the faces of those children was what both Christmas and work was all about. Seeing people with nothing, happy to receive and to find joy in simple gifts. Caring for others and bringing joy to those near and far from us was the most important thing. It is what we do to others that teaches us most about ourselves and what our services should do.
The second reflection was that we are all in this together. The local authority, third sector, shops that gave free chocolates, good hearted individuals who helped and the faith community who hosted the sessions. It said that we work best when we work and learn together. Each bringing their own contribution to make something greater than the individual parts.
In that room she saw how cities and services must be in the future – moving from silos to solidarity. Solidarity comes from the French for ‘interdependent, complete, entire’. Solidarity here was a unity for change and care in the heart of a city.
The last reflection that struck our colleague was that we all have a part to play and that a public service ethos is a powerful connector. She had seen it in the busy colleagues who couldn’t attend but who spent time meticulously wrapping the presents; the local Co-Op manager that donated chocolates; the fact that the city was working to support the most marginalised.
This wasn’t just a Christmas tale but an everyday one – people in the NHS and with a public service ethos everywhere – united in a shared purpose to do good and make a difference, whatever your circumstances, wherever you are from. This was an event perpetually happening in so many places.
“Public services sometimes get things very wrong. At other times they shine like diamonds.”
Public service is a deeply held belief and drives people to create the best they can. This is one of the main reasons why we think so many go the extra mile and work outside of hours to try to help. This wish to publicly serve is something to value, cherish and celebrate. It is about making a contribution to build a better world. A world without social workers, therapists, nurses, doctors, support workers, porters, drivers, chaperones, hostel workers, advocates and everyone who chooses to serve people as a public good would be a lesser place. Public service is a commitment to social wellbeing, development and cohesion.
At this time of the year we hear and see the great Christmas tales. Books like ‘A Christmas Carol’, films like ‘Its a Wonderful Life’ and the story of the health worker at the refugee centre remind us what really matters.
When it comes down to it, it’s all about people – like you, like us and everyone else who makes a difference to those we care about.
The writers would like to wish everyone a great Christmas and happy 2017. We hope it will be a time of great joy for you and yours.
We dedicate this blog to all those – families, patients, carers, staff and volunteers and people out there who every day show us what true humanity and care is all about – thank you – you inspire us to keep on hoping and going.
John Walsh and Rob Webster
Photos used from public sources #AdsParty @NHSEmployers, Closer magazine from @nhsbarnsleyccg featuring @allofusinmind health integration team, York St Practice @lchnhstrust, and drop-in centre @pafras_leeds
Welcome to The View
Hello, my name is Rob, I’m your chief executive.
Values based leadership is essential in public service and the NHS – and I have made it a feature of my ambition for our Trust. I always say that you need to be clear on your values so that in tough times you do the right thing or that you have a guide when there is no ”right answer” to a wicked issue. One of our values is being respectful, honest, open, and transparent. At the heart of this is integrity, including a commitment to equality, diversity and inclusion. We try and reflect the communities we serve in all their diverse glory.
The news is full of stories and debate that may make people who are “foreign” or “different” or not “White British” feel unwelcome. A positive story about boosting medical training has turned into a suggestion “overseas” doctors are not valued. The emerging policy that all companies will be required to list “foreign workers” has been widely criticised. I would like to offer a balancing view.
The NHS was built on “overseas” staff and continues to run because of them. When I met a group of 100 “Windrush” nurses in Leeds in 2013 they were so proud of the NHS they had built following their journey from the Caribbean. Many of them in their 70s and 80s, they were still excited and passionate about their careers, their roles and their nursing contribution.
Our own organisation is made up of a mixture of people from different and diverse backgrounds, each contributing to the successful delivery of services within SWYPFT. Our ambition is to ensure that we harness all of their potential and the strength that diversity brings. If you are feeling scared, stigmatised or disappointed by the wider debate, please know that this is your organisation, we will support you and that we need you. Every day, from porter to professor, OT to trainee you are making a difference and enabling people to fulfil their potential and live well in their communities.
Of course we don’t always get this right. There were challenging discussions at the launch of our own Black Asian Minority Ethnic (BAME) network last week and there is more to do. We have positive staff survey results in 2016 to build on. We don’t yet reflect the diversity of our population across the organisation and must act if we are to deliver services that better meet the need of populations.
Values based leaders accept feedback and challenge and I benefitted from free, expert advice on this agenda when I took part in the “Board” simulation event for the ‘Ready Now’ national leadership programme. The programme takes BAME leaders from across the country and gets them to work on specific challenges. Three groups of leaders were asked to consider SWYPFT’s approach to equality and inclusion, based on our real Board papers and feedback recommendations to the “Board”, made up of 8 real chairs, chief execs and execs. It was a fantastic insight into what was good about SWYPFT’s approach and what was not. Myself, Alan Davis and Tim Breedon left feeling the participants got a lot from the session, and that we got even more out of it. Fresh eyes, real insights.
Perhaps the most courageous statement was from a young woman who said success for her would be
“seeing someone who looks like me sitting at that end of the Board table”.
She was right, and I am sure the Leadership Academy Programme, our involvement in Gatenby Sanderson’s work on NED development for BAME communities and a refreshed inclusion strategy will help. We will certainly be better equipped and informed following the session this week and I would like to thank the participants for their passion and honesty.
Perhaps, she was a good example of “leading from every seat” in an organisation, something I talk about regularly here in the Trust. It’s something I see every day. I see it in the movers and shakers and the unsung heroes putting together the BAME network. I see it in the people challenging stigma and fear, with professionalism, care and a clear link to our values. One of my jobs is to amplify it, point it out and celebrate it.
So, thanks to our team of peer-to-peer vaccinators leading the way on flu uptake. Thanks to the porters at CNDH for raising issues about waste and recycling that was discussed at our executive management team this week. Thanks to the people and teams who were entered for our Excellence awards and congratulations to our finalists. Thanks to the team who put together the SWYPFT cycle club -according to Sarah Hennessy, our librarian, the first cycle this Saturday is an ‘easy’ 22 miles that will be fuelled by mid-way cake.
And thanks to all of you for who you are, how you are and what you do. The world outside is debating difference and there is a risk we exacerbate differences. I’d rather we celebrated our diversity, saw it as the asset it clearly is and used it to deliver for the people we serve.
Have a great weekend,
This post was sent to all staff on 8th October 2016. I send a mail weekly called The View.
“Most of us don’t want to change….but what happens when an event occurs that is so catastrophic that you just change? Change from the known person to an unknown person. So that when you look at yourself in the mirror….do you recognise the person you were but the person inside the skin is a different person?”
I spoke at the 5th suicide bereavement conference last week. It was one of those events that is somehow uplifting, despite the subject matter and the collective experience of an audience shaped by catastrophe and a common desire to make suicide a rarity, and support for those bereaved a universal offer.
It was an event filled with hope and populated by quietly heroic figures. Bereaved families building hope from catastrophic events that had changed them forever – like Hector’s House for example.
At the event, Author Carla Fine spoke about how death and suicide are not the same thing. Unless you get over the suicide you can’t mourn the death. She also spoke movingly about life before and after suicide and how, following the death of a loved one, you are changed forever. In the aftermath of the suicide of her husband, Carla spoke about the things she had learned in almost 30 years of study and travel. She spoke beautifully about 5 things that you should do if you are bereaved by suicide.They boiled down to a few simple observations that resonated with me:
- Protect your health – look after yourself
- Seek out survivors – being with people who understand is important
- Be with people – don’t lock yourself away when you have friends and family who will understand and be there for you
- Get help – you have been part of a catastrophic event
- Accept you have changed forever – life will always now be defined by the time before and the time afterwards
One of the things that Carla also said was:
“I’ve travelled the globe and there isn’t a place where suicide doesn’t carry stigma”
My talk also included ruminations on my old friend stigma. It was bookended by my blogs about saying yes to life despite everything, and 5 minutes to slay a dragon. Tears flowed, some of them were mine.
In between was a description of how suicide prevention is a priority in West Yorkshire. I’m proud that this is a major part of work in the region and that we will be taking a “zero suicides” approach, based on a trawl of good practice. The presentation was loaded with data from the Confidential Inquiry Into Homicides and Suicides and research from Time to Change, as well as work done by the West Yorkshire team. I will post this when it is available. In the meantime, its worth noting that:
- Only 28% of suicides are in touch with mental health services
- An estimated 90% of people who die by suicide have some form of mental health problem
- Mental health issues amplify the chances of suicide significantly
It doesn’t take a genius to see that we have to ensure that mainstream services are more aware of mental health issues. It is also clear that the stigma of mental health prevents people from being open and from getting the help they need – as seen in the report Stigma Shout from Time to Change. The example below is replicated on many ways when you speak to carers too.
In this environment, lives are lost.Stigma. Fear. They will get us in the end if we are not careful. I covered this in my session. Stigma means that people with mental health issues don’t work or disclose their illness. Stigma stops us talking about the issues we face. We have got to end the stigma.
Time to change are pushing progress on tackling stigma with some success. As I write, they have secured another £20m to deliver their work. This is a source of some joy for me. They feature in my story heavily. My pledge in 2013 to talk more about how mental health issues had affected me and my family led to significant changes in my behaviour and my life. They let me see that, as Nick Cave put it, something so catastrophic had happened that I was changed.I speak regularly in public. I have done so four times in the last week alone. I have, I think, become very good at it and rarely get nervous. But the journey from my brother’s suicide to talking about it openly and personally to 300 people in a packed hall has been the longest and hardest I have faced.
I must have looked as wrung out afterwards as I felt. Sharon McDonnell, gave me a big hug and told me to look after myself.
It was worth it. By opening up and talking about it, I hope that more people will find #TimetoTalk and #TimetoChange. I want to make this a feature of our West Yorkshire plan. Operating at scale will be important and scale can be delivered when many people choose to change at the same time. Perhaps then we can tackle the stigma of mental health and the stigma of suicide. The alternative is that something catastrophic happens that means we are changed – with the continued death of many people and the suffering of their families and loved ones.
It doesn’t have to be this way. If we talk, there is always hope, there is help and there is life. Give talking a try. You might just save a life.
I was asked by Jackie Daniel at University Morecambe Bay NHS Foundation Trust to write a blog for the trust. Jackie is a new breed of NHS leader who has shown huge resilience and an approach to system leadership that underlines how some of our most talented people are now working in some of the toughest circumstances.
“In my role I read a lot of commentary and reports about the NHS. Just recently I read about how NHS providers are “in a ditch”, how we have “spiralling” deficits and no plan to fill a “£22bn black hole” and that we need ”a better plan”. It’s always a gloomy picture and there is always an angle if you want to take it. My angle is that we have the biggest challenges for a generation and a huge consensus about how we address them. We should stop commentating on the state of play and get on with the game. That takes leadership at all levels – of the kind being shown in University Hospitals of Morecambe Bay NHS Foundation Trust.
If we are to improve care to meet patients’ needs today, there are some simple things that we need to focus on:
- We need to recognise that the NHS is a system not an organisation – one that is deeply reliant on social care. That system needs to work in ways where the 7 main national bodies – including Monitor, CQC, Department of Health – operate in ways that support local trust leaders like Jackie and her team to succeed. You can’t dictate what happens in Walney from Whitehall and you shouldn’t try. By working together at a local level, we can solve the problems that bedevil the NHS.
- We need to sort out the money. The system needs us to fund social care and prevention properly. A 32% increase in delayed transfers of care due to a lack of social care shows how if you cut social care, the patients suffer, and the NHS bleeds. We also need to manage the balance of investment so mental health, community and GP services get support. Flexibility will be key and Morecambe Bay was the first trust to trigger the arrangements that increase the prices commissioners pay because of geographical isolation. Jackie and Aaron worked with local partners to prove that the national arrangements don’t fit in South Cumbria.
- We need to recognise its our people that matter. The NHS is not made of drugs, kit, hospitals or beds. It is made of people – from porters to paediatricians, secretaries to surgeons, therapists to theatre staff and beyond. People are our greatest investment and our biggest asset . Give them some headroom and they will drive the changes needed. The work that Jackie’s team have done through Listening into Action is a great example of how we harness the power of people. What we need across every bit of the NHS is to build trust with our staff and make them feel supported in their work by an organisation that truly cares for them. This is not where we are today but it is something we can build, ward by ward, team by team, trust by trust.
- We need to work with communities and focus on place. We waste the assets of people every day in the NHS – the patients we see are often skilled experts in their own condition, the carers we meet coordinate care and solve problems every day. They need to be part of the team and part of the future. This is especially true as most of our patients have long term conditions and will always be with us. Looking at people, communities and place is essential – look at what you have achieved in Millom as a brilliant example of this.
Many of these themes come out in the NHS Confederation’s Commission into Urgent Care for Older People. This started as an inquiry into A&E pressures and quickly became about the cause of those pressures and not just the visible symptom of crowding in A&E. It’s a great report that highlights how we are increasingly dealing with an ageing population with growing dementia cases and co-morbidity. The system often fails older people and the result is they end up in hospital. The report also showcases some fantastic practice across the NHS and identifies the how we could change and help trusts thrive. In each, there is a sense of system, financing, staffing and community.
One of the clear messages is that hospitals have a critical role to play in leading change with these services as part of joining up care across communities. Often this debate gets into a bit of a cul-de-sac where people define hospitals as organisations that are somehow not part of communities and hint that they are part of the problem. Anyone who has been to somewhere like Furness General Hospital knows this is a redundant idea. The model ships in the entrance, the paintings and murals, the plaques from High Carley and Roose show a proud history of community. And as a Barrovian I have many memories of the place. They reflect the joy and sorrow that goes on each day within its walls – it is where my twin nieces were born, it is where my younger brother was pronounced dead after he committed suicide and it is where my Dad gets treatment regularly for his hip. The hospital is clearly part of my history and my community. To thrive it needs community based alternatives and to retain connection with the people it serves.
Luckily, we now have an opportunity to plan for a new future in healthcare. This will be set out in place based plans called sustainability and transformation plans [STPs] that cover the next 3 to 5 years. Trusts like yours with effective leaders like Jackie give me hope that the plans will be good. My job at the NHS Confederation is to help ensure that you have the right conditions in which to deliver them.”
Thanks to Jackie Daniel for asking me to write this piece – and for being a great example of what values based leadership looks like in the modern NHS.
Will you indulge me for a moment or two? I want to tell you about my son George. He is 14 and without doubt one of the most popular people I know. Walking to school or in the local community is an experience punctuated by people saying “hello George”, high-fiving him or giving him a wave. It’s the same in school, with pupils and teacher alike. At a recent party we attended, where many of the teachers were mutual friends of the host, one of them whispered to me how he is “universally loved by everyone at school”.
He is one of the most hard working, committed, passionate and fearless people. His school reports are glowing – he is ahead of all his peers, often top of his class and his attitude to learning scores are off the scale. Hopes are very high for him exceeding expectations in his GCSEs and he is world class at spelling.
He has been on the school council in primary and secondary school. He was voted on by the other kids. He is currently a school representative for PE in high school. As a result he gets to sit on interview panels for the some key appointments and also talk to OFSTED about what it is like to be a pupil when they do their inspections. His insights are always important and usually wise.
Being good at school attracts rewards, which results in trips to theme parks like Flamingoland and Alton Towers. He loves dangerous rollercoasters and hair raising rides – as well as zip wires and high ropes.
As well as being a star pupil, he engages in a number of school clubs and out of school activities. He is a member of the school choir and the school performing arts group as well as Stage Door theatre school. He has performed a number of concerts and plays. As part of the school climbing team he has competed in and won events – as celebrated in awards presented by Johnny Brownlee at the school sports awards. He plays Tennis on a Sunday and sails on the local tarn in the holidays with the Sailing Club.
He dances at the Northern School of Contemporary Dance every Friday with his dance group Me2, who have wowed audiences at the West Yorkshire Playhouse, Phoenix Dance Studios, the Audrey Burton Theatre and elsewhere. His stage group performs shows at local theatres in which he sings and acts with a passion and some talent.
He is great at volunteering too. Every week he marshals at the Woodhouse Moor Parkrun, supporting the runners and helping with the arrangements. He was co-director this week and named junior volunteer of the year in 2014. When he marshals other races for local clubs he knows so many of the runners he gets a bit hoarse from cheering to spur them on.
Outside of this, his teenage boy tendencies mean he is glued to his ipad or the computer when he can be, playing games or researching films on ImDB, which he loves to watch at the cinema with his mates or buy on DVD. He is pretty cool and the dance teacher tells me how popular he is with the girls. Theatre and musicals also form part of his obsessions and he can tell you just about everything you ever wanted to know….
I am so proud of him I could burst.
George would not be who he is today without the support of Leeds Mencap.
They were the ones who helped us in the hospital the day after he was born, with kindness and positivity.
They were the ones who provided the space for other parents like us to share a coffee and a chat and get informal peer support.
They were the ones who helped with speech therapy, portage and transition support for inclusion at nursery, at primary school and elsewhere.
They laid the foundations for us as parents and for George to transform from being a lovely baby into the success he is today.
Adam Bojelian was a remarkable person. That was clear for everyone who attended the celebration of his life in Tadcaster yesterday. The celebration was a perfect reminder of the beauty of his poetry – cousin Lara reading The Green Fish was a personal highlight – and the tributes came from across the globe for someone who touched the hearts of many with his can do attitude. A fifteen year old boy who wrote poetry by blinking and captured the imagination of anyone he came across.
Adam was a “No Excuses” role model. The photographer Paul Clarke read “My Creation Myth” and prefaced it with this statement – so simple and true. Adam had every reason to not do his homework, be bitter about life or let his challenges get him down. Instead he approached life with glee, never making excuses. For him “every colour was perfectly placed”. And a duff joke or two was always at hand.
Alongside people like Lara and Paul, I was privileged to be asked to be one of the 15 people to read one of Adam’s poems and say a few words. The poem was Leadership – something I commissioned for the NHS Confederation Conference in 2014. I needed something to set the tone for the whole of the leadership in the NHS and Adam responded brilliantly. He gave us something that defined good leadership and challenged our perceptions about the potential of people.
I read the poem and new that it was right, it was wise and it was clever. A challenge to the reader to be a better leader. It was exactly what was needed and I shared it on Twitter. It was read and retweeted widely. Some time later, someone pointed out that the poem’s puzzle had been solved. It was not just a challenge to the reader but also spelled my name down its spine. I had missed this completely and it was something I won’t forget – one of those moments that catches you inside and is truly humbling and a personal challenge to me to be a good leader too.
Subsequently the poem has had a life of its own. It was a wow at the Confederation Conference receiving spontaneous applause from around 1,000 delegates. The Leadership Academy have used it in their work. NHS Employers have used it in their Equality and Diversity work. It is shared widely. It is a gift that keeps on giving.
Maybe one day I will be as good as the leader it challenges me to be. What is clear is that Adam was a leader and a role model. And I wanted to give a gift to Adsthepoet and his family in return. So here it is – the poem I wrote for Adsthepoet to celebrate his leadership – my no excuses role model:
Leadership (For Adam Bojelian)
This rhyme solves a puzzle, as you will see
This rhyme confirms what a good leader should be
A good leader aspires to be the best
A good leader debates and challenges the rest
A good leader speaks up against poor care and injustice
A good leader teaches us to cast off our prejudice
A good leader helps us to see the funny side
A good leader engages and shares what’s inside
A good leader puns (I know it’s not quite a requirement)
A good leader is open to risk and excitement
A good leader energises all that they touch
A good leader transmits our dreams back to us
Now, this poetic trick has been played before
Look closely and you’ll know whose name is worn
At the heart of this poem
No surprises this time
No poetic reveal
Yet the power of art
Weaves a subtler knife through our hearts
The echoes of good leadership last forever
They beat its rhythm for a lifetime
Listen carefully to yours
What do you hear now in its pulse?
Adam, Adam, Adam, Adam
If you think this is sad and solemn, it’s not meant to be. Kirstie Stott ended the celebration with the poem happiness. Perfect. As was her wordle of the three words Adams’ twitter friends had provided her with. Her choice was for her boys to “be like him”.
It took me 10 years to write about the suicide of my brother – the piece I wrote in 2013 is here and is called Saying Yes to Life Despite Everything. Writing the piece was cathartic for me and the response has been humbling. The blog has been re-blogged, read and shared widely. Friends, colleagues and strangers have shared their stories about suicide publicly in response to it. Comfort has been found in shared experience and perhaps a little hope.
I wrote the piece as part of my pledge to the Time to Change campaign. Approached at the NHS Values summit in 2012, I said I would talk more about how mental health issues had affected my family. It is a pledge I have stuck to personally and professionally since.
Except…..I have never felt able to tell my kids how their uncle died. The stigma, shame and the stain of suicide felt like something I couldn’t put on their tender shoulders. If the subject came up, vague talk of “an accident” sufficed. The tragedy of Phil’s death remained hidden.
In medieval times cartographers denoted dangerous or unexplored territories by putting sea serpents and other mythological creatures on uncharted areas of maps. Over the years, the omission of how Phil died has gnawed away at me and the prospective conversation with my children has appeared on the map of my life with the phrase “Here be dragons” firmly painted over it. The low heft of dread has dragged through the years and the conversation has reached epic proportions in my mind.
I don’t believe in dragons or mythology or fate. I do understand fear. Fear of the unknown and fear of consequences. The irrational white noise that prepares your fight or flight responses and subjugates logic. And just as I have learned suicide is often a consequence of a loss of hope and of feeling helpless, I now know stigma is driven by fear. To end stigma we need to face our fears.
The “Take 5” minutes to talk about mental health campaign is a small positive step in ending the discrimination and stigma around mental health. It provides the permission and support to enter unchartered territory. It will be written off by the cyber-cynics as a fad, a #hashtag badge for the worthy or a promotional campaign. It will also save lives and continue a conversation that we must have if we are to map the world we live in for the 21st Century.
I had signed up to support the campaign on twitter a couple of days ago. I added a twibbon – something i have never done before – and promised myself I would have a chat. I didn’t plan it but left it to emerge.
“How did uncle Phil die” asked my son George today. “Was it cancer? A heart attack?”. We were sitting in a wake and I said I would talk to him about it later. I resolved to use my 5 minutes wisely. Over dinner the subject of Clarke Carlisle came up. Lauren, 12, had heard the story on the radio. We talked about what happens when people become depressed. We talked about losing hope. We talked about mental health. We talked about Phil.
George, 14, looked me in the eye, reached over, squeezed my hand and smiled at me. Questions and answers flowed. The dread sank to the bottom of the ocean. The fear evaporated. The dragon slipped away.
I want to thank Time To Change. It works one person at a time and one conversation at a time. Today it gave me the tools I needed to slay a dragon. It only took 5 minutes. The impact will last a lifetime.
Every year at Christmas, the beautiful, 100 year old Hyde Park Picture House shows Frank Capra’s It’s a Wonderful Life. It’s a Christmas staple that many of us will watch on TV too. The film stars James Stewart as George Bailey , a man who sacrifices his own needs in order to help others and whose imminent suicide on Christmas Eve brings about the intervention of his Guardian Angel, Clarence. Clarence shows George all the lives he has touched and how different life in his community of Bedford Falls would be had he never been born. Its life affirming conclusion where the townspeople rally around George to keep him from prison is so powerful it should be available on prescription.
It would be easy for people in the NHS to feel like George in 2014. In bleaker moments, we can point to a bleak environment. There has been a constant stream of negative press – it is now open season on what the Commonwealth Fund decided was the best healthcare system in the world. So much so, that the real issues can get crowded out. Recent press activity now includes saying the opposite of what is true – this week’s example 4 out of 5 new nurses are from overseas [wrong! Facts here…]. Industrial dispute puts people who work in the NHS against the people who pay for it. We are facing the biggest activity surge and the biggest pressure on services in my career, with staff working tirelessly to deliver great care being kicked about like a political football. On some days, my social media feed often looks less like a conversation and more like a mob, with attacks on “NHS managers”, unpleasant trolling, doctored pictures that show me as Hitler and people behaving in pretty despicable ways to each other. Most NHS leaders and the people who work in the service are pretty resilient. But there have been moments when many of us will have wondered what it was all for….
Fortunately, the NHS’ Guardian Angel came to the NHS Confederation/NHS Employers last week to remind us how the NHS touches all of our lives. The occasion was #AdsParty . It was one of those days – the special days that touch us deeply and we never forget.
Adam Bojelian is a 14 year old poet, Brit Award winner and long term patient at Leeds teaching Hospitals Trust. He communicates his wisdom and wit through blinking. The party was a tweetmeet and celebration of Adam, inspired by Kirtie Stott and Vanessa Garrity from New Healthcare Voices and put together by the fantastic team at NHS Employers of Danni, Sam, Johnno and Andrew. The idea was simple, get Adam and his family together with all of the people he inspires through social media, throw in a bit of food and celebrate Christmas. The execution of the idea showed me why we must never take for granted that the NHS is made of people – give them the headroom and they will always exceed what you expect.
In dark moments, I will always be able to conjure up the scene, with my own version of the guardian angel Clarence whispering in my ear about….
A set of elves doling out mulled apple juice as they greet us, the Horizons team setting the tone and supported by Ronnie the Rhino – reminding us of the great work the Leeds Rugby Foundation does in healthcare and how communities matter, place matters.
The ward and nursing team supporting Adam talking about how tough things are and also how much they love what they do. They have a renewed sense of connection between them and the Trust Board under Julian Hartley’s leadership. I was reminded of Dean Royles’ work and the piece on HSJ about the Trust’s focus on the personal, fuelled by technology.
New leaders emerging in the shape of New HC Voices, with Kirstie and Vanessa’s amazing group augmented by award winners and front-line heroes Sarah Searz, Joan Laplanas, Thomas Shahanan, John Walsh – “real people” doing “real” jobs epitomising a value based approach and wanting to change the world.
Kate Granger, taking time out from being a new consultant to come and meet Adam. She has already changed the world through #Hellomynameis, demonstrating the power of an idea and a personal story that connect us all.
Films like these and these from Twitter pals who could not be there demonstrating the impact that Adam has had on them, from Chief Executives to graduate trainees, international improvement icons to nurses to OTs – and everyone in between. Our very own Paul Deemer, was inspired to verse and NHS Employers’ staff duly obliged with their rendition of “Would You Adam and Eve It”
While the virtual log fire flickered, Kay Mellor the actress, director and author recited Christmas Gibbons and we all laughed at the reality that it isn’t the reindeer but the gibbons that do the deliveries at Christmas.
The Quarry House Choir from the Department of Health, NHS England and DWP singing “Walking in the Air”, one of Adam’s favourites. The assembled crowd look on, connected in the moment.
And above all, the inspiration for the whole thing – Adam and his parents, Paul and Zoe and their family and friends. The team starts here in the service. The patient who always has assets to share. The parents who have expertise. The families who support each and every day.
So next time things get bleak and things get tough, I will remind myself that we have a good set of strategies in the NHS with 5 Year Forward View and its ilk. We have a commitment to more resources. And above all, we have the people who can always exceed your expectations. Forget the HSJ100, Debrett’s and Who’s Who. The NHS is made of people – just like me and you and Adam.
It’s a wonderful life. Happy Christmas!
I was in Oldham recently. I was really taken by the experiences of the system in Oldham and Ashton when I visited Pennine Care and Michael McCourt’s team. Their Living Well Academy and work on Carers and coproduction around long term conditions is right in line with the future needs of the NHS – building capacity by aligning the efforts of the “team” that is already in place. With over 6 million people designated as “carers” and almost a million carers aged 65 plus, this has huge potential.
Oldham’s experiences of recent commissioning decisions is also indicative of the future. They were successful in bidding for new models of care for all of their community services in a partnership with all of the local GPs, the local authority and the local AgeUK team. True collaboration, aiming to bring integrated services through working together – not structural reform.
Both of these developments are good, but I wanted to share a story from the excellent CEO of Oldham Age UK Yvonne Lee.
Yvonne told me of their impressive array of services – from equipment and adaptations to befriending and direct patient care. She then told how 3 prospective partners had come to visit her. After 20 minutes they explained that they needed to go and put more change in the car parking meter. They had only paid for half an hour and two of them disappeared to sort this out. Their colleague leaned over and said
“They got you wrong love. They thought they wouldn’t be here long and were coming to see an old woman in a cardigan in a charity shop”.
Our understanding of the role of the not for profit sector in the NHS is improving – if not quite there yet . We need to exploit the potential fully. Because the sector is clearly part of the integrated team that sits around the families that we work with, the ones who will never be discharged from our care.
That has been my experience in my life as a carer – and it probably is in many of yours too. When George was born with Down Syndrome and we had a thousand questions about the future.
The wise consultant at the hospital said – “just wait, Marjorie from Leeds Mencap is coming in to see you tomorrow. She will help answer anything you want to know.” They were right. A partnership was born that saw us supported in George’s physical, emotional, educational and social needs across his whole lifetime. From using Makaton as his first language skill, through portage, peer support, speech therapy, school inclusion and right through to dancing at the West Yorkshire Playhouse and beyond. Alongside many others – Bradford Down Sydrome Support Service, SNAPs, Down Syndrome Association, Me2, Down Syndrome Education International -they have played a critical part in making him who he is today.
They have done so with great kindness, skill and in line with an array of rules and regulations; a changing policy context and the toughest financial challenge for a generation. If this sounds familiar to NHS organisations, then it is. And what an opprtunity to embrace the contribution of carers and this sector in dealing with a shared endeavour and the biggest challenge for a generation.