The NHS is like James Bond
Do you have a favourite James Bond? Apparently most people say Connery or Craig. Weirdly, I’ve never met a Dalton fan …
Apologies if you haven’t watched any of the James Bond films, the analogy I’m about to share is going to bore the living daylights out of you (you won’t get that terrible pun either).
I remember wet Saturday afternoons as a child, Dad slumped on the sofa watching James Bond films. I wasn’t really interested in the story but I liked the gadgets and the fighting and I liked it when my Dad evaluated the merits of each actor who played Bond. According to him they all brought something different to the role, a different facet of the Bond character. Connery had the masculine looks and steely severity you might find in the eyes of a professional killer. Moore was debonair with Etonian wit, Dalton…well he had a gun and a tuxedo.
They are all Bond, but they are all very different.
We often refer to the NHS in the singular but like Bond it is comprised of many different identities. The NHS is almost fractal; magnify each Trust, each commissioning group or federation and you’ll find more sub cultures and identities.
Resistence to change
The purpose of my rather hackneyed Bond analogy is to illustrate that organisations, while sharing a common name and purpose, are very different.
I’ve worked in different parts of the health service, most recently in a hospital with a two hundred year history. It’s fair to say that when I first joined, there was (in certain quarters) a healthy resistence to change. This attitude felt entrenched. That’s not to say the Trust wasn’t innovative – quite the opposite in fact – but it sometimes felt as though there was a way of doing things.
As a communications professional and as someone turned on by change, it was an interesting tight rope to walk. How do you encourage people to embrace change while not pushing them so far out of their comfort zones that they no longer trust you?
I worked hard to try and meet people’s needs, understand their frustrations and respect their limits – and I had mixed success. We’ve seen huge progress in the past two or three years but there are still a few areas where we want to accelerate change.
COVID the accelerant
It’s been fascinating to see how, during a period of crisis, the resistance to change I believed to be intrinsic in a few parts my organisation, was not intrinsic at all. They say necessity is the mother of invention and for us this has been true; when required to, people adapted quickly.
From digital transformation to pathway development, COVID accelerated change in some of the hard-to-tackle areas us managers have been scratching our chins over since before the pandemic.
The agility with which our teams now access their email, clinical systems and digital tools would have been unthinable in 2020 B.C (before COVID). One of my wonderful colleagues Alicia, with the support of clinical colleagues, essentially designed and implemented an end-to-end orthopaedic trauma service within a matter of days (and the data is telling us that the pathway is safe and of excellent quality). I can’t imagine consensus being reached so quickly in non-COVID times. Consultants agreeing with one another? You love to see it!
While it’s fair to say that change can be painful, it has been an illuminating period for me. I’ll no longer underestimate what people are capable of. When options are limited, people will adapt (because they have to). There isn’t necessarily a ‘right time’ to introduce change, sometimes just getting on with it is the best approach. Change doesn’t have to be scary, it can be exciting and liberating.
Along with the spiralling sense of doom, COVID has also given me a renewed sense of enthusiasm about what’s possible. I work with innovative and talented people. We have some great ideas about how to transform services and I think we’ve all been encouraged to see that change can happen and that the future is wide open.
And the NHS will need innovation. As we emerge from this crisis to face burgeoning waiting lists and inevitable cost pressures, doing things differently will remain a necessity.
