Last week, our Board Director, Nick Dutnall, had the privilege of speaking at UK e-Health Week, a programme of speeches, debates and exhibitions devoted to digital transformation in the healthcare sector. The discussion was chaired by Tracey Watson, Director for Innovation and Partnerships at NHS Digital. Nick was joined on the panel by Mike Chitty, Head of Applied Leadership at the NHS Leadership Academy; Rhonda Collins, Chief Nursing Officer at Vocera, and Keith McNeil, CCIO and Head of IT Health and Social Care England.
The discussion centred around how leadership is needed in order to allow for transformation within the NHS. Fostering leadership skills can only be brought about through a change in culture, so Nick focused his discussion on the power of storytelling to bring about culture change within organizations.
Being in charge of people is never easy – it takes long hours, strength of character, difficult decisions. But imagine being in charge of people in a hospital – when you have to decide between, say, whether you save a cancer patient or someone bleeding to death. There isn’t a management course that will teach you that kind of thing.
Increasingly the NHS can become mired in talk of data, statistics and cold hard cash. Without doubt, a system cannot function without money – something we see doctors battling against with ever greater intensity. However, even in times of crisis, it is important to see the people behind the data. It’s very easy to see patients desperately needing treatment as a ‘waiting list’, or those not able to leave hospital as ‘bed-blockers’. The language we use every day in regards to healthcare attempts to reduce people – who might be difficult, smelly, or irresponsive to treatment – to easily-digestible data.
Ask most people about the NHS and yes, they’ll probably have some sort of affection for it, in the same way that people have an affection for bourbon biscuits or the Antiques Roadshow. They may not always engage with it, or even actively like it – but it’s always been there, and always will be, right? Then ask someone who’s ever been seriously unwell, had an accident, had a baby, had someone close to them die, and you’ll hear something different. This is where the real stories start to emerge. There may be talk of inefficiencies, waiting times, doctors who were too busy, but usually the stories centre around one thing: care. Care is not as soft and simple a word as it sounds – care is often brutal, dirty, labour-intensive. A profound need for care, in one form or another, is the fate of all of us sooner or later. And it is care, in essence, that the NHS was set up to provide – for everyone, regardless of circumstance.
Everybody recognizes that the NHS is on its knees. It’s sprawling, it’s inefficient – but that doesn’t mean we should take it for granted. And this is where just focusing on the higher-level system of the NHS will not help. It’s very easy to say we should run the NHS like a business; drive efficiencies, incentivise the workers. But how can you do this successfully with a workforce that is primarily not motivated by money, but by a desire to care?
The fall-out of focusing on the shortcomings of the system, and not the people behind it, is easy to see once you start looking. There are only so many resources, so many beds, a system can accommodate for. There are always going to be times when you have to prioritize the cancer patient over the person bleeding to death, and vice versa. Yet when we only see the numbers, everyone loses out. Doctors and nurses feel let down by a system that does not understand them, that renders them unwell themselves through overwork and lack of sleep. Patients feel that doctors do not have enough time for them, that they are simply a number, a name on a waiting list. It is not possible to understand an entity so intensely, so viscerally human in terms of numbers alone.
The NHS needs leadership, but it needs leaders who do not only speak in terms of data. It is becoming increasingly necessary to unite those who work for the NHS under a single vision, and to reassure those who use it that there is a vision in place. If we’re going to achieve this, we need leaders who are not afraid to tell stories, as well as crunch numbers. A story can be an important strategic tool, but it can also unite people under a single purpose. A story can also elucidate the messy, emotive, passionate core that boils beneath the surface of any set of information. We need leadership, and we need stories, to get to the heart of why the NHS was set up in the first place, and why people want to work there at all: to care for people. If we lose sight of this, we lose sight of the very thing that makes the NHS so special, so complex, and so critical to preserve.