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10th September 2015 3

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Health Chat

29th October King's Fund 5.30pm

Samantha Jones NHSE Director of New Models of Care and Vanguards.

Last few tickets... here.

All of us

News and Comment from Roy Lilley

The NHS seems to be awash with teams. Community teams, hospital teams, emergency teams. We are teeming with teams.

I'm not sure how many of them really are 'teams'. A lot of them look like groups of people who have to work together because someone said so.

Being in a team is no easy thing. Think about your favourite football team. They will train Monday, Tuesday, Wednesday, Thursday, Friday... play Saturday and have a day off Sunday. Give or take the exigencies of the Premier League and TV schedules that's about it. They will practice to play football for longer than they actually play football.

The SAS; they practice killing people more than they kill people. It's true of all proper teams; they will practice, train and rehearse for longer than they will actually be doing the job.

The NHS? We lock a primary care person, a finance bod, a hospital manager, a community nurse and a social services representative in a room and call them a team.

To make things worse we open the door and throw in 20 problems no one else has been able to fix and demand elegant answers by Friday. Then, we take the finance person away because there is no money. Welcome to the world of NHS teams.

We don't have time to practice and train to be a team. We have urgent problems to solve and the solutions have to be arrived at and shared by disparate groups of people who all have a different idea of what good looks like. We have to hit the ground running.

What can we do to fix that? Is there a sort cut to being a team?

Maybe; there are different ways of working. All the players in your 'team' will have some skin in the game. Maybe it's your problem but they will want to be sure your problem doesn't make their problems more of a problem.

Some will want to save money, some will want your money and others will be looking for time and urgency. If we are just looking for a solution, maybe that's what's wrong. We should be looking for a 'shared motivation'.

Get agreement; why are we here and what do we want to achieve. Make sure everyone spells out what the objective is for them. Be serious write it down.

Faster discharge maybe good for the hospital, bad for social services budgets and crippling for community staff. Sharing the motivation to do the best for the patient puts another light on the problem.

Put the patient at the centre? Wrong! You'll just wrap them in the stuff you are already doing.

Start with the patient and work backwards... much better idea. What does a perfect service look like? It will force you to describe best-in-class and for every step you take away from the patient you will have to confirm it's what you want, justify a compromise or really explain why it can't be done.

Identify the problems up-front. Don't hide them or pretend they don't exist. Agree who does what and hold them to account. If one fails you all fail. Be transparent with the data, facts and detail. People can't deal with what they don't know.

You can't form a team but you can build one. The three guiding principles; discipline, persistence and focus of which, in a distracting and pressured environment, focus is the hardest to achieve.

Teams aren't places for personal ambitions but they can fulfil dreams. Teams can survive foul-ups but they thrive where there is forgiveness if an honest try goes wrong.

Teams are all about adventure and going to places you can't reach alone. Working with others is a knack; what you put in you get back but teams can be a torture chamber for the unprepared and the half-hearted.

Talent scores goals, skill drives us to the chequered flag, courage goes to the moon and back, intelligence creates the plans but it is teamwork that makes it all happen.

No one of us is as smart as all of us.

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Contact Roy - please use this e-address

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Medicine for Managers

Dr Paul Lambden

Headache

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News and Stuff

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>> There is no shortage of nurses - according to the migration advisory committee; se page 71/2. So no reason to relax rules to allow non-EU rules to allow nurses to come here.

>> Care home smartphone 'surveillance' - looks like a good idea to me. The CQC can guarantee safe care and care homes are running out of money and staff. This would be a must-have for me.

>> GPs looking to vertically integrate - transferring staff and selling buildings to the local Trust.

>> Chair of Health Select Committee says there are not enough GPs - the obvious, really, but it is who is saying it that is important.

>> Chair of RCGP says a seven day NHS already exists - I wish everyone would make their minds up just what it is they want.

>> New nurse coaching model - double the number of students to be trained.

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HealthChat

Sam Jones

Chief Vanguardista

Last few tickets today.

King's Fund

29th October.

Couple of tickets remain

Here

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PLUS

1st December

King's Fund 5.30pm

Janet Davies

New boss at the RCN

King's Fund 1st December 5.30 pm.

Details here.

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Sir Robert Naylor

HealthChatting with me on 16th September at the King's Fund 5.30pm.

Extra ticket sales Click Here

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>> I'm hearing - some Trust Chief Executives have written to Downing Street asking for changes in immigration policy to allow the recruitment and retention of nurses from outside the EU.

>> I'm hearing - Tameside is out of special measures; well done to all.

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>> Take your cold to the pharmacist - NICE telling GPs they should tell patients to consult NHS Choices or the pharmacist. Why are NICE getting involved with this? Wouldn't have happened if Mike Rawlins was still there.

>> New EOL framework - I thought NICE was doing this?

>> Child mortality - falls.