15th October 2015

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21st October King's Fund 5.30pm

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The F word
News and Comment from Roy Lilley
If you are of a nervous disposition, press delete. I am going to use the 'F' word. I think we should use more often.
I'm going to talk about failure.
Let's start with some simple misconceptions. JK Rowling, author of the Harry Potter books; rejected by a dozen publishers. She kept going. That's not failure that's persistence and perspicacity with a bit of luck.
How about the light bulb-bloke? Edison. He says he has never failed; he just found 10,000 ways not to make a light bulb.
Michael Jordan, basketball player; this is what he says:
"I have missed more than 9,000 shots in my career. I have lost almost 300 games. On 26 occasions I have been entrusted to take the game winning shot, and I missed. I have failed over and over and over again in my life. And that is why I succeed."
Is that failure or determination? Well, if he learned from his missed chances, changed his game, learned to block out the moment and focus... that might be learning from failure.
It's easy to confuse 'failure' and wrap it in all sorts of things it is not. And, it is certainly not always a nose-dive, bomb or go pear-shaped.
Almost all of human achievement and progress has been based on failure. Scientific experimentation is just another way of saying, fail enough times and eventually you'll find the right way.
The history of aviation is written in failure. Serious failure that cost people their lives. But, each time there has been a failure we have looked, looked again and learned lessons. We are safe because others have not been. At a time when we thought we were doing our best, accident and misadventure soon demolished our pride into the ruined rubble of people's lives.
Healthcare is no different. The history of medicine is full of well-intended people doing the wrong things, blithely unaware that there was a better way.
People had their lives taken by clinicians who thought they were doing the right thing. Our safe care today is built on the foundation of the lives it has cost and the unwitting damage we have done.
All of human progress has been built on failure. Buildings are safer because we have learned from failing foundations, roof beams and fire stops. Trains and railway tracks, fairground rides, cars and ships. Where ever there is failure there has been learning, understanding and progress.
It is only by opening our minds, our hearts, our ears and our eyes to failure; to look for it, listen for it, think about it will we ever find that fickle friend.... success. Even then it can be plucked from our grasp by another failure. Another 'take your eye off the ball' moment, a forgetful moment or a moment where someone didn't speak up.
Recognising the key role 'failure' has in success is the first step in a long journey to where the management bugle no longer drowns out the whistle blower.
Who, in their right mind, running an organisation that deals, daily, in the life and death of its 'customers' would not be interested in failure. To ignore failure is to invite catastrophe.
Complex healthcare is a fertile place for error and failure yet we pillory staff who reveal theirs and others shortcomings; teach them nothing about the value of errors, give no training in error management nor the skills to detect them, neither the facility to share and learn from them.  
For dread of prosecution, humiliation, or being ostracised, condemned by our peers, shunned by the people we work with; we know whistle-blowers still end up getting the sack. We know fear of regulation leads to cover-ups, denials and has contributed little to safer care.
If we want people to ring the bell, shine a light, speak out we have to understand the paradox of failure. Failure has to become an ally in the battle for safe care and our partner in progress.
If learning from failure is good enough for F1, NASA, Boeing and BA, it's good enough for the NHS.
An error with drugs, diagnosis, procedure, operation, poor care it doesn't matter what it is; it is a precious gift that the victim would rather not have donated to the sum of our knowledge but when we have it, it is an obligation upon us to respect it, cherish it, learn from it and make sure we share it... so that never again will that unsolicited sacrifice be needed.
Use the F word, make it a friend.
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Keith McNeil
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Lord Hunt
Labour's Health Leader in the Lords.
A remarkable career; from leader of NAHAT (a forerunner of the Confed) and Trust Chair to the front-line of politics.
This will be an absorbing evening of politics, policy and no few insider secrets (we hope).  In conversation with Roy Lilley; come and hear from the heart of Westminster.
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