The NHS must capitalise on all voices for change

I’m sure we all work in healthcare because we feel we want to make a difference, but how many of us actually do? How many of us go home at night and think “my goodness, I’ve made a difference today”?

In reality, how many of us sit in meetings talking, not about the patient, but about how we can make that 5 per cent efficiency saving.

‘We must open up the conversation so more people can contribute’

What services can we reconfigure? How many nurses can we take out before it becomes unsafe?

Hand on heart I can say that in the past year I have attended an increasing number of meetings that have involved this type of conversation, often neglecting to mention the word “patient” at all. As an NHS manager it can feel removed, almost broken and it certainly feels wrong.

So how do we begin to mend this, to change the conversations in the room and look at new approaches?

For me the answer is in the question: we must “change the conversations in the room” or, better still, open up the room so that more people can contribute.

• From drawing board to bedside: Getting ideas through the system
• Public health gets with the programme using technology

The great leveller

As an advocate of social media, I feel it adds a whole new dimension to our normal ways of working. We love structures and hierarchy in the NHS and social media disrupts both.

Social media helps to build communities and offers a level platform for health workers and patients to debate issues, share ideas and connect with each other.

‘How often do we really embrace our staff and communities when we are talking about change?’

It offers a platform where a healthcare support worker can hold a conversation directly with a chief executive, where people with shared interests can openly discuss their successes and failures, and one where patients can make their voices heard.

But how often is that richness and levelling of hierarchy translated back into the real world? The conversations on Twitter that excite people and open doors to other people and worlds are often shut in reality.

How often do we really embrace our staff and communities when we are talking about change? And why are we having the conversation about change behind closed doors, with the same people, with the same views and the same solutions?

Removing obstacles

Bricks, mortar, walls, rooms, structures, hierarchies – don’t they all stand in the way of whole systems and an inclusive way of working?

So, I am calling for a more open, social and connected way of working. By utilising networks not hierarchies, by building relationships not contacts, and by encouraging people to have conversations not meetings, we can step away from the competitive drivers that create obstacles and barriers to people talking and sharing.

Diversity in all its guises is absolutely fundamental to changing the way our current system works.

No longer can we continue doing things in the same way, with the same style of leadership and the same thinking.

‘No one person is perfect; no one person has the answers’

We all know that “leadership” is bandied around the NHS like the antidote to a sick system; I too believe an inclusive leadership style is needed, but I don’t think this is the sole answer.

However, I do think that this, coupled with a strong commitment to creating diversity and inclusion, pushing forward on equality and making it unacceptable to have inequality within the workplace is a great starting point. And by commitment, I mean real equality and equity.

Embracing diversity

No one person is perfect; no one person has the answers. Our religious beliefs, values, social determinants and demographics, our culture and family, every minute of our lives make us uniquely different.

The NHS wants us to embrace different ideas and be innovative, so why are we not embracing diversity in its purest form? Should we not be capitalising on people who are different, who think different, who look different, who sound different?

How are the thousands of NHS staff voices being heard? How does your organisation ensure everyone’s voice is not just heard but holds equal value to those sat on the executive corridor?

‘Should we not be capitalising on people who are, think, look and sound different?’

How can you be sure that Joe, who cleans the floor on the admissions unit at night, doesn’t have ideas that will help to transform that ward and keep patients safe? Do you really hear and value everyone?

This is a huge task but I don’t know if its one from which we can afford to shy away. How can we tell the public we have done everything we can to safeguard the NHS when we are not investing in those people who represent the services we provide?

I wonder if our current style of communication, whereby the national leader stands at the front of a stage, is just replicating the command and control style of leadership we are so desperate to move away from?

The NHS loves neologisms, one of the latest being “through diversity” and I agree with it. We do need diverse thinking, but it is not only thinking that we need – we need diversity of action too.  

Shaping the future

This is why we created the New Health and Care Voices initiative to create a space for those passionate about having a voice that helps shape the future of health and care to come together as a community.

This space is where they can share innovations and ideas that might ultimately shape the future of health and care.

It enables participants to hold conversations in a safe non-threatening environment, to connect and build relationships, and for leaders to be accessible to everyone at any level, sector or community.

‘It’s clear from the conversations we hear that people are not feeling included or valued’

It sounds really simple but it’s clear from the conversations we hear that there is a need for this – people are not feeling included or valued.

New Health and Care Voices has grown since its launch in March 2014, both virtually on social media and in person at our events.

To date, we have organised three free events across the country in Leeds, Birmingham and London, with contributors including Karen Lynas, Rob Webster and Helen Bevan.

The community of voices is growing and people are embracing the new forum for debate, but for me the marker of true success will be when it no longer needs to exist – that’s when I will know we have got it right.

Kirstie Stott is programme manager of West Wakefield Health and Wellbeing and one of HSJ’s Rising Stars