“Cause More Trouble”
That was one piece of advice from David Nicolson, Chief Executive of the NHS speaking at a Department of Health conference 8th July to those representing the patient interest. The venue was the cathedral-like space of the Lawrence Hall in the Royal Horticultural Halls before an audience of specialists and enthusiasts working in the area of people participation, involvement, engagement – the vocabulary changed as fast and as frequently as the sky over Wimbledon. Many of them had gathered before in halls to be assured that the future of patient participation was now safe and on a good road only to be disappointed by the reality down the line. Does the NHS this time have a new story and a new song that will not just promise a new dawn but deliver it?
NHS – the New Story and why not? – a Song as well
The speakers assured us that this time it would be different and I was tempted to believe them. What has changed for the better? The NHS now has a draft Constitution which will fix the customer at the centre of the system. That system will be based on World Class Commissioning. The Constitution will define the expectations and service aspirations. The commissioning process and the associated systems will assure compliance. Not a national target in sight and now we have local service designed and commissioned with local people and their needs in mind. Hence the Merle Haggard lyric celebrating the new freedom that will flow from commissioning and delivering for the local community. Going with the show biz flow, we conference attenders did get a playlet that dramatised the present and the future, daring to look 5 years into the future. Alas one thesp running to embrace this vision, fell over Meredith Vivian’s dog. I was cheered by this note of realism that reminded us that there would be obstacles in the road to the future but nevertheless the show went on.
The ducks seem to be all lined up. The juggernaut is rolling. Satisfaction with the NHS as measured by Ipsos MORI has never been higher. PCTs have never had so much money. The presses at the Department of Health have been rolling without pause or interruption – in the period between 9th May and 3rd July the Department pumped out no fewer than 7 publications including the final report by Lord Darzi.
Ben Page of Ipsos MORI provided a valuable corrective to the mood of euphoria in the form of some facts about the gap between the promise and the reality. Almost everybody thinks being involved is a great idea – 82% according to his data support the idea of being involved but at the end of the day about 2/100 actually turn up. But everybody likes organisations that offer the chance of getting involved and Ben told us why South Tyneside had been recognised this year as the Best Achieving Council. Their ads showed the engagement process the Council favoured “We Asked, You Told Us, This Is What We Did”. Closing the loop and reporting back on what happened as a result of a consultation or engagement programme is emerging as the key ingredient in sustainable engagement programmes. Ben made the point that the best regarded local authorities were on the whole the best known ones. Information is a vital precursor to engagement.
Keep telling that story or indeed singing that song.