Weeknote: 13 to 19 April 2020 – notes from the top of a hill

Both literally and metaphorically, I live at the top of a hill.

Leeds city centre lies in a dip where smoke and traffic fumes linger, so the middle classes have long chosen this leafy suburb, 100 metres higher, as a place to be socially distant.

Here I am holed up in a house that’s big enough for my family, with a garden, and a well-stocked store cupboard. Working from home is no hardship, and my children are old enough to be left to their own devices. In my work, I have a high degree of autonomy and influence in decision-making. My income is secure, and we have money in the bank.

Ours is a very comfortable self-isolation.

I’m acutely aware that the same is not true for all my colleagues in digital health, let alone for all health and care workers, or for the patients and public we serve.


Here’s hoping that the line on the logarithmic graph showed the real peak this weekend. Even if this is the worst it gets, every new day still sees people dying before their time, fewer than before, but that’s no consolation to the families and staff.

I’m in awe of all the people who march up this metaphorical hill in less ideal circumstances to support health and social care every day.

Tempting though it is to separate the world into heroes and villains, everyone involved is human, and doing their best given what they know, their skills and abilities, the resources available, and the situation at hand.

  • What haven’t we noticed, in the rush to prepare for this peak?
  • Who is at risk of being left behind?
  • Who is missing from the virtual rooms where decisions are made?


One day my colleagues and I will return to our workplace down by the river and the railway tracks.

The physical environment will be much as we left it more than a month ago. The desks and chairs will still be there; the same posters and sticky notes on the walls. Will we look at them differently, knowing what we did without them?

People are already saying they don’t want to go back to the old ways of doing things. Momentous though the sudden switch to digital tools may be, it’s only a tiny part of the sustainable, adaptable, contextually-informed transformations that we need to make in the long term.

But first we have to get down this hill. The descent could be more treacherous. One moment of inattention and we’ll slip.

We will be more tired on the way down. Pride in a tight-knit team’s achievements could easily tip into disrespect for others who have different experiences and vantage points.

The next destination will not be as obvious as the summit. The paths coming down are divergent, not convergent, so shared maps become more important than they were on the way up.

The ways of leading that got us to the top of this hill may not be the ones that bring us safely down.

The NHS Constitution, Healthcare leadership model, and our design principles should be our guides.

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