Weeknote: 16 to 20 May 2022

Rear half of a white car wih NHS and 111 logos on it. Green and yellow check strip to denote urgent response
Urgent response car at IC24, Norwich

What did you enjoy?

A trip to Norwich to visit the 111 contact centre there. Almost all of the NHS England Digital Urgent and Emergency Care (UEC) team were there, along with Gareth, our clinical lead for integrated urgent care, and 4 colleagues from the 111 online team. What made the visit really powerful was that we had a couple of our patient and public voice board members with us too. Their questions helped us stay focused on the things that will really make a difference to patients. We heard from IC24, the 111 provider, about their model of care, and listened to a recording of a health advisor taking a call from a member of the public, supported by Pathways, the NHS’s clinical decision support system for UEC.

What was hard?

It’s always hard to hear about times when care could have been better, and one of our PPV board members recently lost a family member who had a mental health condition. We need to hear those stories from the family’s point of view, even when it’s hard to do so. It’s the only way we will make our service better for the future.

What did you experiment with?

Listening to the stories of patients and carers puts into perspective some of the frustrations I’ve been experiencing with the long-running restructure of our national NHS organisations.

In last week’s note, I mentioned that I can currently count at least 6 people with a specific interest in overseeing the work for which I’m senior responsible owner. This week, I decided to make things clearer by circulating my senior team’s draft 2022-23 objectives to all of them, as well as to my team members and other people who I know have a strong interest in our work. I added a link to a short survey form asking 2 questions for each of my 5 top-level objectives:

  • How important is this objective to you?
  • How should we involve you in our work on it?

I was pleasantly surprised when 3 senior people came back to me within a couple of days, giving thoughtful feedback on my objectives. The responses to the survey will give me some data to help steer the programme through the next 12 months, while formal accountability remains diffused.

What did you learn?

I reminded myself of this classic advice from Elizabeth Ayer: “Don’t ask forgiveness, radiate intent.

What do you need to take care of?

Given that UEC (and healthcare in general) is complex and interconnected, there’s an ever-present risk of scope creep, whether intentional or not, when people start trying to solve one problem but get drawn into addressing another. I can see that happening in a couple of pieces of work, and it’s a tricky balance – to know when the evidence is calling for a genuine pivot, as opposed to those times when it’s better to stick to the task at hand.

I continue to balance my work on UEC with support for my wider directorate and profession, which includes a mix of NHS staff and Department of Health and Social Care civil servants working in the joint NHS Transformation Unit. I’ve identified a gap on the NHS England side and volunteered to help fill it, with the support of Simon, my direct line manager.

One of my draft objectives is to nurture a diverse and inclusive multidisciplinary team environment. In the past couple of weeks, I have heard about two times where people in my team felt they weren’t treated with respect by someone senior to them in another part of the organisation. In the first case, I’ve already mentioned it to the senior person’s line manager; in the second, I will do the same next week. Everyone deserves the presumption that they’re doing their best according to the goals they have been set, and the tools they’ve been given to do their job.

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