Weeknote: 27 June to 1 July 2022

Garden with shrubs and trees in front of 7-storey red brick office building
3 days in the Leeds office this week

What did I enjoy?

Meeting people, some face-to-face for the first time, out for drinks to mark an NHS England colleague’s retirement. There’s a close-knit team around urgent care in the NHS national organisations. They’ve worked together for many years, and supported each other through the toughest of times both professionally and personally, but they’re still very welcoming of newcomers like me.

It was great to see the importance of user-centred design reiterated in this week’s plan for digital health and social care, including a link to the NHS digital service manual. My team also contributed a small amount of content about Digital Urgent and Emergency Care (UEC), but there will be more on that as part of forthcoming strategies covering UEC services more generally.

One of the things I’m learning since moving from NHS Digital to NHSX, and now the Digital Policy Unit, is how to work with policy colleagues. My respect for them has definitely increased as I’ve seen the pressures they’re under to provide timely, high quality support to ministers.

For the UEC strategy work, Barbara and Brin have done a great job of structuring some key questions and identifying people who we need to involve. This includes linking with patient engagement work that Brin has kicked off in the past couple of weeks.

On Friday morning, I took over the NHS England Digital UEC team’s weekly retrospective with an activity structured around our directorate’s new purpose statement and ways of working. The purpose statement was written and revised through a series of workshops with colleagues from across the teams that will be part of the new NHS Transformation Directorate. It talks about how we all enable the delivery of the best care and outcomes for the NHS and people that it serves.

I started by asking my colleagues, “What did we do this week that delivers this purpose?” The team had loads of concrete examples. We also looked at how we aspire to work together, and how we work with other parts of the NHS and social care.

It’s easy to be cynical about statements like these, especially on the difficult days when the behaviours we experience seem a long way from the aspiration, but it’s an important step in bringing organisations and teams together, to acknowledge that even though we’ve come from different places, might use different language, and don’t yet know each other very well, we still share the same purpose, and all need the same kinds of conditions to do our best work.

Bonus thing: with the formal merger of NHS Improvement into NHS England, I now have a shorter email footer. I liked that the guidance on how to update our signatures recommended all text should be the same size, same font and same colour. The new organisation is taking accessibility seriously in its branding from the outset.

What was hard?

Against the long list of great stuff above, there was a blocker on an HR issue all week, which remains unresolved. There have been times in previous roles when I have really struggled with behaviours that disempower managers, without seemingly promoting either fairness for the colleagues involved, or aligning with the organisation’s purpose. I hope I’m wrong, but this felt a bit like one of those.

What did you learn?

A conversation with a senior leader who is new to the NHS reminded me how confusing the whole system can look. This is especially true in our organisation’s transition state where the leadership and communications infrastructure around our teams has been dispensed with, and its replacement is still very tentative. Little wonder that it’s hard to tell who does what.

I reflected that we always need to disentangle the things that are over-complicated from the ones that are inherently complex because of the scale and fluidity of the health and care sector. Where we find genuine duplication, we should try to address it. On the other hand, the health and care ecosystem across England is massive – well over a million people work in it. No single team or management hierarchy can ever address it all, so we sometimes have to get out of the way and respect that we can’t solve everything ourselves. Connecting our service means that we have to trust our colleagues elsewhere in the system; they might just know what they’re doing! When we jump to conclusions without this trust, things start to go awry.

Not long after that realisation, Alice posted this:

I agree with Alice.

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