A couple of years ago I spoke to healthcare professionals in the US about what makes for a joyous day at work as part of a project sponsored by the Commonwealth Fund, when I was working in America as a Harkness fellow.
The project took me to two states on different sides of the country and gave me the opportunity to talk in depth to obstetricians, midwives and physician associates, using formal qualitative project methodology.
Think back to the day it started. The day you realised that life would never be quite the same again. I imagine nothing quite prepared you for that moment. Maybe it was planned. Maybe it was suddenly thrown upon you. Or maybe you just realised now was as good a time as any.
At first, it might have felt like you were furiously treading water. And then one day, you realised you were simply doing it, the parenting thing. There was even the odd day when you’d congratulate yourself on just about nailing it. And then your children would pass into a new decade, or life would throw a new curve ball, and it would feel like that first day all over again.
I know you’re in the middle of something – thanks for even stopping by – but could I borrow you for two quick thought experiments? Only be a minute.
First, you’re a government minister. Or a chief executive of a national statutory body. You’re announcing a nationwide change programme to help safeguard the future of the NHS, our most beloved institution.
You want it to sound suitably impressive, capable of making headlines and winning plaudits. What do you say? A pot of money? A new ‘thing’ – an institute perhaps? Probably a number (containing many zeros) of new clinicians to spearhead your charge. The creation of a new acronym certainly.
Here at Kaleidoscope, we think a lot about trust. And while we don’t sit around campfires carrying out trust falls (not yet, anyway), it does shape how we work both internally and externally and impacts how we foster collaboration.
Over the coming weeks, I’ll be blogging about this somewhat broad and seemingly insurmountable topic, ranging from the definition of trust and the importance of it to how it is built. I'll also be talking about why it isn’t reaching its full potential.
A recent survey by CIPFA draws attention again to the essential capability that sustainability and transformation partnerships (STPs) need: the ability to collaborate.
Why is this basic capability in such short supply? Because we have invested instead in highly accountable organisations, targeting measurable, manageable transactions. 'World class commissioning' was not collaborative but contractual. Success or failure was cashed out not in health outcomes, but in the financial outturn.
It was one of those conversations. I put the phone down, swore gently to myself, and sat staring into space. Four hours later and I still don’t know what to do with the information I received. Putting it on a screen is one thing, finding an adequate personal response is another.
I found Alex on the internet. He’s fiendishly articulate, writes brilliantly and happens to have spent some time detained at Her Majesty’s pleasure. He also, it turned out, was open to having a conversation with me about health care in prisons. It’s that conversation that I’m recording here, and in acknowledgement that in a world of multiple truths, this is one of them.