"Better Doctors Safer Patients"

Chief Medical Officer, Sir Liam Donaldson - Author of the 'Report Better Doctors, Safer Patients'

I am currently heavily involved in some work that has required me to read a 218 page report recently written by Sir Liam Donaldson, the Chief Medical Officer in the Department of Health.

The report is called ‘Better Doctors, Safer Patients’ and this is the culmination of inquiries, adverse reports and scandals about the behaviour of some UK doctors over the last few years. The best known is the infamous General Practitioner, Dr Harold Shipman who murdered over 250 of his patients. The exact number of patients he murdered will probably never be known.

A good friend and colleague of mine who is a well respected and high profile GP always says to me, “We must remember that Harold Shipman was first of all a murderer and secondly a doctor. All doctors should not be tarnished because of the actions of one murderer.”

I agree with that statement. The greatest quality I have come across among the hundreds (maybe thousands) of doctors I have worked with in 35 years in the NHS is their professionalism and their caring attitude for their patients.

Having said all those positive things I am nevertheless delighted to see Sir Liam’s report being so honest about the deficiencies in the regulation and continuing professional development of doctors. The report contains 44 recommendations and the report is currently out for consultation until early November.

To this point doctors have been the subject of mainly self-regulation and whilst there is clearly a place for that, it seems to me inevitable that the medical profession must be dragged – even if screaming - into the current world of appraisal from various interests rather than simply doctors judging doctors with all the inevitable problems that brings.

Sir Liam’s report is also interesting because the language used is generally straightforward and not full of intelligible NHS jargon. What a joy that is for a change!

I guess a few regular readers of Simplicity Blog might be interested in reading the report and if so you can see it at this by clicking here

One staggering statement is that once doctors reach ‘independence’ status – i.e. consultant level – their knowledge, competence, clinical skills or performance are not formally assessed from that point until they retire. That could be 30 years. Contrast that with pilots who are formally assessed up to 100 times in that same time period.

My feeling is that Sir Liam’s report provides a framework to protect patients, the medical profession and the doctors. This can be a win-win-win if the report if implemented and acted on fully.

Time to Savour a victory over our friends in America!

Biggest cheer of the day went to Darren Clarke, who broke down in tears after beating Zach Johnson 3&2

It was just wonderful to see Europe win the Ryder Cup for the third successive time.

It is not often we beat the United States so comprehensively in any sport so I hope my friends on the left hand side of the pond excuse me for making the most of this rare experience

Surely the most poignant thing was to see Darren Clarke win so soon after the tragic death of his wife who sadly lost her battle against Cancer.

Well done Darren, well done Europe - we will savour this.

The Nine Fruits of Leadership

I am delighted to say my new – and very brief book - The Nine Fruits of Leadership is published. More details here

This is a short, reflective piece about how managers and leaders can take our Christian beliefs to work. It intrigues and confuses me how some argue we must leave our faith ‘at the door’ of our place of work and become ‘someone else’ while we are at work. This makes no sense to me.

The nine fruits are Love, Joy, Peace, Patience, Kindness, Goodness, Faithfulness, Gentleness and Self-Control.

These will instantly be recognised by leaders and managers as what is often called the ‘soft side’ of management and leadership. My belief has always been that to achieve lasting success it is more important to focus on the ‘softer’ values than their opposites – often refered to as the ‘harder’ aspects which are sadly more ‘fashionable.’

I believe it is much more difficult and challenging to lead and manage using the ‘softer’ approach than the ‘hard’ approach which I have always regarded as the simple option.

The Nine Fruits of Leadership will be followed by 9 small pocket books (each on one of the fruits). These will be written with my two writing partners Felix Gerena from the Basque Country, Spain and Roger (Rocky) Noe from Kentucky, USA through our own publishing brand Sweet Friendships. Each of us will write three pocket books.

An exciting project that we look forward to completing in the next three months. This is our second collection under the Sweet Friendships brand after our recent book Three Amigos with One Message.

Felix, Rocky and I want talk to anyone interested in hosting a workshop about how three people from different continents and separated by thousands of miles, and who have never met, can collaborate ‘virtually’ to plan, write and publish a number of books.

By Christmas 2006 we will have collaborated to write at least 11 books (and possibly more) in 18 months. If anyone out there is interested in hosting a learning workshop about innovation and making things happen in our ‘virtual’ world then get in touch – we want to spread the learning.

Let's close a few large hospitals to improve the NHS.

A very serious matter today.

My apologies for the length of this posting but this is important.

The latest criticism of the Government’s health policy relates to a suggestion that some large District hospitals may have to close.

I totally agree with the proposals.

Why?

Simple really – Hospitals should be places we go to when we are ill, not when we are well.

Hospitals should only be places for those who are most ill and thereby offer the best care for those relatively few people who actually need to be in hospital beds. Many billions of pounds every year go into hospital care and much of that could easily be redirected to develop healthcare outside hospitals.

There is actually nothing knew in these ideas. Managers in the NHS have known this makes sense for years.

So why haven’t these ideas been introduced before now?

That is also simple – it is far ‘too hot’ politically – and a guaranteed vote loser for politicians - to even remotely hint that closing hospitals makes any sense.

No aspiring Member of Parliament will ever win votes by suggesting what is considered political suicide.

My argument goes like this;

By closing the hospitals and ‘releasing’ the money, we can improve services in the GP surgery; in the community; and in working partnerships between health and social care providers. This means all ‘less critical’ services can be provided more effectively outside hospitals, in more local care settings, for the vast majority of people who do not need to go to hospitals. This really is a no-brainer.

Ask yourself; Why do people have to go to the hospital out-patient appointments when most of the service they actually receive can be provided in the GP surgery just down the road?

The answers is; Simply because the hospital exists and that is the way we have always done it.

It is always seen as a radical suggestion to close big hospitals. Complex arguments will be put forward about why it is impossible to close even one large District hospital in the entire country.

And yet we all know it makes sense.

I suspect in 20 years time we will still be having these arguments as we were 20 years ago. And I suspect not one large District Hospital will have closed in 20 years time unless the ‘wake up call’ is really grasped

Closing hospitals makes great sense from another angle. They are dangerous and unhealthy places to be in.

If you think I am exaggerating or using emotive language about the dangers of being in hospital as a patient please read this and reflect:

‘It is estimated that around 10 per cent (900,000) of patients admitted to NHS hospitals have experienced a patient safety incident, and that up to half of these incidents could have been prevented. Furthermore, it is estimated that 72,000 of these incidents may contribute to the death of patients.’

Source: The Health Foundation
http://www.health.org.uk/ourawards/service/index.cfm?id=41

At last - Truly GREAT 'customer' care!!

I have long been outspoken about the total lack of real ‘care’ and responsiveness to customers from business. I am therefore delighted to redress the balance today.

My greatest criticism is the total lack of concern and response from companies when customers have genuine questions or indeed criticism.

In my experience most companies just don’t ‘get it’ about customer care and they hide behind corporate defensiveness and complex language …. Or even worse ….. They don’t even bother to respond at all.

This morning I was surprised and delighted to receive a personal phone call from Duncan Bannatyne, the Owner of Bannatynes Health Clubs, a National Chain in the UK with 60 Health Clubs and over 180,000 members.

His phone call followed an e–mail I sent to him just two days ago with a couple of questions as a paying customer of a Bannatyne Health Club.

The fact that Mr Bannatyne personally found the time and interest in his busy schedule to respond to me within 48 hours on an individual basis means that my feeling about the Health Club goes up.

Come on!! This is not rocket science!!

When someone 'at the top' is responsive to customers then customers are likely to feel good about the product; remain loyal and spread the good news – just like I am now doing.

Mr Bannatyne also said that if there are future issues of concern I can write to him direct. That is excellent service and the sort of role model I have advocated for leadership for many years.

All it takes is for the top people to show that level of interest and care for their customers.

It really is that simple - thank you again Mr Bannatyne!

Leadership Qualities

Mother Theresa - humility personfied.

Leaders have many qualities and we all have our opinion about which are more important.

The best leaders I have worked for; those I have met; and those I have interviewed have all had one outstanding feature and that is HUMILITY

Wikipedia defines Humility as follows:

‘A humble person is generally thought to be unpretentious and modest: someone who does not think that he or she is better or more important than others.’

That says it all very nicely.

What the greatest qualities of leaders you have known?

ONE - A Consumer Revolution for Business!

I’ve just finished reading ONE - A Consumer Revolution for Business! by Stefan Engeseth from Sweden.

Stefan argues – and I am 100% with him – that ‘lines’ drawn between customers and businesses are artificial and completely unnecessary. He argues persuasively that customers should be partners rather than being ‘outside’ the company. It will lead to more innovation, greater loyalty and more profit. Business and customers need to become ‘ONE.’

I have argued long and hard that patients should have far more say in the UK National Health Service and so the book is music to my ears. As far as I am concerned Stefan is preaching to the converted but I fear we are still a minority voice.

Stefan and I also share the view that the internet is forcing transparency which of course has not existed for decades. We all know that there are things the customer has not been privileged to know. Customers now have masses of information at their fingertips through keyboards connected to every corner of the world, meaning they are better informed; have more choice; and can force business to become more 'customer friendly.'

As always business has a choice. They can ignore the fact that customers are now in charge but that is probably a guarantee of death in the short or medium term. Or they can embrace the new customer, welcome them in and thrive.

The book is packed with innovative examples where this concept of ‘ONE’ is already happening successfully and there are some wonderful practical ideas in Stefan’s book.

I recommend 'ONE' highly.

You can see more about the book here

Stefan’s Website is here

Take a look

I am too embarrassed to go into too much detail but you can have a good chuckle at Annie’s latest posting on Simplicity Gallery.

I would like to make it absolutely clear this was not my idea.

Please Enjoy :-)

Some posts are worth repeating

In June 2005 I posted this.

Today someone commented about it - 15 months later!

So I decided as a bit of light relief to publish it again. I like it - hope you do too.

15 Things to do in the supermarket, if bored….

1. Get 24 boxes of condoms and randomly put them in peoples' trolley when they aren't looking. 2. Set all the alarm clocks in houseware to go off at 5 minute intervals.

3. Make a trail of tomato juice on the floor to the toilet.

4. Walk up to an employee and tell him/her in an official tone, "Code 10 at Pharmacy" ... and see what happens.

5. Go to the Service Desk and ask to put a bag of M&M's on hold.

6. Move a "CAUTION - WET FLOOR" sign to a carpeted area.

7. Set up a tent in the houseware and tell other shoppers you'll only invite them in if they bring pillows from the bedding department.

8. When an assistant asks if they can help you, begin to cry and ask, "Why can't you people just leave me alone?"

9. Look right into the security camera and use it as a mirror while you pick your nose.

10. While handling knives in the kitchen ware department ask the clerk if he knows where the anti-depressants are.

11. Dart around the store suspiciously while loudly humming the theme from Mission Impossible.

12. In the car accessory department practice your Madonna look using different size funnels.

13. Hide in the clothing rack and when people browse through shout, "PICK ME! PICK ME!!!!"

14. When an announcement comes over the loud speaker assume the foetal position and scream, "NO! NO! It's those voices again!"

15. Go into a fitting room and yell real loudly...."Hey! We're out of toilet paper in here!"

To all our friends in America

We will be praying for you and thinking of you today on the 5th Anniversary.

These two dramatically contrasting pictures save a thousand words. Please visit my friend Starbucker's Blog by clicking here to read a powerful posting. Best wishes from Trevor and Annie to all in America who are still suffering.

'Leadership is a Decision' - Brian Ward

Brian Ward and Judy Worrell

• In my long healthcare management career I worked for many leaders, some good and some not so good.
• During my career I have been in leadership positions.
• I studied leadership for my dissertation when I did my MA Management (Health Care) in the mid 1990's.
• I have maintained my interest in leadership and it is a topic that fascinates me and many other people.
• In the last 30 years I have seen many wordy and academic definitions of leadership. All of them are, no doubt, very worthy.
  
  

However I like simplicity and a couple of years ago, in conversation with my good friend Brian Ward from Edmonton, Canada, Brian came up with a wonderful definition that has stayed with me. Whenever I think about Brian’s definition it re-assures me that simplicity really is the key.

Brian said ‘Leadership is a decision.’

Isn’t that neat? – The most economic use of words that says it all.

I think what Brian means is that we all have a choice about leadership. We can try and ‘take control’ of things or allow things ‘to be done to us.’

Any aspiring leader would, in my opinion, do well to consider Brian’s wise words carefully. We can all learn a lot through reading books about leadership but in the final analysis leadership comes from within. Some people choose the road of taking control and others do not.

‘Leadership is a decision’ – I love it – thank you Brian.

Brian and his partner Judy Worrell run Affinity Consulting in Canada and his new Website is well worth a visit – click here

I like this ..........

Overheard recently ....

Question: How many managers work in the BBC?

Answer: About half of them!

Sorry BBC but I just couldn't resist ... it fits with my sense of humour.

Manchester United on a roll!

The football season is only three matches old.

My team, Manchester United have scooped the awards for both manager and player of the month after the club's perfect start to the Premiership season.

Sir Alex Ferguson has been named the Barclays manager of the month for August and Ryan Giggs, 32, has won the player of the month prize.

During August, United beat Fulham, Charlton and Watford, scoring 10 goals in those three league matches.

Ryan Giggs, despite playing over 600 games, has never won the monthly award before.

I hope United keep up the good form and if they do we may be celebrating again next May.

In 1999 United won a magnificent and unique treble when they won The Premiership, The FA Cup and the European Cup. This has never been done before or since by any other British team.

It is a bit early to set out such high aims but things are definitely looking good so far.

Go on your terms Mr Blair

It’s pretty obvious that the knives are out among senior Government Ministers to force Tony Blair to leave office when clearly the man does not want to go until he chooses the day.

Politics is not that much different to work settings and during my career in healthcare management it was usually clear who was stabbing who in the back as people jostled for position during re-organisations. It is a sort of game.

What is particularly ironic is that the most senior people are the ones who usually proclaim how they will deal with change sensitively. Yet when Mr Blair wants to be allowed to make his own decision about the right time to go all that supposed sensitivity goes out of the window and there is implicit and sometimes explicit pressure for him to go.

I think if I were in his position I would go now because otherwise I can visualise a repeat of those embarrassing and indeed sad scenes when Margaret Thatcher left 10 Downing Street in tears all those years ago.

Go now on your own terms Mr Blair before you leave on others’ terms.

Sometimes it's good to take a break

I have been ‘addicted’ to Tom Peters Blog for almost two years. I have probably made as many comments on that Blog as anyone.

I believe Tom is the greatest Management Guru and his work has influenced me for over 23 years since I read his first book In Search of Excellence He will continue to inspire me I am sure.

Recently however I feel I have become a bit ‘stale’ and 'dull' with my comments on Tom Peters Blog and I have therefore decided to take an extended break from it. It simply doesn't inspire me as much as it did! I suspect this is just a temporary thing that will pass.

What works best for me is positive feedback and I know I am too sensitive about that. This has been a trait of my personality I have learned to live with for as long as I can remember.

In life it seems to me (generally) that everyone gives more than they take and it is important in my opinion to have positive feedback and encouragment. The absence of positive feedback is a critical part of understanding how people are motivated or not.

I would be really interested to hear your views about how to motivate people.

And another book recommendation ....

I’m on a bit of a ‘book roll’ at the moment …

Annie and I often say we don’t find enough time to read and as a result our pile of 'unread material' is growing.

Annie has just finished reading a wonderful book called 'The Diving Bell and the Butterfly' that I am keen to read next!!

More details on Simplicity Gallery

This is the link: http://www.simplicitygallery.blogspot.com/

Read Dan's book in 2 hours

I’ve just read a fabulous new little book in a couple of hours – just my kind of book!

The book is written by my friend Dan Ward in America and is called ‘The Desert and other Good Stories’

Dan, a fellow Christian, says his book aims to ‘present stories and reflections about the Good News in new and memorable ways.’

If you are a Christian then you will find the book re-assuring, amusing, powerful and yet simple. If you are not a believer, not a Christian or if you have another faith I am sure you will find the book worth reading.

As I was reading Dan’s book it occurred to me how humble we should always be given that we are always loved by God and always forgiven whatever our faults and sins.

Dan and I enjoy a mutual interest in simplicity and I highly recommend this book which you can see more about and that you can order by clicking here.

'White Van Man' for the Day!!!

The picture is not me by the way - it is by courtesy of Google Images!!!

Isn’t it great when you do something completely different from your normal day to day work? Today I was ‘white van man’ as Annie and I spent the day clearing the garage at the old house and taking rubbish to the Local Authority tip in a Ford Transit – wonderful feeling!!!

There is something rather nice about becoming ‘someone else’ for the day and this was certainly different to our normal day.

We both found 'dumping' all the stuff somehow invigorating – are we the only two who enjoy this activity ?

I have never been a ‘hoarder’ but I know many people have real trouble ‘letting go’ of stuff.

Two years ago I left Torquay after 22 years to move to Solihull to be with Annie. My entire worldly belongings fitted into my tiny Renault Clio which also had me and Annie inside ... oh ... and my golf clubs of course :-)