The joy of being appreciated

Regular readers of my Simplicity Blog will remember a few weeks ago I posted my thoughts on the Pain of Learning. This was about some poor feedback we had after one of our Trust Me I’m a Patient workshops.

This morning in my email inbox came this from the person who commissioned our latest Trust Me I’m a Patient workshop yesterday morning.

‘Thanks so much for such a fun and useful workshop. I had a great time and am really pleased it went so well. The few people on my floor that also attended were still buzzing when they got back – it was the talk of the office for the afternoon! Feedback was fantastic and it was wonderful to see everyone engaging and having fun’.

So my posting today is not about the pain of learning but about the joy of being appreciated.

Say 'thank you' to someone today - they will enjoy the feeling - you might just make their day. And I suspect you will feel good for doing it

Enthusiasm Rules OK!

As a 'mature adult' I have to say I get more than irritated when youngsters are criticised. I am very optimistic about my future being in the hands of the young people of today.

How fabulous it is when we see a youngster with real passion to make a difference. Yesterday Annie and I met such a youngster working in the National Health Service.

She is only 23 and it is just so obvious from her whole demeanour that she really wants to make a difference for her patients in the caring role she fulfils in the National Health Service.

She works with some very challenging clients and yet she approaches her job with such brilliant enthusiasm and optimism. I pray that she never loses those qualities and I just hope ‘the system’ does not beat that innocence out of her and wear her down. We simply cannot afford to lose people like this.

We need people like this young woman more than ever before in management and leadership positions because it seems to me there are far too many people either burned out, tired or demotivated .... or worse still .... all three!

Trust Me I'm a Patient

Today we delivered the first of a series of 25 ‘Trust Me I’m a Patient’ workshops across the South Central part of England in the National Health Service (NHS) between now and the end of June.

This workshop is about winning hearts and minds of front line staff, clinicians and managers working in the NHS about greater patient involvement in health services.

Annie and I work together in these half day workshops and that just adds to my joy. Not only does it feel like we are trying to help NHS staff and managers to increase customer involvement but the fact I am working alongside the woman I love makes it doubly enjoyable – life does not get much better than this. Annie is first of all a wonderful wife and also a brilliant professional. Thank you God!

If you are interested you can see more about our workshops at my Website - click here

The first workshop today was in Southampton and it went well. We had excellent feedback in the evaluation.

One down 24 to go ….

Electronic Patient Records

I said I would return to the subject of the introduction electronic patient records in the National Health Service.

I will nail my colours to the mast from the outset – I am a great fan of electronic notes. I actually believe most clinicians working in the NHS are also fans in principle.

I look forward to an electronic system that means wherever I am as a patient in the UK (or indeed wherever I am in the world) the health professionals involved in my care can log in and see my health record wherever I happen to be. I am convinced this will improve patient safety and could save lives.

The main concerns appear to be about security of information and whether our information is safe or not.

This has been highlighted in recent scandals in other government departments such as the Tax Office and Child Benefit where CD’s containing personal information have apparently been ‘lost.’

It goes without saying we need to make sure there are strict safeguards built in to the NHS electronic patient records system to ensure no such ‘accidents’ happen with our personal health records.

I certainly do not want a system that is so insecure that my health records may end up for public viewing!

There are also concerns about who will have access to view patient’s notes within the NHS. Will all staff for instance have access to all patients’ notes? The short answer is no. Modern software easily enables restricted access and the issue of access to non clinical staff is less of a security risk than we currently have with paper notes.

I will share a story to illustrate my point.

When I was 16 years of age I joined the NHS straight from school as a very junior clerk. One of my first jobs was in the medical records department. As a 16 year old - and very green around the ears - I had total access to all the patients’ notes of that particular hospital. That is how secure/insecure patient’s paper notes are in reality in a hospital. So the idea that paper records are more secure than electronic records is totally flawed in my opinion.

Also there are numerous examples over the years of paper notes ‘getting lost.’

I share concerns of all who worry about the security implications. I think we have to make sure whatever electronic system the NHS finally plumps for gives the patients the guarantees they need about security.

I hope patients support the principle of the electronic record because this is definitely the way forward.

Our Mental Health is precious

Three of my favourite films are;

*A Beautiful Mind
*One Flew over the Cuckoo's Nest
*The Dream Team’

All are powerful films portraying the challenge of people who have mental health problems being fully accepted by the rest of us – the supposedly ‘normal’ population.

In ‘A Beautiful Mind’ Russell Crowe brilliantly portrays the mathematical genius John Nash in his battles to rid himself of the images and voices that haunt him as he struggles to cope with his own genius.

Jack Nicholson in ‘One Flew Over The Cuckoo's Nest' is fantastic and I feel this film should be compulsory viewing for all employees working in mental health care. How the rights of people are completely stripped in an old fashioned institutional setting is emotionally harrowing. But the ‘inmates’ rise gloriously if tragically above it all in the end.

‘The Dream Team’ is a touching and moving story of how four inmates from the local mental institution are left to fend for themselves in the centre of New York after their Psychologist is mugged. The ‘inmates’ have to cope with life in the City for a few days. It is a remarkably powerful film tinged with comedy and poignancy.

We all walk a very thin line between staying mentally healthy and becoming mentally ill.

People who have mental health problems need to be understood and helped - not shunned by society.

A trip to London

The spectacular Canary Wharf, London

I spoke to a group of 25 dentists in London on Thursday evening about the value of patient feedback leading to improvements in services.

The great news is that it seemed to go down well which I was delighted about because dentists in the National Health Service are often portrayed as 'stuck in the mud' old school folks who do not want to change. Nothing could be further from the truth.

This group of dentists seemed to take on board the concept of listening to patient feedback and making changes as a result

So I felt good that it was a worthwhile visit to the smoke …

On the way back from the meeting I got chatting on the train in London to a young American lad (probably late 20’s) who had moved to London from Chicago four months ago. He worked in the financial quarter of London in the Canary Wharf area - which by the way is a spectacular sight at night from the train on the journey back into Central London. The young American was telling me how much he loved London and the English lifestyle. It made me feel very proud of my great country.

One thing he said was how he finds it odd that Brits are generally so miserable first thing in the morning at his office. He is obviously getting to know the average Brit pretty well methinks!

He told me he believes London will become the financial capital of the world in the near future. Already he tells me London is the financial capital of Europe and is challenging New York and Hong Kong for the number one spot in the world.

Tony Blair could not have been all that bad after all.

As regular readers of Simplicity Blog will know I am a great fan of TB. I realise I am now in a great minority - but hey come on – that has often been true of my opinions so why change the habit of a lifetime of being in a minority?!

Patients Stories

I do a number of talks nowadays to health professionals about greater patient involvement and improving communication between patients and professionals in the NHS.

I often use this fictitious story to illustrate some of the problems.

Joe Bloggs goes into his local hospital for routine surgery and a couple of days after his operation there is a phone call to the ward in which Joe is a patient.

The caller asks ‘Can I ask how Joe Bloggs is doing please?'

The nurse in charge of the Ward replies – ‘Oh Joe is doing fine. His surgery was successful; he is recuperating very well and we are expecting the Surgeon to allow Joe to be discharged home today. Can I ask who calling please?’

The caller replies ‘Thanks for that information, this is Joe Bloggs. No bugger tells me anything around here.’

Of course that is an exaggeration … isn’t it?

I would love to hear stories from Simplicity readers about the good and bad experiences of communncation in healthcare settings whether in hospital or General Practice.

Real stories (anonymous of course) are always great subject matter in my work

Thank you in anticipation.

Carers - the invisible army

I am honoured to be part of a small team of facilitators currently running a series of 9 consultation events in various regions of England asking carers to have their say and their input to the revised national carer’s strategy.

The 'New Deal for Carers Strategy' will be published in early 2008 by the Department of Health.

Today I met another 10 fantastic carers as part of that process.

I have worked closely with carers for over 20 years and I sometimes rather arrogantly start to think I know a fair bit about the subject of carers. Then I am pulled up short and reminded with yet another amazing story from carers themselves how little I actually know about what it is really like to be a carer.

Today two people in my group told me they have been caring for their spouse for a total of 15 years between them and neither of them has ever had help from the services that are meant to help them such as social services and the NHS.

For instance neither have ever received respite care – indeed one of the two did not even know what the expression ‘respite care’ actually meant.

It is incredible that in 2007 we have so many 'hidden carers' who are just 'doing the job' from a sense of love, duty and obligation and they are not asking for help because they do not know they are legally entitled to it.

The Government is getting care on the cheap through carers goodwill and the more we can promote the needs of carers the better.

'Trust Me I'm a Patient' - 14th Episode

Early start on the train at 7.15 am for Annie and me as we head up to ‘Geordie’ land in South Shields near Newcastle tomorrow for our 14th Trust Me I’m a Patient workshop … Good fun and serious learning in the same workshop.

As I always say at the outset of every workshop …. ‘It really is not compulsory to be miserable at work.’

Another 80 delegates tomorrow … that means almost 800 delegates have now been through our workshop. We are both very proud of that.

More details can be seen by clicking here

In a nutshell it is about trying to get NHS staff and managers to see change through the eyes of patients….

We love it!! And feedback to date has been good

Memo to All 1.3 million NHS staff!

As a follow up to the Ricardo Semler posting this is a copy of a slide I use in all my talks on healthcare. This says it all - simplicity and a wonderful reminder to all staff in the NHS why they are employed.

I'll stick with the NHS thanks!

Having worked in the NHS for over 30 years I am one of the biggest critics of our NHS when it fails to deliver for patients.

I am also one the NHS's greatest advocates.

I am immensely proud that we in Britain still have universal healthcare for over 60 million people regardless of their wealth. The important thing to know is we have a NATIONAL Health Service even though I acknowledge all its warts and wrinkles.

The NHS will never be perfect but I saw this video from the United States – one of the richest countries in the world - and it really made me think.

As I watched it I thought to myself … our NHS is wonderful!!!

Although the clip is 8 minutes long it is well worth sticking with to understand just how lucky we are to have the NHS. I would love to have some comments on this.

Trust Me I'm a Patient

In the next month or so in various parts of England, Annie and I will be delivering 4 more of our highly successful inter-active workshops called Trust Me I’m a Patient.

This is an exciting and creative way for healthcare staff to see change through the eyes of others - especially patients. Click here for more details.

Trust Me I'm a Patient is a facilitated workshop that last for between two and three hours. It enables all participants to play a different role to their normal role in a scenario we re-create similar to those everyday scenarios faced by healthcare managers in the real world. For example the closure of three GP Surgeries and their replacement with a new purpose built health centre in the out of town shopping centre. The issues of public and patient involvement are then played out.

Feedback to date has been good and we have delivered the workshop to almost 550 participants.

It is great to receive bookings for more workshop as words gets around that role play and drama is an effective way of learning.

It is even more encouraging that hard pressed NHS managers who are struggling to balance their budgets are finding money to invest in this creative way of developing their staff.

Confucius Says

The best advice is often just a few words.

I was 24 and very inexperienced when I got a good job as manager in healthcare in a residential unit for people with a learning disability.

To be perfectly honest I was scared of people with a learning disability because in my childhood in the 1960’s these people were never in the community – they were in hospitals.

I met the doctor I was to work with for the following 4 years and he told me;

‘I expect just two things from you as a manager. One is to keep an open mind and the second is to spend time with the patients and their families’

That was terrific wisdom from a man I greatly respect. By following his advice I came to love the time I spent working in that service.

It turned out to be the best possible advice I could have had at that time in my career. I spent 4 years working in this area of healthcare alongside this doctor and it was the most rewarding and educational of the 35 years I spent in the NHS.

What great wisdom have you received in your career?

Spare a thought for the Receptionist

Annie and I ran a Customer Care Workshop for front line receptionists in a GP Surgery this week.

We had the pleasure of working with 16 receptionists and we were impressed with the dedication and enthusiasm of these people to improve the way they do things.

Receptionists in doctor’s surgeries often get bad press and until you spend time working with them I would ask you to try and understand some of the pressures they are under.

They have to deal with the demands of ‘customers’ coming at them constantly. At the same time they are acting under strict instruction from doctors who are busy people and have to ration their time very carefully to meet the demands of their patients.

It makes for an interesting life as the ‘meat in a sandwich’ as a medical receptionist. Given the pressure they work under, it was good to hear that patient feedback is excellent on the whole.

What impressed us most was their willingness to accept that however good their service is, there is always potential to improve.

We enjoyed working with these front liners who represent their service very well.

Next time you visit your GP Surgery try and remember the Receptionists are key players in your treatment and they do their best under sometimes trying circumstances.

Scandal of Hospital Car Parking Charges

I can remember in the early 1980’s when I was a young hospital manager and car parking charges were introduced.

All those nice accountants in my hospital said … ‘This is only a nominal sum and merely a gesture. It will never become income we rely on in the NHS’

How times have changed …

I recently read the exclusive BBC news report (click here ) about hospital car parking - here is an extract

'Hospitals in England are each charging their patients up to £1.5m a year for car parking, the BBC has learned. Twelve hospital trusts each raised over £1m in charges, figures obtained under the Freedom of Information Act show.'

My lesson - Confucius he say:

‘Beware he of the numbers game called NHS accountant who brings promises of jam tomorrow’

At the time in the early 80's as an outspoken young rebellious manager I complained long and hard to my bosses about my abhorrence at charging patients to park.

I was accused of being a socialist extremist.

Without being arrogant I was right and it still riles me today 20 plus years later.

It is scandalous that patients and relatives pay for being ill or visiting someone who is ill.

I have spoken to people who pay £35 per week to visit their sick next of kin in a hospital bed.

Mr Bevan will be turning in his grave.

I DON’T ACTUALLY CARE WHAT NHS ACCOUNTANTS SAY ABOUT THIS BEING NECESSARY – IT ISN'T – END OF STORY.

Apologies!

Apologies for lack of Blog Posts this week – I’ve been busy!!

As a self employed person, being busy means I can afford to eat in March after all.

On Tuesday I was speaking at a big healthcare conference in Swindon and today (Thursday) I had the joy of speaking at another healthcare conference near Belfast. A joy because this was the first time I had visited Northern Ireland.

Trying to fit in some telephone coaching for a client and generally keeping on top of an increasing workload meant that something had to give this week. Sadly it was Simplicity Blog.

It feels like I have withdrawal pains when I miss out on reading the rich comments I receive from Simplicity readers so I will try to get back on course this coming week with more regular postings.

Three pictures from the Northern Ireland conference are included in this posting.

Annie and I travelled over to Belfast on the 6.50 am flight from Birmingham International Airport to Belfast International and we were back in our house by 6.30 pm.

One of the greatest joys of being self employed and working from home is that Annie and I get to go places together in my work. Being with someone I love when I am working makes me feel great, boosts my confidence and makes work an absolute pleasure. Thank you darling Annie for your support and your love x

Keep Asking Patients

I’m spending two days (Wednesday and Thursday) at the conference of the National Institute of Clinical Excellence (NICE) in Birmingham.

NICE is the body that publishes the best evidence-based practice in the National Health Service. They are well known for making the most authoritative statements about whether new drugs should be introduced in the NHS based on strict trials.

Imagine my delight therefore when I heard a discussion on stage in front of 500 or more people involving 4 highly regarded healthcare Gurus who all agreed that there is a desperate need for more patient involvement in the work of the NHS. Hooray - I have been saying that for 30 years!

It is music to my ears that these words are coming out of the mouths of such high profile people. My concern is whether this message is understood and implemented by Chief Executives, Directors of Finance and Senior Managers in the NHS.

In my experience (35 years as a manager in the NHS) when the chips are down and hard decisions have to be made the patients opinion comes nowhere in the list and it is the financial position and the bottom line that always is the priority.

So many times in my career I heard expressions like “We agree in principle about greater involvement of patients but our priority is to balance the books.” That sort of statement says it all.

My feeling is, and always has been, that if we genuinely engage with patients in an honest and open relationship then patients will help us make those difficult decisions. I believe patients are harsher critics than managers about wasted expenditure and inefficiency in the NHS. And patients have many creative ideas to solve these problems.

Nevertheless I remain optimistic as long as I hear these encouraging words from NICE.