Siva Anandaciva, Chief Analyst
In 2017 more than one NHS leader has said that staff shortages are a more serious concern than financial challenges. While the recently published draft national workforce strategy is welcome, for me it wasn’t the most illuminating workforce discussion this year. This happened in a room at The King’s Fund where two GP trainees gave a candid presentation about what their professional life was like.
When I joined the Fund this year I was allowed to ease myself in, with induction meetings and guidance on how everything worked. These GP trainees were thrown into the deep end of a deep pool and were expected to hold the angst of patients and staff as operational pressures rose. They spoke of having to seek out how basic processes, such as escalation procedures, and of spending hours on the phone to arrange referrals for patients – only to find later that referral procedures had been changed. While a new national workforce strategy is important, there is much that organisations and employers can do to support staff more effectively. In 2018 the Fund will look at how we can capture and share opportunities to improve the working experience of NHS staff.
Harry Evans, Researcher, Policy
This year our events team put together something new for The King’s Fund: a festival of Ideas that change health care – a futuristic, yet realistic, day of colourful talks from inspirational people. I chaired a session on artificial intelligence (AI) in health care, and I was fully prepared for the usual hype that accompanies AI.
What I actually heard was a collection of talks that were optimistic and grounded. Dr Dominic King, of DeepMind, painted a hopeful picture for what AI might achieve in health care, while Dr Matt Fenech, of Future Advocacy, highlighted the deep societal challenges that come with AI. Maxine Mackintosh, co-founder of One HealthTech, showed the importance of diversity in data science (or else, ‘everybody dies’), and Carol Platt, from Alder Hey Children’s Hospital, demonstrated the importance of technology in children’s health care.
Instead of being a session about the unbounded possibilities of AI, I left with a profound sense of how the success of technology is contingent on putting the patient and society first.
Katie Mantell, Deputy Director of Communications and Information
The one thing from 2017 that really sticks in my mind is Elin Roddy’s vivid portrayal of some of the challenges and contradictions of being a physician in an overstretched and under-resourced hospital. Her honest account of the daily challenges of her job – which see her and colleagues walking past people on trolleys, patients waiting for vital medication, families in distress – prompted her to ask, ‘Are we accepting the unacceptable?’.
I wasn’t the only one affected by the strength and honesty of her account – her blog attracted unprecedented numbers of views on The King’s Fund site, with almost 6,000 views in the month after it was published. I think that as we approach what looks likely to be a tough winter for the NHS it’s vital to give voice to the reality of the way some of these pressures play out for clinicians, patients and their families.
Alex Baylis, Assistant Director of Policy
Earlier this year the Care Quality Commission reported that a child and adolescent mental health service had been operating with a 31 per cent staff vacancy rate. For me, this really brought home the difficulties arising from our national inability to plan, to recruit and to retain staff. In purely practical terms, how exactly do you manage a health service day in, day out with a third of your staff posts vacant? It doesn’t bear thinking about – it must divert huge amounts of time and effort into ensuring basic safety for patients in vulnerable circumstances, and (probably) to beg, steal or borrow to cover the extra costs, rather than channelling that time and energy into providing good-quality care, which is why many people choose to work in the NHS in the first place.
Tricia Boyle, Senior Consultant, Leadership and Organisational Development
2017 was my first year at The King’s Fund and I spent a considerable amount of my time working on four collaborative leadership projects alongside Mark Doughty. The projects varied, but always involved collaborative working between patients, citizens, clinicians and managers, and included a practical element of implementing an innovation or improvement in their local setting.
I worked with participants directly to dig deeper into what’s changing, what’s being learnt at an individual, group and organisational level. It has been insightful to track which approaches have been helpful, what’s not yet landed or is of no interest, and what’s needed next. Personally, I’ve learnt not to be surprised any more at how some things are really meaningful to some people and just not relevant to others. Yet I have been also pleased to see how almost everyone needs to learn to set aside their own agenda and to really listen and attempt to explain themselves better when trying to move from a ‘them and us’ mindset, towards a collaborative ‘we’.
Leo Ewbank, Researcher, Policy
The launch event of Nicholas Timmins’ report on the Getting It Right First Time initiative (GIRFT) stood out for me. At this event, Nicholas spoke alongside Tim Briggs, chair of GIRFT, and David Sloman, chief executive of the Royal Free London Foundation Trust.
Briggs talked about the origins of GIRFT, its evidence base and plans to roll it out across medical and surgical specialties in the NHS. He explained how interrogating the data reveals the extent of unwarranted clinical variation in the NHS and taps into clinicians’ instinctive desire to do the best they can for patients. Sloman highlighted that one of GIRFT’s key strengths is the way it engages frontline clinicians in driving improvement.
While the case for more NHS funding still needs to be made, I left feeling optimistic that there is scope – and, depending on GIRFT’s success, a method – to use existing resources better and deliver greater value for patients.
Durka Dougall, Senior Consultant, Leadership and Organisational Development
From the many experiences I had during my first year at the Fund, the one thing that probably stands out most in my mind was a series of interactions with a clinician who was a participant on one of our programmes. One of my colleagues, who was facilitating the programme, recognised that this participant was struggling to cope with a very challenging period at work. This colleague made personal efforts to connect the participant with support, and together over a period of months we helped them to cope better with their situation, slowly turning their outlook into a much more positive one. This person-centred focus, both in desire to make change happen and investing constructive efforts towards this, demonstrated exactly what we are trying to foster across health and care. It reminded me of our collective potential across the Fund and just how well placed we are to support improvements more widely.
Shilpa Ross, Senior Researcher, Policy
This year it has been refreshing to work on two research projects that have been about shining a light on how the NHS can be at its best: quality improvement in mental health and transformational change in health and social care. Personally, I have been inspired by how individuals working in health care and the voluntary and community sector have pulled together in a concerted effort to innovate and make things better for patients and the communities they serve. In the face of very tough conditions, so many people are still committed to doing whatever it takes to improve the health and wellbeing of others. This keeps me feeling positive and motivated about what we can do to help make things better too.