There is trauma and guilt, there is fear but there is also excitement at what has become possible. Things that have been talked about for years have suddenly happened. Some say, ‘The future NHS is out there’ and ‘See what can be done when there is a real sense of shared purpose and we are able to let go of the things that usually tie us in knots: money, meetings, regulation and poor data.’ People now have different pictures of how health services could be.
My colleagues and I sense an urgent need for people at all levels to pause, draw breath, to try and make sense of what has been experienced. What happened? What was more or less important? What helped, what hindered? What was my/our part in it? And what did we learn that needs to inform what we do from now on?
But how to achieve this learning? Where to find the time? And how to create the conditions for genuine learning in groups and organisations? There is lot of talk currently about how to create enough ‘psychological safety’ for people to be able to say how they feel and what they really think.
Some simple suggestions
From experience here are some suggestions for straightforward (if demanding) steps.
- Start with yourself. Are you open to not knowing? Are you curious about what just happened and how it came about? Talk to those you trust. Ask how you could set an example.
- Keep it simple. Work with the immediate and practical: things you can influence. Ask simple questions: What worked in the crisis and what didn’t and why? What needs to be built on? And what needs to change?
- Bring in different voices. If you talk to the same people in the same way as before, you will have the same conversations. Think about reaching out to groups that you don’t routinely speak to – for example, patients, the public, carers or less listened-to groups; they have the potential to change your thinking.
There is an old saying: ‘Don’t waste a good crisis.’ In the pressure to rush on to the next stage the health service risks simply returning to the world of targets, performance management and pretend certainty. Vital learning will be lost. The work done by so many during this crisis deserves better than that.
In the past I thought there were unnecessary face-to-face consultations between Clinical staff and Patients - many could have been done via telephone or e-mail. Now the pendulum has swung the other way - where GP practices are almost surrounded by barbed wire, (Daily Telegraph, letters 11th July). Perhaps, in a couple of months we might get to a happy medium!