NHSEngland Chefs wash their hands a lot


So, I’m in Leeds on Thursday. Sunny morning. Bad chest and nose cold. Feel fairly bad. Wish I was at home.

I’m there to co-present what we did in the (excellent) Patient in Control project handled by South East CSU.

I walk into a large, angular room tightly filled with big round tables and chairs. In one corner a huge screen presenting the brand image. It’s hot.

An hour later we start. I count 70 people. Half the chairs face the wrong way. There’s little space to turn round. Can’t chat across the huge tables. Projection of presentations not allowed, so little groups of people gather nervously in front of the towering screen for their (timed) 3 minutes to tell their stories.

It’s all good fun. The timer klaxon goes off regularly. Each person dashes through their speech. It’s a rush. We laugh a little nervously as these people are stopped from explaining what they have spent 18 months doing.

It’s hard to hear these stories. The PA system hardly amplifies, and most of us don’t hold the microphone close enough.

There’s no highlighting of the speakers. No stage. No celebration, other than the clapping after each, in recognition of their brave timekeeping.

Near me, an NHSE person spends the whole morning on his laptop, doing email, writing reports, whatever…He’s not present. Another has the highly responsible work of timekeeping on their phone.

I cannot get a fix on what is being said.

Before these report-backs started we had two rushed, though not short, talks about the lead up to our projects, and then about the NHS Citizen project.

NHS Citizen. What a great label. We’re all citizens, so it’s for everyone. We all use the NHS so it’s for everyone. Citizens behave respectably, within the laws and traditions of the country. We all want to be good citizens. Citizens support their country, and of course the NHS.

What does this all mean? Well it looked to me like a Spanish omelette. Get a few eggs, find whatever is in the fridge, chop it all up, mix it, cook it…wow! That looks good.

Or is that a frittata? That sounds more citizen like. NHS Frittata.

And what is this frittata going to deliver? It reminds me of that dear old project “Patient Leaders”. Great sounding lightbulb idea from NHSE people who needed something for unspent year end money. What are leaders leading? The NHS? No. Their own needs? Perhaps.

Are they leaders? A few.

But the work has contributed to awareness raising of the need to get patients involved and engaged and round the tables when services are designed, commissioned and evaluated…

And if we end up with a frittata-patient-expert-activist bank it’ll be at least one good outcome, assuming anyone has the money to run any projects and use us activists. We of course are free, but those who organise us have to be paid.

NHSE is not paying for any more of these projects, so CSUs now have to sell their products to CCGs.

Another NHS example of a short burst of activity for a good idea which is withdrawn before it gets traction. If social movement is supposed to take this forward let’s make it a real social movement! Rather than a pseudo commercial hand-off.

So I have had two hours of rushed, disjointed talking, in an uncomfortable hot room, facing the wrong way, hardly able to hear…and I think…

I have got to get out.

I am totally discombobulated. Can’t put my finger on any one cause, but I just cannot take all of this in, process it, understand it, store it…and feeling ill hasn’t helped.

It strikes me that there are people whose working lives revolve around thinking up ideas, meeting people and persuading them to do things on their behalf.

There are people who know that their salaries depend on doing what their masters ask of them, so they go out and do those things. They have to listen to these ideas makers and be polite and a little subservient. These people (some at least) are caught between their own passion, and others’ needs, to see something happen.

And there are people who want to see change happen, but who aren’t subservient (tied) and do not want to spend their time listening to chopped up, whisked bits and pieces fed by people who are eager to wash their hands.

When you are not paid for your time you learn to quickly diagnose that feeling of slight nausea rising as you see the frittata ingredients being prepared. And you know it’s time to get out.

Yesterday it took longer than usual. I left at lunchtime and got home in daylight. To peace and quiet and fresh air.

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