You may, or may not, have noticed that the Health and Care Act 2022 finally passed through parliament recently. After a great deal of contentious debate, the mainstream media gave it very little coverage in its final stages. Much of its focus is on paving the way to enable significant reforms to the way the NHS in England functions. At its heart is a shift from using competition between providers to collaboration and integration with other care services to improve quality and efficiency. You may well soon find that you are working more closely with doctors from other trusts, sharing equipment and even team members.
Integrated Care Systems will now use this, in part, to address issues of staff shortages, whether due to short term holiday, absences or long term vacancies. As a result, you will want to be skilled in team communication. You need to be capable of efficiently joining new teams. You also need to effectively welcome other doctors to temporarily join your team if you are going to work together efficiently.
What’s wrong with weighing the pig?
One key aspect of the new legislation is that it creates a duty for the Health Secretary to publish a report on workforce planning at least every 5 years. With staff shortages being one of the biggest issues which the NHS is facing, critics argue that this requirement falls far short of what is needed.
There’s an old saying that “weighing your pig doesn’t make it any heavier.” If you were a farmer, you’d want your livestock to grow big and healthy. That’s what increases their market value and feeds your family well. So, knowing how they are progressing is important. And the obvious thing to do is to weigh them regularly. But weighing them alone is not enough. You need to take action if you want to make a difference. That starts with nourishing them properly. You want to provide a good environment with exercise and intervene by calling the vet if things are going in the wrong direction.
So, simply reporting on numbers of doctors or nurses by age, specialty, grade and ethnicity along with numbers of vacancies will, in itself, only take us so far. Making the badly needed difference requires well considered and well executed action planning. Otherwise, our Health Secretary will be doing the equivalent of just weighing the pig.
What’s going on in your own back yard?
The vast majority of us don’t have any direct influence over the way the Health Secretary goes about his business. So, let’s switch the focus to your own daily activities. How many targets are you aware of that you or your team have? What scores are your organisation comparing against other providers, against local or national averages? How often are you keeping track, ticking boxes or filling in forms, contributing to the collation of these statistics?
Now, here’s the big question. How often are you and your team actually using this information? Are you genuinely utilising them or is their generation a pointless bureaucratic exercise? Our peer reviewed research published in BMJ Leader found that 40% of doctors felt they don’t effectively discuss progress toward goals with their team. Sadly, it appears that many are wasting time weighing the pig rather than taking actions that will make a difference.
Making a difference
On our Practical Leadership and Management Course for Doctors we discuss how to go about making a genuine difference. Yes, making measurements is important. But it has to go hand in hand with clarifying why things are the way that they are and how your performance compares to others. Next, it’s about defining what you want to achieve and why? Before going on to develop clear, allocated and time action plans. Then, it’s about making sure things get done. Making sure everyone is taking the agreed steps, dealing with procrastination and overcoming obstacles.
Often the difference comes when we understand why something matters. Is your team tracking how well you keep to appointment times? Or are you striving to see patients when they are expecting to be seen as you realise they currently have to take a half-day off work for a 10 minute appointment with you?
So, are you simply weighing pigs or are you striving to make a difference?
