I love Twitter. It’s a fantastic way of listening to the debate and discussion surrounding the NHS – the financial challenge, the need for service change, the implications of innovation and the everyday experiences of NHS staff and managers.
I follow a range of people with different political views, I follow nurses, occupational therapists, physios and doctors, pharmacists and managers. I follow policy workers, academics, lobby groups and many of the organisations that make up the complex and vibrant NHS – and many more.
I smile and can burst with pride when I read of some of the NHS’ achievements, the care, the compassion and stories about succeeding against the odds. And I can feel embarrassed, shocked and ashamed by some of the stories of poor care and apparent needless bureaucracy. Twitter is a great listening tool and helps me check and test my own views and opinions.
Mostly, it’s a positive, enlightening and uplifting experience. It’s quite a forgiving medium and often self regulates (most people seem to be able to avoid and ignore the trolls).
It’s also incredibly supportive. People send messages of support and show empathy to staff who may have had a tough time, congratulate people and share in disappointments. It feels very real.
But something is missing.
Hardly anyone supports and encourages NHS managers, or shows any recognition or appreciation of the context they work in or the difficult, sometimes intractable challenges they face. In fact, most of the commentary paints them as heartless, incompetent, bullying, shallow bureaucrats – with the occasional exception. It’s not something I recognise with the people I know and work with in the health service. I accept there will be an element of parody and I know some act inappropriately, as do staff and managers across all industries. Many managers are clinicians or have clinical backgrounds as general managers, directors, section heads.
Most have long, if not a lifetime of experience working in the NHS and the public sector.
They care passionately about patient care – not just about the bottom line.
We have managers of just about every profession – engineers, accountants, scientists, chefs, electricians all bring incredible expertise.
They work in a complex political environment, with limited resources. They wish it wasn’t so, but generally navigate it effectively and compassionately. These stories rarely surface, as that’s them doing their jobs.
Importantly, many NHS managers show a desire to have an effective, high-quality health service because:
they, like the rest of the population have their own health issues and need access to NHS services
- they have parents with dementia or Parkinson’s, or MS and other long-term conditions
- They have children who get sick and injured or have learning disabilities, or both
- They suffer from things like stress, anxiety and financial problems, divorce and bereavements, just like everyone else.
And they often live in the communities they serve and care deeply about the quality of services.
So come on, Twitter, do what you do well and raise concerns, shine a light on poor management and leadership. It’s really important that we do.
Raise issues about whistleblowing and culture, but let’s also do what you do better and recognise we have some – in fact a lot of –brilliant managers doing a tough, demanding and mostly rewarding job that they love and care about.
Dean Royles is the director of the NHS Employers organisation. Follow Dean on twitter @NHSE_Dean
Important point you make Dean, but not sure it is as bad as all that?
There is frequently mention of great initiatives, on for example patient safety or patient experience, and they all involve managers in the implementation if not the pre-planning. They may not be mentioned explicitly but my sense is that we have moved on from manager bashing and understand that all achievements of note tend to be multidisciplinary?
Certainly in my career I have seen a steady change towards much greater mutual respect. And I haven’t had the ‘dark side’ comment l levelled at me for some years now!!
Mark (Newbold) @drmarknewbold
Posted by marknewbold | December 9, 2012, 10:49 pmI can’t help feeling that this is a plea in pursuit of a problem I don’t see. Sure, there are some uninformed people out there who may have bought into the government’s shameful trashing of NHS management under the previous SoS. In my experience, however, it doesn’t take much to put those people right … to point to the fact that the NHS, with 1.4m staff and £100,000,000,000 to spend wisely, needs administrative management to run … and to point out that that management was incredibly lean already, compared with most private sector organisations (on a proportionate basis). I don’t see any current of consistent criticism of individuals. And the criticism of policy that I see (and sometimes lead on) tends to reflect a wish to preserve that which is good. So, as I say, I don’t quite see the need for this call. Either that or maybe I follow a different kind of twitterer
Christine Burns @christineburns
Posted by christineburnsmbe | November 22, 2012, 1:18 pm