Nearly everyone I speak too recently has a horror story to share about their experiences with the NHS. And nearly everyone has a fairy tale to tell as well.
For several decades now I have been contracted by various parts of the NHS at different times to provide management development and leadership training, to run assessment and development centres, to develop standards for the board of NHS trusts, to turn HR teams into organisational development teams and so on. And for just about all of that time the training has been done against a permanent backdrop of policy and structural changes that makes real learning almost impossible.
So it was with some interest that I read about some work that the National Health Service Social Media Group had been doing to explore the potential of social media to transform healthcare. Recently this group have been talking about how the use of video cameras by patients could provide feedback to drive service development.
I love the idea of social media being used to report on both the good practice and the bad. To shine a spotlight on all that we love and hate about how healthcare is delivered.
But, until we we build a culture where such data can be collected, analysed, reviewed and acted upon by experienced clinicians and managers with the time and resources to provide excellent management and leadership we run the risk of finding ourselves with ever more tearful and frustrated health professionals.
And I suspect that it would be the failures and lapses that would get the attention and the resources. A culture of name and shame is unlikely to work in the long run. And what would it do to the relationship between patient and staff? Do we really want patients to be policing their own healthcare experience? They can recognise and film obvious lapses of protocol and procedures, but the more subtle stuff? And, do we really want service providers to change what they do just because someone is pointing a camera at them?
At its best great healthcare is delivered as a partnership between clinicians and patients. I find it hard to see how this partnership can really thrive when when one party is busy filming the other.
It may have a role in driving out bad practice – but I am not convinced that it can ever drive excellence.
As Deming has shown us the road to excellence is reached by driving out fear, not by increasing it.