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.
I spent a fairly surreal afternoon in a lecture theatre in the Leeds Met. Rosebowl yesterday afternoon.
We had been invited to ‘take part in’ (actually watch) a live simulcast from the TEDx team in New York, working with the Gates Foundation to look at progress on the UNs Millenium Development Goals (halving poverty, reducing infant mortality, improving maternal care etc).
Surreal because the entire front row was filled with bagels, muffins, cookies and fruit, the lecture theatre was half empty, and we sat gawping at a large screen while some people in a foreign land berated and congratulated themselves in roughly equal measure on their progress.
As the afternoon went by I got increasingly uncomfortable. A feeling not assuaged by copious bagels and cupcakes, as we witnessed a theatre full of rich folks in New York clapping along to Bajah and the Dry Eye Crew.
But the source of my discomfort was more than just the cultural dissonances. It was that for me some of the central tenets for good development work appeared to have been overlooked.
Instead of being invited in by communities to work on the issues that mattered to them it felt like we (the great and the good of the west) had dropped into their world to work on the issues that mattered to us, as judged by our moral compass and our self interest. Not theirs. And we could do it because we were rich. We could hustle our way into the game because we had a whole stash of cash.
So we celebrated the fact that through increased access to contraception ‘we’ had succeeded in reducing family size in just about the whole world. And as we all know reducing the planets population growth is essential. No mention of the fact that small families in the West use a gazillion times more of the earths resources than even a large African family compound for example.
We celebrated the fact that Coca Cola had a distribution network to flood the 3rd world with diabetes inducing corn syrup based products and that we could use the same channels to flood the same communities with our ideologies of entrepreneurship and ‘progress’. In my experience the tobacco companies have been even more successful in setting up networks of distribution and influence throughout the planet – but I guess they are just too clearly part of the dark side for happy, shiny people to embrace. Good old Coca Cola on the other hand….
One of the first principles of good development should be R.E.S.P.E.CT.
Respect for the culture on the ground. Respect for what local people value and find important. Respect for how they are trying to shape their futures, whether or not they fit neatly with our ideologies and ideals. A certain humility and a refusal to believe that ‘our superiority’ means that we have the solutions to their problems.
Good development work should be less about turning the developing world into entrepreneurs who can, and do, control their own fecundity than about helping people find the power to act in their own interests, rather than ours.
Ted Turner said recently “War is obsolete. You end up bombing your customers.”
And at times yesterday I felt as if the whole Millennium Development Goal thing was a kind of ‘anti-war’, the objective of which is to make everyone healthy and rich enough to consume.
A massive exercise in expanding viable territories. Rather than an exercise in compassionate facilitation of self determination.
As Ted Turner went on to say….’why do you think I gave the UN $1bn? I could have bought a couple of really big yachts with that money.’
Big thanks to @imranali and @herbkim for setting this gig up. One of only 2 in the UK. It certainly engaged the heart and mind of this leeds citizen of the world.
We agreed that…our government’s purpose is to make two major shifts in our political and national life:
The first is a radical redistribution of power from government to communities and people, to reverse decades of over-centralisation. Almost all our plans involve giving individuals, families and communities more control over their lives – whether that’s through opening new schools, giving locally elected councillors a say over local NHS services or holding local police to account.
Clegg and Cameron’s Letter to MPs of the Coalition Government
At first glance this is a gift for those of us who have advocated the potential of individuals and communities to shape their own destiny. But I think it shows a lack of understanding about how such processes can work.
Communities and individuals are being offered power to do the work that some aspect of the state had previously done. They are being pointed at opportunities identified by the powerful where they maybe allowed to play a part. In the examples cited above to manage schools, health and policing. Perhaps also to buy the local pub and turn it into a social enterprise or cooperative. Or to take over an old school or library and turn it into a community asset.
All very laudable at first glance.
But there is no real shift of power going on here. Individuals and communities are being invited to play a larger part in delivering the strategies of the powerful. There seems to be little or no sign of individuals and communities being allowed to set their own development agendas, to build their power to tackle the issues that really impact on their lives. There is little evidence of real self-determination being encouraged, just more gentle manipulation to ‘good folk’ to do their bit in times of austerity.
And much of this will play well to middle Britain and its obsessions with schooling, policing and the delivery of healthcare.
But how will it play out in some of our poorest communities? What will the impact of this ‘radical redistribution of power’ be on them?
My best guess is that for many the impact will be detrimental, unless we find a way to really engage them as individuals and communities in working on their agenda rather than on the agenda of the state. Doing things that will make a real difference in their lives and the lives of their loved ones.
When we tell people how we wish them to participate in transforming their own worlds we can be sure that either:
- we are not really sincere in our wishes for any such transformation, or
- while we do wish for a radical transformation we do not understand the processes through which it might be achieved.
There is the world of difference between ‘putting power in the hands of individuals and communities’ and helping people to develop their power to shape their lives.
This practical workshop will introduce you to the theory and practice of social marketing – how to use marketing techniques to achieve specific behavioural goals designed to lead to social good.
Whether you are trying to promote healthy lifestyles, encourage people back into work or to start a business, get back into education, or engage in a campaign, an understanding of social marketing can help you to:
- find new people who want to work on your agenda
- support them on their journey to make real change happen
- get the right people at the right events at the right time
What Will You Learn?
You will learn how to:
- Develop marketing collateral (leaflets, posters and websites) that might just work
- Use the media effectively – PR and role models that work
- Build ‘Word of Mouth’ strategies and referral networks
- Work with ‘gatekeepers’ to ‘gain entry‘
- Manage introductions in the community
The day will involve some theory and explore a number of examples of good and not so good social marketing campaigns. Participants will have the opportunity to apply what they learn to a real campaign of their own.
What is social marketing and how can I use it?
What behaviours are we trying to promote?
Using Segmentation to Increase Impact
Eating an Elephant – bite sized chunks….
Social Marketing Tools – with a focus on emerging social media (twitter, facebook, wikis etc)
The Role of Traditional Marketing and PR
Developing a Social Marketing Campaign (making a start)
Marketing through Relationships and Networks
Find out more and book your space – http://socialmarketingworks.eventbrite.com