Listen, listen and then listen some more
13 April 2022
Our Chief Executive – Bev Fitzsimons – shares her thoughts about the recent reports into failures of care within the NHS for patients and staff.
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The excellent Picker Institute recently published this year’s NHS staff survey. On the same day, we saw the release of the Ockenden Report into the tragic events relating to the maternity services at Shrewsbury and Telford Hospital. These publications follow hot on the heels of the Cavendish review, which described the NHS as “not human enough” to take on a greater role in social care to ensure a more fully joined up care continuum as it’s too “hierarchical” and “centralised” in nature.
My heart sank as I read these documents, and the countless others over the years (including the Francis enquiry report which led to the establishment of our own organisation), which describe in painful detail the failures of culture which led to untold suffering for people who had every right to expect their care to be safe, kind and compassionate. Last year, our former Chief Executive wrote powerfully in the BMJ about the rage and despair that led her to found the Point of Care Foundation following the harrowing experience for her own family when her young nephew was born. Please read the piece if you haven’t already – it is very moving.
In the Ockenden Report, we hear again about heroic individuals whose quests for justice shone light on a system that simply didn’t want to hear. One can only marvel at the commitment and dedication of the families of Kate Stanton Davies and Pippa Griffiths, who have done everything in their power to ensure such tragic events never occur again.
So what is to be done?
The message from the report that comes over loud and clear is that it is important to listen – really listen – to patients and the staff who are providing care. It is no surprise to see that the organisations where there are huge problems for patients and families correlate very strongly with those that the staff survey identified as poor performers in terms of being good places to work. These are inextricably linked. The Picker report stated that almost half of staff have felt unwell because of work related stress over the last year. Levels of burnout are also unprecedented, with more than half of ambulance personnel experiencing burnout because of their work.
This isn’t about token consultation or tick-box involvement, but ensuring that NHS organisations have a genuine commitment, strongly and purposefully led from the top, to understanding deeply what it is like to experience the care their organisations offer, and to question themselves about whether these experiences live up to their aspirations. This understanding must be built up over time, with enduring relationships developed between people receiving care, delivering care and leading NHS organisations. This is the only way that it can be possible for sometimes difficult conversations to be had and truly heard.
Of course there need to be systems and processes for ensuring that this involvement work is done robustly. But sometimes it can be as straightforward (and as human) as chatting to patients in the coffee queue, exchanging pleasantries in the car park, or senior leaders hanging out at the nurses’ station to do their emails. These simple things we all do in everyday life can help address what is going on around us.
What’s more, we know reflective practices (such as Schwartz Rounds) can make a huge difference for staff by helping reconnect them with their values and motivations for working in healthcare. These interventions can have ‘ripple effects’ throughout an organisation by helping build stronger interprofessional relationships which, in turn, help create a more open and transparent culture. But with services under such pressure, these interventions can only be accessed by a minority of those who could benefit.
At the Point of Care Foundation, our mission is to support health and care organisations to ensure care is more human – both for people receiving care and for those providing it. It’s a lifetime’s work changing the culture of health and care organisations. But, to ensure patients and their families are given the care they deserve, none of us working in and around healthcare can afford to stop trying – even for a moment.
So I would like to issue a call to action for all leaders in health and care: Please commit to putting practices in place which guarantee all is being done to produce an environment where compassionate care can flourish. This includes ensuring your staff are able to take the time and support they need to stave off burnout and keep from feeling overwhelmed. And get out there – listen to the people and patients you serve. It could save someone’s life.