18,000 or so salutes

It is probably fair to say that the last 12 months have had a few bumps in the road in the world of healthcare.

For me personally, I can say that whilst I have hit a few potholes along the way, it has generally been okay. But for the thousands of people left reeling by various announcements of job cuts, it has been a very different year.

One of the things I have taken an immense of pride in during the past few years has been my role championing transparency and supporting those who haven’t got a voice. And it is through this microscope that I wanted to pay homage to a wider group of people who have had a much harder year.

The history of speaking up, or more correctly not speaking up in the NHS goes back a long way. When the Francis report rocked the industry, one of the most noticeable findings was that people were actively discouraged from raising concerns, and those who did, the “whistleblowers” were threatened and in some cases punished.

One of the positive outcomes of this tragedy was the formation of the Freedom to Speak Up movement, with a central National Guardians Office that provided resource, input and support to those who were supporting those who needed supporting.

That isn’t a typo.

Anyone who has ever been leant upon by someone who has needed support knows it can have its own burden. And so, the crutch needs a crutch.

In terms of what the NGO have done, it has been a combination of stewarding and supporting, facilitating and vocalising. Championing from the centre and supporting those fighting the cause from afar.

Amidst the announcements and predictions came the Dash Review from Penny Dash, which quite rightly recognised the duplication and overall messiness of the safety and quality ecosystem. There was a horrible combination of both gaps and treading on toes. It was a jumble of acronyms and remits, which included the Freedom to Speak Up HQ, the National Guardian's Office .

When it all sunk in, it was apparent the National Guardians office was going in the bin. Although, and this is the tricky bit, when and how wasn’t apparent.

There then followed months of uncertainty and lack of clarity.

We now know a little bit more. We know that the NGO will close at the end of June next year. There will be further engagement and conversations with stakeholders to establish what will happen to its functions as it gets swallowed into the also doomed NHS England. But let’s ignore that for now.

This is just one bit of the horrendously messy jigsaw puzzle that has been impacted by the announcements. And to be clear, I wholeheartedly agree with the main ambitions of the reforms. Fundamentally they are about doing less reporting and providing more care. It is about stopping needless duplication and the horribly confusing picture of organisations that are individually mostly brilliant, but collectively a regulatory mess.

What has saddened me, is that the 18,000 or so people affected by this have been in limbo. This is not a criticism of the policy makers, because as I have said above, the intention is good. But indecision and uncertainty are thoroughly exhausting things to be exposed to.

I have focussed on the NGO because I know some of the team, I represent them locally and I deeply admire the work they have done. But the reality is that they have 6 more pay checks. And the consultation will continue, and the answers will gradually become clearer. The same is no doubt happening across the wider sector and throughout the UK.

The thing I want to draw attention to, is that anyone who has tried to sell to the NHS at scale in the past year, will have been aware of a degree of decision paralysis. And this has made a frustrating market even more so. But whilst decisions and purchasing commitments have gone on hold, these 18,000 people or so have continued to turn up to work, and deliver, and perform. This, despite the horrible uncertainty hanging over them. This is professionalism.

The NHS has a habit of treating patients with very high standards but treating its own workforce with much lower standards. As an observer, this past year has felt, intentional or not, to be more of the same. But rather than throwing scorn, I want to acknowledge those who have carried on grafting and putting in the hard work because they believe in what they do and they do what they believe. And whether that aligns or not with national policy is a different question.

There are approximately 18,000 people who have carried on amidst this uncertainty and to those whom have stuck it out, and continue to stick it out, I salute you and want to express my appreciation and solidarity for what the past while has meant for you.