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Excited yet just a little daunted, Janice pushed open the big green door and entered the Department for Making People Work Harder. The horn-rimmed spectacles of the fearsome PA to the CEO glinted in the afternoon sun as Janice announced her arrival.

“I’m….Janice Goodstaff. Here to see Mr Amplewaist….about the leadership programme?”

The PA wordlessly looked from Janice, to her computer screen, and back to Janice.

“Mr Amplewaist is running late – he’s with Mrs Overspend in the Finance Refresh Committee. Take a seat.”

Let’s stop couching our language in terms of the crisis befalling healthcare, the inexorable rise of C Diff and the latent menace of MRSA. Let’s dig beneath the crisis and highlight the diligent daily work being done by thousands of staff, around the clock, to manage the medical, social and domestic crises which land on their doorsteps, be it hospital, clinic, front room on a visit, or pharmacy. Let’s publicise those pieces of work that are stemming the tide of bacterial infection and work together to help those who are finding those things a challenge.

Lunchtime brought with it the chance to scout for fellow volunteers happy enough to brave the canteen. It was a Friday ritual: other days of the week just didn’t cut it when it came to trekking across site to join the snaking queue.  Because Friday was, of course, fish day. And our canteen cooked up the best fish and chips for miles around.

The headlines are, I know, driving you inexorably toward the next brainstorming meeting for some blue-sky thinking about the corporate challenges which face us all as we grapple with the big issues of the day.

Tempting as it is to begin crafting that next innovative piece of transformational culture-changing strategic work without further delay, can I just ask you to pause and reflect upon the nuts and bolts of the thing. It won’t take a minute, I promise. I ask mainly because we are all of us otherwise in danger of forgetting the rudiments.

I was having dinner with a good friend yesterday who works as a doctor in a particularly challenged hospital. I’ve known him since I was a houseman and although we’ve taken different career paths we’ve been able to share many stories of highs and lows which have resonated with both of us irrespective of speciality. I know from personal experience that he is a compassionate and diligent clinician as well as being a loyal and proud family man.

"This place is like a cattle market!" exclaimed one visitor recently, upon seeing our A&E waiting room on an evening walk-around. Sure, it was extremely busy - we had been feeling the full force of the A&E "crisis" and the seething crowd of expectant patients bore testimony to that. But on reflection, the reference to cattle markets was profoundly unjust. The last cattle market I happened to be at was an ordered and fairly swift affair.

Before I go any further, a reassurance: I mention the Francis report in this blog, but won't insult your intelligence by giving you the reference for it at the end. If you do need the reference, please stop reading this now, Google it, and spend your time reading him not me. My words aren't important; his are. 

When you have absorbed even a twentieth of its contents, come back to the blog, for I want to make, on the basis of the report, a claim now in support of Shizaru, who has much to tell us about healthcare and was right all along.

Mired in poor performance and bedevilled by dysfunctional teamworking, a large healthcare organisation hired in a new clinical leader to sort out the mess. Just before his official start date, the new leader met privately with his predecessor as he cleared his office. The departing incumbent fixed his successor with a gimlet eye and handed him three sealed envelopes. "It's tough at this hospital" remarked the soon-to-depart leader with monumental understatement, "and you might need these. Open them in order whenever you feel you've nowhere left to turn."

Seeking solace from the rigours of the day job, you secrete yourself away in your office and sip at that much-needed cup of coffee. Targets not met, staff not happy, it's all looking grim. You need inspiration. You need a boost - and not just caffeine. You need some inspirational words of leadership to see you though the day. So where better to turn to than your e-inbox? Surely someone will have taken the trouble to have emailed you those words which mean so much when all around you seems...well...a bit rubbish.

It's not the most immediate of comparisons, but a recent conversation with a regional medical director led to us discussing how best to conceptualise effective leadership as a sustainable entity. The slinky spring made a metaphorical appearance at this point and I wonder if you've ever heard this one, or might have forgotten it. It's not new but it bears repetition, and you can make as much of it as you wish, the longer you mull it over.


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