Before you begin the transformation

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.

If – like me – you aren’t near a window at the minute, try to find one to look out of. I assume you’re at work, but it doesn’t much matter for this bit. Can you see members of staff walking about out there? Perhaps they’re on their break, or perhaps on their way to start a shift. Do you know any of them? Do they know you? You might know a few. I wonder what they’re thinking. Most probably, they are occupied with how on earth they will cover childcare in the summer holidays. Or they might have a spring in their step because they’re off to Alicante tomorrow. We don’t know. What I am fairly sure of, though, is that they won’t be thinking about large-scale transformational change. They’ll be glad they have a job, working for a healthcare system which remains, when all’s said and done, a decent employer; they’ll be worried about whether that old lady they saw on the ward last night was able to get home safely after nobody could find her keys; they’ll have listened to the radio or TV and be worried about what all the publicity about the NHS will mean for them and their ability to do their job well.

Or are you at home? Can you see some passers-by? You might well know them of course. There goes Bill from number 12 – his wife passed away last year quite suddenly. How is he getting on? Has his son been to visit lately? Who’s doing his shopping? Bill’s not thinking about transformational change. There goes Francine with her twin boys off to playgroup – did they get the school they were keen on? You must remember to ask next time. She isn’t too bothered about systemic care modelling – too busy getting to work on time. Because there are linkages here: Bill volunteers at the hospital two days a week; you might have seen him out of either window. Likewise Francine – when not a busy mum, she’s a phlebotomist busily engaged in doing some junior doctor venepuncture teaching in this imminent F2 handover week. They are, like the rest of us, embedded within the healthcare system in a myriad of ways.

Bill and Francine haven’t, in all honesty, got the time to spare to design and deliver fundamental systemic change; the one is probably still grieving his loss, the other is shaping her family’s future. But what they will and do have is a bunch of ideas, experience and narrative from their own life stories, both personal and professional which will help us craft the deep changes to healthcare we so desperately need. So before you put pen to paper on the next page of reform, shout out of the window and ask them what they think about things.