Don’t you think

Training Primary Care - We will be thoughtful in all we do

It’s Monday morning.  It’s very quiet.  I’m sitting looking at the screen.  Thinking.

Thinking is good, isn’t it?  We don’t do enough thinking.  Spending time in uninterrupted thought.

The day is getting started.  In the distance I can hear the faint whisper of traffic.  Somewhere out there is a workman with a hammer.  A tattoo of hearty clouts and he is gone.  I wonder what he’s building, demolishing, repairing?

The fabulously blue sky has one wisp of cloud.  An airplane rumbles high above.

I’m sitting, thinking.  I’m thinking about the lack of thinking there is.  In the NHS there is knee jerking, there is fixing, there is working around… that takes thinking but where’s the thinking, thinking.

The maelstrom of the day robs us of any chance to think.

There are think-tanks.  They are very good at doing the mental heavy lifting.  I’m thinking about another sort of thinking.  I’m thinking about being thoughtful. 

Most of the time we think about getting out of a problem, facing a challenge and more recently stretching and panel-beating hopeless political policies to make them fit the reality.

Am I right in saying we have the most educated workforce in England?  Educational qualifications, professional qualifications, continuing professional development.  Loadsa thinking gone into all that.  But how thoughtful are we?

Sad to say, most of the time we are thoughtless.  Thoughtless in the way we focus on outcomes.  Thoughtless in the ways we approach improving quality and performance.  

Looking busy, busy doing, it isn’t thoughtful.

The NHS is standing at a cross roads.  We know that… in a mess.  But not a mess of its own making.  The NHS jogged along nicely until the banking crisis put paid to funding matching demand.  Since 2010 the NHS has struggle to keep up.  

Casual thinkers declare; ‘sort out the NHS’ it has to be ‘changed’ or ‘transformed’ or ‘modernised’.  Wrong.  That’s stinkin’ thinkin’… 

More thoughtfully, we might do better getting the funding trajectory to pick up where it left off in 2010.

Innovation, change?  Let’s think about that.

For most workers, the driving force of change has been factory automation.  Machines making machines, that make machines.  For office workers it has been the PC.  For the nooks and crannies of most workplaces, it’s the internet, wifi and the web.

For a ‘business’ as unique as the care business, where does the change come from?  Buying cheaper bog rolls?  Yup.  Changing organisational structures, so they soak up less money and take less sweat to work in?  Yup.  Using technologies to make recording information easier?  Yup.  To get smarter at using data to forecast and plan?  Yup.   

That’s about the best we can hope for.

But, let’s think about thinking.  A baby learns to walk by falling down.  We have to learn to think by getting thinking wrong.  We learn by reflection.

Most of the work of the NHS is thoughtful work.  Thoughtful in the way we talk to people at their most vulnerable, deal with them at the ragged edge of their lives.

How do you innovate thoughtfulness?  How do you improve it?  Can you buy more thoughtfulness through bigger wage packets?

The thoughtfulness of a handwritten note.  The thoughtful nurse who popped to the shops and bought an ice lolly for a Chemo-patient with a sore mouth.  The thoughtful porter who reverses the wheelchair over the bumps.  The thoughtful GP who rang, ‘just to see how you’re doing’.

The thoughtful people who make our days seem shorter.

Thoughtfulness is at the heart of patient relationships, at the heart of workforce relations, staff retention, supplier relationships.  Thoughtfulness speeds things up, slows things down, makes the wheels turn.  

Thoughtfulness is the oil in the machine, the wind in the sails, the spring in a step. 

Thoughtfulness makes you feel good and the people around you feel good.  Maybe it’s the secret key to efficiency and innovation.

Your organisation probably has a mission statement or values or some such; putting patients at the centre, nice to staff, use resources frugally and all the usual.

Forget it.  Cross it out.  Write in; 

‘We will be thoughtful in all we do’.

Works better…. don’t you think?


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Reproduced here at by kind permission of Roy Lilley.