Over to you…

Primary Care Training_NHS General Practice_Over to you...

Image by Fronteiras do Pensamento – Tzvetan Todorov no Fronteiras do Pensamento Porto Alegre 2012, CC BY-SA 2.0, https://commons.wikimedia.org/w/index.php?curid=56003613

It is said there are only two stories.  A hero goes on a journey and a stranger arrives in town.

It’s hard to argue with.  Look at BoJo.  For some, a hero on a journey for others a stranger arriving in Number 10.

It’s all about the narrative.  Narratives are persuasive, drawn from literary theory.  

They are engaging and start from the assumption that a narrative, a story, is a basic human strategy for coming to terms with some important circumstances or fundamental facts. 

In 1969 Todorov described five stages to a narrative; 

  • Equilibrium (life as usual), 
  • Disruption (where something goes wrong), 
  • Solution (the fix), 
  • New Equilibrium.  

Narrative implies ‘long’ but it doesn’t have to be.

Here’s a narrative: 

‘Let’s make America great again’…  implies equilibrium (it was once ‘great’), disruption (insinuates something has gone wrong) and it is no longer ‘great’ (hence the word ‘again’), the solution (‘let’s’, implies the  enjoinder ‘let us’… together, a call to action) and finally, back to the new equilibrium, it is great once ‘again’…

… it’s perfect.

Narratives have to be recognisable, true and are the new mission statements.

I’m not sure what the NHS narrative is?  In fact, I have no idea.  We have a Long-Term-Plan but put ‘long’ and ‘plan’ in the title and I doubt more than 1% of NHS people have read it!  When really, everyone should.

Doesn’t it say; push the problems down the road when what a struggling NHS really wants is a ‘fix it now’ plan. 

How about the Tory promise to recruit 50,000 nurses?  

It’s a fake narrative.  Everyone says its baloney, particularly the retention bit.  But how do I actually know, for sure?  Because I’m one of the 1%… I’ve read the LTP.  No one has noticed it includes; 

4.36: … a commitment to improve… “staff retention by at least 2% by 2025, the equivalent of 12,400 additional nurses…”

So, a campaign promise to improve nursing numbers, through better retention, was filched from what has already been announced and funded.  

A promise to get nurses to stay with us, over the next parliament, was happening already, before the Conservative manifesto stole it.

It’s a very fake narrative and Number 18 must know… and…

there were 114,000 places on nursing and midwifery courses between 2012-16 which only delivered about 84k nurses and midwives, into the NHS, by 2020.

I make that 21k a year.  Add, say, 40k ‘new’ nurses, that’s another 8k a year, where 8k extra placements have to be arranged and funded. Training nurses are supernumerary on the wards and expensive…  

…and, let’s not forget, if, for every 19 places we only get 14 nurses, somebody needs to fix the drop-out.  Is it the training, uni’s or placements?

None of this hangs together. 

Anyone who has ever gone through the malarkey of getting planning permission to build an extension on the back of the kitchen, knows, building 40 new hospitals is a ludicrous promise, even over ten years.

Fake narrative.

We need to stop, reboot and find a new narrative… make the NHS great again…  

‘We all know the NHS is fabulous but it has gone through some tough times.  We need more people on the job, more nurses and midwives in training and more nurses staying, doing the job.  We are on it!  Come and join us, the NHS is a great place to work and together, we will make it better.’ 

Equilibrium… disruption… the solution… new equilibrium… follow the rules.

We need a narrative that inspires our people, energises who we work with, reassures patients and invites new people to join-in.

The context of the narrative has to be framed in human terms.  Not as the NHS but the people who make up the NHS.  It must define a shared purpose… what it means to us and our patients.

We must realise, neither people nor organisations change fundamentally.  There is a strong sense of vocation running through the NHS and we must tap into that.

The boss of Starbucks developed a narrative,  He spoke of a ‘third place’ between home and work… he wants it to be his coffee shops.

Walmart said; ‘If we work together, we’ll lower the cost of living for everyone.’

IBM just said; ‘Think’. 

What should we say?  How about…

‘Come and help us give peace of mind…’ Well, it’s a start.  Over to you!

News and Comment from Roy Lilley

Contact Roy – please use this e-address roy.lilley@nhsmanagers.net

Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.