Plackard meets his match

training for primary care staff computer

“How would you describe your state of digital readiness?”

The woman from the global management consultancy paused and looked around the room. The board and senior management team at NHS Blithering stared back. After nearly two hours of having their digital expectations reset, post-traumatic stress was setting in.

Martin Plackard, strategic head of digital delivery, started to speak but Charlotte Ditcher raised a hand to make it clear that no one should answer the question until she had provided the answer.

“Here are four terms that may help you decide where you sit in the digital fitness quadrant,” she said, writing “reactive participant”, “digital operator”, “ambitious transformer” and “smart digitalist” on an electronic whiteboard.

“I’d say we’re mainly ambitious transformers,” Plackard said. He pointed to the right-hand side of the quadrant. Several heads nodded, though it was not clear if they were indicating agreement or displaying further symptoms of shell shock.

“What about here?” asked Ditcher drawing a cross in the bottom left-hand corner above the word “laggard”.

More nodding, particularly enthusiastic from Plackard, who had worn a sickly expression all morning.

“What I’m seeing is some late follower characteristics combined with strong innovator tendencies. So I would put Blithering in the emergent mediocrity phase on the change continuum. Questions?”

Sir Trevor Longstay, chief officer of the Blithering STP, beamed. “Excellent,” he said. “We look forward to your recommendations, Charlotte. I’m sure they’ll be very…” he tailed off.

“Expensive?” suggested Dr David Rummage. Sir Trevor glowered.

“Enlightening,” he said, firmly.

Procurement challenged

“I can’t believe the nerve of the old fraud, giving the job to his niece,” said Rummage after the meeting.

“It must be galling for you, David,” agreed Liz Wanhope, accountable officer of Blithering CCG.

“We were this close, Liz,” said Rummage, whose own arm’s-length consultancy, McRummage and Co, had been favourite to win the contract. “We’d have pulled it off if Ditcher’s mob hadn’t challenged the procurement process.”

“There was no procurement process, David,” Wanhope reminded him.

“Exactly,” said Rummage, “so they had no legal basis for a challenge.”

He looked over at Plackard, who was toying with a quinoa salad and staring out of the window.

“What’s wrong with Plackard?” Rummage asked. “He looks even lamer than usual.”

“He told me Sir Trevor’s niece is the most inspirational change agent he’s ever met,” said Wanhope. “I think he has a crush.”

Rummage chuckled. “I’m not surprised. She talks even more gibberish than he does. Plackard has met his match.”

Untapped communities

Plackard wandered over. “We’re ready to restart,” he said. “It’s the cultural realignment session next.”

Rummage had not seen Plackard this excited since the NHS 70th Birthday Resource Pack – some paper hats, a few tatty streamers and a plastic whistle for raising concerns – had arrived from NHS England’s comms team, with a handwritten note from Simon Enright and a signed photograph of Roy Lilley.  

“Sorry, I have a surgery this afternoon,” said Rummage, “but keep me posted.”

Plackard looked puzzled. “Surgery? Oh yes, I forgot you did that sometimes. Don’t worry, David, I’ll be live-tweeting the highlights,” he said.

That afternoon Ditcher led an intensive session where participants were invited to challenge their assumptions and harness the untapped energy of people and communities to co-produce a new culture.

She dismissed the failure of people and communities representative Mrs O’Riordan to show up as a “bump in the asphalt not a roadblock” and Sir Trevor was given the role of ordinary person, which he played with relish.

Meaningful engagement

“That’s outstanding, brilliant in fact,” said Plackard three hours later, as the group surveyed its handiwork.

“Martin, perhaps you could run through our six high-impact strategic imperatives,” Ditcher said.

Plackard rattled them off.

“1. Stop doing and start delivering. 2. Focus on creating value pools. 3. Embrace proactive decision making. 4. Grasp contextual interactivity. 5. Be a disruptive innovator. 6. Ah, wait, what was six again? Something about patients…involving them in meaningful engagement?”

“Never mind about that one, fill it in later,” said Sir Trevor.

Ditcher stood up to draw the meeting to a close.

“What we did that was really exciting was uncover some of our embedded cultural preferences. Did everyone feel invested in the process of rejecting unhelpful inherited behaviours?”


“Did everyone buy in to our conclusions?”

More emphatic nodding as participants sensed imminent freedom.

Ditcher’s gaze fell on Plackard and her voice softened. “So have we reached a clear consensus about next steps?”

Plackard nodded so vigorously that he parted company with his Georgio Armani spectacles, which flew across the table into Sir Trevor’s lap.

Sir Trevor made a weak joke about Plackard’s lack of vision. Everyone laughed politely. The meeting started to break up.

“A word before you go, Martin,” said Sir Trevor.

There was something about the clinical waste magnate’s unusually genial tone and even more unusual use of his first name that alarmed Plackard.

“Of course, Sir Trevor,” he said, a little too brightly.


“Have you managed to enter the world of consultancy yet?” asked Rummage, when he ran into Plackard later that day. “Are you and Charlotte ready to share a support chassis or…?”

“Knock it off, Rummage,” said Plackard.

“God, man, you look terrible,” said Rummage. “Did the course of true love hit a strategic roadblock?”

“Don’t talk to me about that woman,” said Plackard.

“Ah, not even a quick bump on the asphalt then,” said Rummage.

“All that rubbish about buy-in and proactive decision making. The old bastard has only appointed her as interim head of digital delivery, which means…”

“You’re out of a job?”


“Ah,” said Rummage again.

Digital editor: Julian Patterson


Reproduced at by kind permission of Julian Patterson.