The impossible may take a little longer…

The impossible may take a little longer... NHS_Training_in_Primary_Care_General_Practice

Achieving the impossible.  Oxymoron.  You can’t.  That’s why it’s impossible.

Yet, some people do… therefore nothing’s impossible… but it is.

With me so far!

‘The impossible’ isn’t an absolute, it’s our perspective, our state of mind and circumstances.  It starts with our core beliefs and values.  Can we say, nothing is impossible because; 

… I am worthy, people are good if you give them a chance, if you are alive there will be problems, what looks beautiful depends on who is doing the looking, if you don’t fail, you wont succeed, experiences are better than things and influence is better than power.

One of the key talents that leaders have is to make the impossible, achievable.

Focus on what you want, break it down, little steps, set goals, celebrate success, however small…

… and, it’s a wise leader who knows when to wait, stop, shuffle priorities, pause and think.

The NHS has delivered the impossible.  Built Nightingales, cleared 33,000 beds, got an army of retired clinicians back working… was not over-run and somehow coped.

Now, the pressure is on to deal with waiting-lists, organise Covid-Red and Covid-Green hospitals, on the same-site.  Create socially-distanced operational-procedures and keep A&E working.

On top of that, people are asking why all BAME staff have not, yet, been risk assessed.

It’s urgent, everyone knows that.  In many cases they have but some will say, not fast enough.  It’s worth adding, do we know enough?

None of the reports, so far, persuade me that we properly understand causation, which can only mean a blanket risk-management response, rather than targeted policies, which would be better for individuals and for employers. 

There are Trusts where over 40% of colleagues will be in that group.  Thousands.  It is a huge task.  

Start risk-stratification; identify all BAME staff, sort-out who works where, arrange priorities, set-about individual risk-assessment interviews based on the person’s health-record, (if they are willing), their age and occupation and train enough people to make sure it’s done confidentially, with skill and sensitivity.

We may find a high percentage of the workforce will have to be re-deployed.  Some will be advised they cannot work and others may have to be helped to the conclusion that, until there is a vaccine, their career is on hold.

There are huge implications for BAME colleagues, as there are for organisations that through no fault of their own, are already short of people.  Workforce planning has been a disaster and I see nothing that’s going to fix it any time soon.

That is not the end of the problems.

A significant number of NHS staff have been shielded.  They’re now ready to return to work but, guess what… before they do, they need a risk assessment.  Some will be back, no problem, some won’t.

Once a risk assessment has been carried out, the employer has clear legal liabilities to recognise and mitigate.  Some staff may not wish to return to work on risk-managed terms.  They may chose to work in safer occupations.  Trusts have only so-many jobs in administration.

A BAME, A&E consultant with diabetes and high blood pressure may well find it difficult to cope with carrying on the job in a risk attenuated way.  Given the disclosed risk, a Trust may not be able to keep the doctor in that post and will have to solve redeployment.  Taking into account, re-skilling, seniority and grading.

None of this is easy.  No Trust wants to put people at risk.

That’s not the end of the staffing woes.

When a member of the team pops up, COVID positive, if they’ve not been in a PPE environment, Track and Tracing requires everyone they’ve been working with, is sent home for 14 days.  HMG won’t permit them to be tested, so they have to sit-it-out, on the sofa, watching Holby City.

Shielding, serious BAME risks, T&T, a triple whammy, creating huge demands on hosptials, on workforce and individuals.  Creating rota gaps that we just don’t have the people, to fill.  Creating risk and delays for patients and service-users.

Plus, demands for waiting lists to be reduced, cancer delays resolved and running a business-as-usual NHS… well, you be the judge.  

Are we asking for the impossible?

The NHS has shown it can do urgent, the impossible may take a little longer.

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.