NHS Wales on the road to Damascus...

Published on 11 April 2016 to Blog

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NHS Wales on the road to Damascus.

By Rob Thomas

I admit I have been frustrated and sometimes hurtfully (on reflection) critical of the direction of travel of NHS Wales. My disappointment has been a product of the genuine frustration with what I have witnessed and deep care I have for a great service.

This paradigm of frustration has been shattered though and I am dearly glad of an experience I had that helped this. I am an NHS man from Bridgend who spent a large part of my adult life in the NHS dating back to those brilliant days of being a graduate management trainee in the late 1980s. I left the first time (much to the chagrin of the best CEO I ever worked for in Bridgend and District NHS Trust) to manage a hospital in the Middle East fully intending to return to NHS Wales. Instead I came home to the British Independent Acute Sector where I enjoyed some very high profile roles leading some frankly beautiful private hospitals in rather lush parts of the country. There always remained that hard-to-explain feeling of hiraeth and frankly some good old fashioned South Wales guilt about the life we led and the people we helped.

After helping to set up an employee owned venture in healthcare I returned to NHS Wales in 2007  and spent another 5 years there before working for myself fulltime. I still have the guilt, this time, of the survival type!

My paradigm shattering day came when I was spending some time teaching young doctors about things like business planning and team working. I have had the privilege of helping over 250 young higher medical trainees transition into consultant roles over the last 4 years. It has come to me quite easy, the role of gamekeeper turned poacher i.e. giving all the docs the skinny on how the system works. On occasions i have felt like Mr Incredible felt when telling claimants how to navigate the impossible system of insurance claims in the company he was 'retired to' as an ex-super hero (before any one says, the analogy to yours truly stopped well before reaching either the term 'superhero' or sadly, physique!).

The folk I met in January this year were both young and doctors at a troubling and difficult time and rather naturally, a lot of discussion centred on the junior doctor’s action in England. Passions were high but measured but here comes the moment:

We discussed NHS Wales. To a person each doctor mentioned: ‘friendly’, ‘inclusive’, joined up, ‘clear focused’.

There was a deep awareness of the challenges remained especially around the demographic time bomb but also massive appetite for embracing the changing landscape in NHS Wales with more upstream intervention, changing the methods of working and leveraging off the IT. More ideas than one could genuinely brandish a wooden stick at!

My paradigm has therefore 'shifted', as the saying goes. Once infamously called: “an acute secondary care episode merchant” by a UHB Chairman I recognise and applaud the integration work that has been done in Wales. Joined up thinking with Local Authorities etc. and a recognition of the need for collectivising, sharing and designing not from a position of legacy but from the perspective of what is needed.

It is a true true cliche that turning the NHS is like turning the Ark Royal (bless her and all who sailed on her when in service) but turning it is in Wales at least. It may not be recognisable as the manoeuvre is being made in the heavy seas of austerity and escalating demand.

We (and I mean me) need patience for our patients. The work of development in NHS Wales is noble work. The seas are heavy and some will be lost overboard sadly. Let’s remember though that journey of progress has to continue diligently under a policy from WG that I see as ethical, intelligent and critically, given the nature of the beast, long sighted. Money and resources are tight (yes we only spend 9.8% of GDP versus 11-12% in the best of Europe) but the love is high and long may it continue.

Thank you to those young clinicians, our leaders of the future for helping me to rediscover my faith

 
 

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