“Managers in the NHS appear to be pre-occupied with ‘excellence awards’, innovation and leadership, but appear to have lost sight of the big picture of the real distress shown by some working at the coal face in the NHS.”
Shibley of the Socialist Health Association
This quotation got me thinking and I am not sure I agree. I think Shibley is talking about senior managers and only some not all.
It seems to me that middle managers sandwiched in between the frontline clinical staff and those at the top of organisations are in an invidious position where they often know what is right and how they should support clinical staff but are employed by more senior people who are giving them a different message altogether.
The people who are often pushing the message about leadership and innovation are also those furthest away from the frontline and of course that can make a perfectly reasonable message look unreasonable and out of touch.
There is real distress at the “coal face” but that is more often than not a lack of resources and staffing and the constant state of flux which the political landscape seems to bring to the NHS.
Of course distress is often passed on from top to bottom just like other messages such as finance before all else and we are under pressure. If the person at the top is fearful that he or she might get a call from the Department telling them to come to a meeting at which “coffee will not be served” and cannot be innovative because they are given mixed messages from policy to politicians it is not surprising that this fear is passed through the service.
What we have found through Nurse First is that there is a real desire to innovate, change practice and save money amongst clinical staff in the community but that often managers get in the way. The pressure of change, time and lack of resources makes for a mind set which cannot see a way out and believes in a scarcity rather than abundance mentality.
We need to listen to the voices below us whoever those people are and value the opinions of those who actually do the job and that includes listening to all care staff irrespective of qualification.