Communication, localism and action – or lack of – at the NHS Alliance Conference 2011
In his opening speech at this year’s NHS Alliance Conference, chairman, Dr Michael Dixon, seemed to suggest that yes, we are having a revolution. And yes, I did think that beginning a conference by punching your way through a paper wall was pretty revolutionary. Break through! Good start.
Along with ‘revolution’ we heard a number of other exciting words such as ‘innovation’, ‘integration’ ‘change’ and ‘liberation’, but throughout the two days the big name speakers struggled to maintain the exciting rhetoric with which that the conference began. There was repeated suggestion that this innovative revolution should come from the bottom up / next generation – which is just as well, as the view at the top – (or the ‘bridge’ as NHS chief executive Sir David Nicholson referred to it in what we can only assume to be a private joke) – was decidedly uninspiring. Both Sir David Nicholson and Andrew Lansley (in speeches attended en masse by the hopelessly optimistic) talked general nonsense about how they were in favour of the reforms and hit all the buzz words – ‘quality’, ‘efficiency’, ‘productivity’ ‘ensuring excellence for all’ – and we heard that in a few days we would be seeing a ‘draft guide to clinical commissioning’ – all slightly patronising considering we had been hearing excellent examples of innovation and change on a local level all day. Sadly, there weren’t many ‘bottom uppers’ present – perhaps they rightly thought they’d be out of place among the generally pale, male and stale audience. Or perhaps they were at home – actually making changes in their areas.
One noteable exception was an excellent presentation delivered by Helen Chapman, locality service manager and Sarah McCarthy, community matron, from Sheffield Teaching Hospitals Community Services. The pair talked about how a relatively small telehealth operation in Sheffield was making a difference to the lives of elderly people with long term conditions. In nine months of the programme running, they had seen a reduction of 64% in unscheduled admissions and a 48% reduction in A & E attendances. It was encouraging and inspiring to see that a community matron can be a conduit for change, and I hope that the 15 – 20 or so people present felt inspired to try something new in their own areas (because we can be assured that the hundreds of people who watched Lansley and Nicholson didn’t).
This brings me to another big theme of the conference – communication, or lack of. Several speakers, including Andrew Donald, director of commissioning development, Staffordshire PCT Cluster, and Dr Hugh Reeve, chair, Cumbria Clinical Commissioning Group, referred to the importance of communicating with a variety of audiences in order to make the changes happen smoothly (again, a poor example of this was set by those on the bridge). Since the people expected to lead the change from the bottom up weren’t at the conference, we can only hope that their betters have by now delivered the messages to them. But I remain cynical that the conference will have inspired real revolutionary spirit in those who are expected to make changes on the ground.