A personal exploration of the NHS Constitution

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I often feel a fraud.  This is different from the imposter syndrome I’ve blogged about before – this is feeling like a genuine fraud.

Chris LakeNot in my role as a leader or practitioner of leadership development – I’ve done my apprenticeship in that regard through 20 years of learning.  No, I feel like a fraud as a staff member of the NHS.  True, I spent four years at the King’s Fund – and did good work I hope in developing leaders from across the service.  But the King’s Fund sits on the sidelines of the NHS – commenting, supporting, critiquing – but never inside, it’s not with and amongst the NHS.

‘The NHS belongs to the people…’

My own real experience of the NHS has come not as a clinician or manager but as a service user.  When I think back, there have been years where I slipped along with only the lightest of brushes with the NHS.  But there have also been years where I was what you might call an enthusiastic customer.  ‘Highlights’ (not really the best word) started early with the four month hospital stay I had as a toddler when I poured scalding water down my chest (I still bear the scars).  Then there was the recovery from a near-fatal car crash when I was in my late 20s, including the reconstruction of my shattered right humerus that took 4 years and several operations to mend.  Then there was the safe delivery of both my kids by alternate routes (caesarean and traditional) and the simple, yet parentally, scary tummy operation to my first born when he was just nine weeks old.

‘…It is there to improve our health and wellbeing, supporting us to keep mentally and physically well, to get better when we are ill…’

My sister’s not a fraud though – she’s the real deal.  Claire (@ckentone) has 28 years service as a nurse, sister and matron.  I carry Claire in my head.  I ask myself questions like ‘What would Claire say about that budget?’, or ‘How would that message land on Claire leading real care teams?’  She’s always been an inspiration to me – she’s a natural staff leader and a developer of teams.  Over the past 10 months, since I joined the NHS full time, she’s also been my sense check, my conscience, and my source of on-the-ground, lived experience, warts-and-all coalface reality.

‘…It works at the limits of science – bringing the highest levels of human knowledge and skill to save lives and improve health….’

That said, I’m having quite enough on-the-ground experience of my own at the moment.  If you follow my blogs (and seriously – there’s no need to – they range from mildly insightful to genuinely irrelevant) then you might have read my blog ‘It’s personal’ about my discombobulating summer and the wonderful care and fabulous skill of professionals in diagnosing and removing a brain tumour from my 10 year old daughter.  To bring you up to speed, I accompanied Sophie back to King’s last week for a follow up MRI scan.  The scan confirmed that the tumour removal was fully successful, and Sops continues to recover, supported with exceptional NHS care.

Anyway, we were planning on a half-term break – a holiday to France to replace the one lost in August. Then my mum’s cancer went from worrying-but-not-urgent to fully end-of-life.

 ‘…and, when we cannot fully recover, to stay as well as we can to the end of our lives…’

Six weeks ago mum was winning golf competitions – then things suddenly changed.  My fabulous sister has been leading the familial support as mum declined rapidly.  Tonight, mum’s dying in a hospital side room.  I arrived 4 days ago to take over the nightshift.  I found myself, for the second time this year, observing NHS care from the vantage point of a reclining armchair.  This time it’s Shouldham Ward in the Queen Elizabeth Hospital, King’s Lynn.  The hospital is all over the local press at the moment – following critical reviews from the CQC and NHS England, Monitor have this month placed the Trust special measures, accompanied by a raft of executive job changes.  However things are at the most senior levels, on Shouldham Ward the care continues with the highest standards of professionalism and compassion.  Interesting that two of the four CQC warning notices call for improvements in staffing levels and supporting workers – the real deliverers of care.

‘…It touches our lives at times of basic human need, when care and compassion are what matter most.’

ChrisLakeNHSblogI watch the nurses coming into mum’s room.  They greet me gently, with no condescension or uncomfortably pitying sympathy.  They know mum is more or less unconscious on a cocktail of pain relief and sedatives delivered by an automated syringe-driver.  Yet they still softly call her name before surprising her with their touch.  They look after me, and dad too when he’s here during the day – simple things like a cup of tea for me or a meal for dad as he sits for hours with his wife of over 50 years.  The nursing care is gentle, compassionate and helpful.

At a different time, in a different blog, I’ll talk about the sick disparity between how we treat dying people in this country and, say, our dying pets.  Suffice to say that, right now, the care is wonderful and is within the law, but the law is not wonderful and is without care.

Why am I writing all this now?  Well, partly it’s selfishly therapeutic – helpful to me to share my thoughts and feelings beyond the side room in which I sit.  But there’s a bigger goal here too.  My daughter’s amazing rescue from a brain tumour.  My own urgent recovery from a wrecked car.  The painstaking rebuilding of my right arm.  My mum’s compassionately held end-of-life.  My sister’s dedication to leading people in the delivery of care.  All these things and more were provided by the NHS and the wonderful people working in it, dedicated to the care of others.  Team NHS.  Not perfect.  Often maligned.  And yet, a precious national jewel that we must cherish, develop and protect.

Postscript

My mum died on Friday at 4pm.  As was I think fitting, my fabulous matron sister was with her at the end, supported by two wonderful nursing colleagues.  Meanwhile, a hundred miles away, I was in King’s with Sops viewing her clear and positive MRI brain scans.  Two hospitals.  Two loved Ms Lakes.  One NHS.

 

The opening paragraph of the NHS Constitution in full:

The NHS belongs to the people.  It is there to improve our health and wellbeing, supporting us to keep mentally and physically well, to get better when we are ill and, when we cannot fully recover, to stay as well as we can to the end of our lives. It works at the limits of science – bringing the highest levels of human knowledge and skill to save lives and improve health. It touches our lives at times of basic human need, when care and compassion are what matter most.

16 thoughts on “A personal exploration of the NHS Constitution

  1. Chris, all our thoughts are with you. It is irrelevant that you have only been ‘in’ the NHS for 10 months. Just remember – the contribution you have made in that short time will improve patient care for thousands of people for years to come. Quality is just as important as quantity.

  2. Thinking of you Chris, and love that your playing for ‘Team NHS’ . Hope your mum continues to get the care she needs and you do too.
    Man hugs. x

  3. Chris, as always your blogs leave me moved and reflective of my own role in the NHS. This one is topical right now for me leading the work on the values of the NHS Constitution with Health Education East of England. It is stories of experience such as yours which really bring it to life, and we are doing all we can in supporting that through training and education tools and materials. Having sat with both my own parents at their hospitalised end of life, my thoughts are with your family. Would be good to chat to you sometime about our NHS Constitution work. Louise Kitley, Health Education East of England

  4. Chris,
    I remember all those years ago when nesh took the call about your accident while at our house (number 10).
    She went into “mum mode” re the accident and will always remember her telling us girls to get a BMW wherever possible as It would save our lives!
    Having flown from Australia to visit nesh last week, I was reminded of the uttermost tenacity of the NHS to “get the job done”. Where we may be understaffed, we make up for in genuine patient care and consideration. Everyone learned nesh’s name and humour acted as if she were one of their own.
    I will always know her appreciation of this and her pride in her amazing children.
    Joanna.

  5. Chris – my heart is with you and your family. Thank you so much for using your personal family experiences to highlight just how wonderful our NHS is. This is the most powerful blog I have read – thank you for taking the time to write and share.

  6. Thank you for sharing this Chris – enormously touching and powerful words, which resonate with many of us and our experiences of the NHS. Very best wishes to you and your family at such a tough time.

  7. Chris – firstly I would like to extend my deepest sympathy to you and your family.
    Via your sister, my inspirational matron, I have become a fan of your blogs. Your NHS life may yet only be short but in that time you have made a huge contribution. Your eloquent blogs help me to realise that despite recent scrutiny from the CQC and other authorities we can get it right. Here at the QEH our staff are passionate and dedicated to providing the best service to our patients. To hear of your personal experiences provides us with the reassurance that we as care deliverers are not failing.
    Your blog is a fitting tribute to your Mum and Claire, beautifully written and immensely powerful.
    Thank you for sharing.

  8. Chris,I just read your blog having been forward to me by my tutor. Firstly I want to express my deepest sympathy to you and your family for the loss of your mum and it was reassuring to hear that you felt the quality of care, support and attention your mum and the family received was exemplary.

    I have worked in the NHS for many years and had the pleasure of working with some wonderful, caring, devoted people. They brought the qualities to the NHS that were key ingredients to supporting and providing successful and positive outcomes and providing patients with the reassurance that they were in ‘caring hands’and would ensure they were treated with the compassion, respect and dignity they deserved.

    I have witnessed change some for the good and some that achieved just sheer frustration and little in the way of improvment in real terms. I have shook my head in disbelief and sighed with exasperation. I have also smiled and wanted to shake people by the hand to congratulate them for going beyond what is expected of them.

    A variety of pressures continue to bombard the NHS and probably always will because the NHS is a business! However, money and incentives cannot buy that emotion of simply caring about another human being. At what point do the staff who care for our patients start to lose this vital emotion? Did they have it in the first place? How do you mend the fracture? It is not simply a matter of manipulating it and putting a plaster on it until it mends. The key ingredient of caring is inherent.That’s demonstrated by the majority of staff who remain working within the NHS and can be proud of. When people stop to care, it is time to move on to new pastures!Wrong job, wrong place!

    Whether one is a manager, clinician, nurse, porter etc.each and everyone of us who works within the NHS team needs to ensure we are all in tune with one another to reap success. We can be likened to an orchestra,one instrument out of tune affects the whole orchestral piece.Simply, we need to work collaboratively and remember the objective; to ensure ALL patients receive good, quality care be treated with the respect and dignity they deserve.

    Your experiences of the NHS Chris have enabled favourable accounts and outcomes to be disclosed and thank you for sharing them.It is important that we also focus on the positives because, undoubtedly there are those who work within the NHS who deserve a pat on the back and provide a reminder for others that a smile,the time to listen and simply demonstrate they care costs nothing!

    Thank you Chris!

  9. Chris, sympathy to you and your family. Lovely personal blog. Thanks for a great contribution on the Leadership course a couple of weeks ago in Leeds, cheers Rob

  10. I cried when I read your blog. I was looking for some tools to help me to work with a team to help with conflict resolution as I am a trainee Team Coach and came across your honest account of how things are for you and your family. I wish more people spoke in the way you do from their heart.It takes courage to be as open as you have been and look at the response you are getting!!!!! I hope these responses help you to feel that you are not on your own and that people basically want to help in anyway they can.
    I believe that if you see people as a problem than that is what they become. If you see them with potential now thats another story in the making.
    I am in the process of completing a Team Coaching programme facilitated by The Performance Coach which has had a powerful impact on me. I am working with a team tomorrow helping them to work through their issues and to develop and empower them to build the team they want to be a part of and not the team they have become. I agree with you Chris that you dont have to look too far for problems and sometimes that obscures the amazing work that is happening all around us.
    I am extremely proud to be able to be of service in the NHS in my role as Matron of Health Visiting and School Nursing and I work with the best team that I have ever worked with. We trust each other and look out for each other and that is what helps a good team to become a great team.
    Thanks again Chris for sharing with us.
    Look after yourself.
    Jo

  11. Thank you to everyone who has sent me such lovely messages – here, on twitter, by text and many by phone or in person. Your support has been, and continues to be, felt and appreciated, and your appreciation of the blog gratefully received.

  12. Hi Chris

    Sorry to hear about your mum.

    I have been deeply moved by your blog and your experiences. I think you sum up the issues that we are currently facing in the NHS. In the main care is second to none and it is the frontline staff who work tirelessly to get it right to make a difference and to do all of this against a back drop of pressures from politicians and journalists who are determined to bring this great system down. We need more good news stories like this to demonstrate the level of care and compassion that is within the system rather than the constant “headlines” that unfortunately continuously knock the jewel in our crown.

    I feel ashamed that I have often sat in the waiting rooms of this complex free service bemoaning the delays that affect our busy lives. When I reflect on this I am dismayed by the lack of compassion that I feel to my fellow colleagues. Real life often gets in the way which leads to these pressures. However this great institution has never failed me or mine it has always been there when needed.

    Thank you for sharing this very personal journey with us.

  13. Sorry to hear about your mum.

    I have been deeply moved by your blog and your experiences. I think you sum up the issues that we are currently facing in the NHS. In the main care is second to none and it is the frontline staff who work tirelessly to get it right to make a difference and to do all of this against a back drop of pressures from politicians and journalists who are determined to bring this great system down. We need more good news stories like this to demonstrate the level of care and compassion that is within the system rather than the constant “headlines” that unfortunately continuously knock the jewel in our crown.

    I feel ashamed that I have often sat in the waiting rooms of this complex free service bemoaning the delays that affect our busy lives. When I reflect on this I am dismayed by the lack of compassion that I feel to my fellow colleagues. Real life often gets in the way which leads to these pressures. However this great institution has never failed me or mine it has always been there when needed.

    Thank you for sharing this very personal journey with us.