Lessons from Paris

Last week I was lucky enough to go to the Institute of Health Improvement (IHI) Quality and Safety in Healthcare conference in Paris. Apart from the fact that the conference was held in Paris, arguably one of the most beautiful, historic not to mention romantic cities in the world, the conference content made me feel really excited. High quality patient care and delivering it in a safe harm free way is what the NHS is in business to do, it’s what I came into the health service to do.

My week in Paris began with attendance at the low and middle income (LoMIC) seminar. This seminar brought together healthcare workers from different parts of Africa to talk about the various initiatives they have been involved in to improve healthcare in the region. It was a humbling experience to listen to the stories of how maternal and neonatal deaths had been reduced by up to half following intervention by healthcare workers, very few of whom were trained professionals. The importance of community involvement was highlighted time and time again and seen as a necessary if not essential part of any healthcare strategy being developed or delivered in that part of the world.

Nigel Crisp’s book, Turning the World Upside Down came to mind – if you haven’t read it do! It talks about the unsustainability of healthcare in high income countries and how we are going to have to learn to do things differently and can learn a lot about making resources go a long way from people in low to middle income countries. The following points were repeatedly made throughout the day.

  1. Engage with and get the support of your communities – we could definitely do that better in England.
  2. Use the power of storytelling to engage with people – this reminded me of the Ubuntu work we are currently doing with the Tutu foundation, we are indeed all bound by our common humanity and stories are the best way to connect with people on a human level.
  3. Keep things simple – if only…The NHS excels in making things complex and complicated.

For me, someone who has worked in the NHS all my adult life, it was surprising to hear about the difficulties experienced in some parts of Africa with things we take very much for granted here, for example an initiative on cleaning hands had to stop when the hospital ran out of hand cleaning gel. It took three months to get some more. Basic things like having enough blood to use for transfusions was a challenge, healthcare workers have to be innovative and creative in their approach – thinking outside the box to redesign services, engage with communities and work with procurement and storage colleagues to save lives. I learned so much and that was just day one.

On Tuesday, I was lucky enough to be invited to the IHI board meeting. The CEO and COO of the IHI asked me to give a short talk to the board about the work we are doing in the UK with regards to diversity, inclusion and leadership. Those of you who know me will know that I can spout forth forever more about those subjects. I have to say (without boasting) that I think I did us (the NHS) proud, the board was blown away by the story I told about the work we are doing in England and wanted to know how we can help them to improve the diversity of their workforce. I must admit to enjoying the fact that our work in the English NHS around BME leadership was considered ground breaking and an inspiration by such eminent people as the ones on the IHI board.

On Wednesday, the conference started in earnest. 3,000 people were in attendance from all parts of the world. Some of the speakers were so inspirational it left me speechless, our own Nigel Edwards – Kings Fund, Jim Easton – Commissioning Board and Helen Bevan – NHS Institute were very well received by the audience, Helen getting the audience to sing en masse and in French will be remembered by many for a long time!

The highlight for me was a talk given by Dr David R Williams, who is now CEO of Southlake Regional Health Centre in Canada. This man is in his early 50s but as well as being a surgeon and a professor of medicine he is also a fighter jet pilot, an astronaut and a musician…Awesome. How can one man be so talented? He talked about the importance of teamwork and how essential it is in outer space to have absolute trust in your team members. He pointed out that trust and support between team members is just as important in hospitals where sick and vulnerable people are being cared for. He talked about the importance of open and honest, accessible leadership and high quality followership.

Dr Rosemary Gibson was another person who had an impact on me, she talked about the overuse and misuse of health care in high income countries. An example of this is perfectly normal and healthy pregnant women being induced or having surgical intervention to deliver babies at between 36-38 weeks gestation or overuse of diagnostics such as CT scans for very trivial reasons. This struck a particular chord having as I had been in the LoMIC seminar a couple of days before. She said that some medical interventions are not always necessary but are carried out to increase the profits of healthcare companies or because patients have grown accustomed to medical interventions and expect tests to be carried out or medicines issued – all for the wrong reasons. By drawing attention to this practice, she hopes that practitioners in higher income countries will begin to consider their actions and reconsider intervening if it isn’t absolutely clinically required.

The common themes in the conference from most of the speakers were leadership, engagement and teamwork. It felt very much to me that there has been a shift worldwide in terms of how we lead and get the best out of staff for the benefit of our patients.

The NHS constitution highlights our common purpose. The trick would be to get everyone singing off the same hymn sheet with equal enthusiasm and commitment just like Helen did at the conference.