It can’t be fun working in an NHS trust in special measures: constantly under the spotlight; a revolving leadership carousel; being told what you are doing wrong by scores of 20-somethings with spreadsheets.
With every last drop of energy and goodwill going into keeping the hospital running, it’s perhaps not surprising that the world outside the A&E doors often doesn’t seem to matter. It goes without saying, though, that it really does.
I recently spoke to a board-level executive of a trust that had just escaped these central chains, but who was clear the trust must not re-enter them. What struck me was was how isolated the trust and its staff felt in their local community. What I considered fairly routine information about their local external partners, such as council plans for a new joint venture or a higher education provider from elsewhere opening up on their high street, was completely new to the trust. Throughout this period of internal system challenge and change, they had simply stopped talking to the outside world.
Or perhaps, as it soon dawned on the executive, the outside world had stopped talking to them.
Viewed from outside, special measures is a means of the centre taking back control. Local relationships come second to the focus on ensuring the trust’s every last penny is spent for the greater NHS’ good. Given the changing leadership within NHS trusts, even if one did want to reach out, to whom would they call?
Contrast this with another trust currently in special measures that had maintained and strengthened the post of director of partnerships throughout this difficult time. Through a growing range of new relationships, it is now at the heart of the area’s local growth plans and involved in shaping novel, community-led solutions to the historic NHS challenges of estate, workforce and innovation. There is still a challenge for this board-level executive in trying to convince his colleagues this agenda matters, but he considers the external local support the ace up the sleeve.
For those NHS trusts currently in, or on the cusp of, special measures, it’s very rare that the answers to their problems lie within. They need support, but not just from the centre of the NHS. As the place agenda grows and regional planning across sectors becomes better aligned it’s in all our interests to have strong, well connected anchor institutions serving our communities. If one is allowed to turn inwards, then we all suffer.
Michael Wood, local growth advisor, NHS Confederation, @NHSLocalGrowth