#ImInWorkJeremy Campaign – Can we change the rhetoric @Jeremy_Hunt ? #NHS staff are Burning out!

So, I feel that I must blog about the #ImInWorkJeremy twitter campaign, which is currently in full force following Jeremy Hunts call for a #7dayNHS. Firstly, I believe that everyone is on the same page in terms of wanting the safest patient care possible. However, I am not so sure that the health and well being of NHS staff is being as valued at present, which as we all know, is surprising given the direct correlation that #NHS staff health has with the quality of patient care.

NHS staff are tweeting this weekend about how they are already working and keeping patients safe. They are doing so largely without breaks, food or a stress free environment – THANK YOU!

However, 65% of NHS staff have attended work when they have felt unwell enough to do so. I am concerned that this is not conducive to safe and effective quality patient care. If more pressure is put on NHS staff to perform for longer/harder hours, how will this statistic be affected? and how will that impact upon patient care? Will we find problems with the Wednesday service if we prop up the Sunday service? How can we deliver a #7dayNHS with more doctors if we don’t also have more nurses/midwives and support staff?

The challenges to achieve this are many… and it is clear by the many tweets I have seen this weekend that a #7dayNHS is already happening….

So why does Jeremy Hunt want NHS staff to work more unsociable hours? Well he has claimed that “Around 6,000 people lose their lives every year because we do not have a proper 7-day service in hospitals.” Yet there are further claims that there is yet to be a source for this claim. Confused yet?

I think the real problem here is that NHS staff may have been made to feel like naughty children who are being told what to do to make things better, rather that being inspired and carried forward by strong leadership. Everybody wants to make the NHS the best it can be. We are on the same team, so why have NHS staff been made to feel devalued?

The Secretary of State for Health (Jeremy Hunt Himself) asked Lord Rose to conduct a review into leadership in the NHS. The review asked:

• what might be done to attract and develop talent from inside and outside the health sector into leading positions in the NHS?
• how could strong leadership in hospital trusts might help transform the way things get done?
• how best to equip clinical commissioning groups to deliver the Five Year Forward View

This review reported that: “First, the NHS consistently delivers great service through a committed and passionate workforce of 1.38m staff in England . During my Review I heard many great stories (only a few not so great). Mostly I found staff motivated and focused, often running on goodwill in a tough environment; some places felt more positive than others.”

This was great to hear! Our NHS staff are being praised for the amazing work they do! Praised for the service they provide and acknowledged for the sacrifices they make to do so. We are all on the same page to do good things. The service is great! But yes, the environment is tough Jeremy..tougher than you may think it is….NHS hospitals are pushing young medics to brink of ‘burnout’ by relying on them to work extra hours…NHS staff want to work towards an even better service, but they need support in doing this, not be whipped and forced into doing so. Picking a fight is not in anyone’s best interest.

We know that engaging NHS staff will improve patient care and staff absenteeism ….so Jeremy I ask you…can we change the rhetoric here? Can we engage staff in this conversation rather than isolate them? They need to feel valued, inspired and driven in order to perform at their best. There is now an Outcry in the blogging community, calling for Jeremy Hunt to resign… However, I think what may be needed here is a new narrative, where staff feel valued and empowered to engage with the vision for the future NHS services alongside you, rather than feeling as though they are being dragged by their pigtails.

We are on the same team… Let’s be kind to each other.

Is our own Secretary of State Jeremy Hunt damaging the psychological wellbeing of NHS staff?

I have been thinking a lot this week about how midwives may be over compensating for the fact that historically, they may have been unfairly held accountable for poor outcomes in childbirth. In fact I have just submitted a paper about it (hence lack of blog posts)!

Watching social media news this week, my paper seemingly came to life in reality! – The Times Newspaper published new facts, figures and commentary blaming the UK’s comparatively high level of stillbirths and perinatal deaths squarely on the NHS and midwifery care.

Cathy Warwick (Chief Executive of the Royal College of Midwives) responded… “When I read this article in The Times last Wednesday, and the newspaper’s accompanying editorial, I just felt angry”.

These articles explained that the annual bill for NHS negligence in pregnancy has reached £1 billion after more than 1,300 babies were killed or maimed last year. – Strong words and statistics indeed.

Following these articles…. I watched a torrent of complaints rain down upon these articles. Midwifery was again accused of being ‘Faddish’ in its pursuit of natural childbirth.

Has this reignited professional turf wars? the fear of natural childbirth? and the historical distrust of midwives?

It has certainly done nothing to promote healthy professional cultures.

“Perhaps the secretary of state will step in to make this right?” I thought hopefully…

And then he tweeted this….”Shocking that 1300 babies killed or harmed during childbirth last year: we must go further&faster to make the NHS the safest system globally”
— Jeremy Hunt (@Jeremy_Hunt) June 10, 2015

Is our own Secretary of State damaging the psychological wellbeing of NHS staff?

We already know that healthier staff mean healthier patients… these comments do nothing to facilitate a healthy workforce. In fact, we have to wonder whether they may be actually psychologically damaging to NHS staff.

If staff are not afforded the healthy experiences of attachment, containment, communication, inclusion and agency within any organization, this can result in unhealthy, or frankly toxic, psycho social environments (Haigh, 2013) .

Are these statements in the media conducive to creating therapeutic a environment/relationship with the NHS?

If not, then we must consider whether they may create a toxic environment/relationship which may actually inhibit effective patient care.

I do not see anything coming from our own secretary of State to facilitate a healthy relationship with NHS staff, in fact, I believe this may enforce further hostilities between the public, the NHS and our own leadership. A sad step backwards for progress.

In my opinion….The very words “Killed” & “Maimed” imply that horrendous actions have taken place deliberately, when in fact we know that the vast majority of NHS staff do not go to work to intentionally be poor practitioners, make mistakes and fall below expected standards (Denham, 2007).

This brings us back to the key principle that better staff experiences are associated with better outcomes for patients.

Does Jeremy Hunt believe that he is creating positive staff experiences with his words through tough love? Are his comments meant to shock the NHS staff into not Killing babies???…

No, because NHS staff do not go to work to do this. They go to work to make a difference and achieve something wonderful.

The NHS often has to deal with the fallout and consequences of wider government decision-making, and this is no different. Nobody wants to see mothers and babies put at risk and experience a poor obstetric outcome. Everyone is saddened for these 1300 babies.

Cathy Warwick has confirmed that the true reason for the UK’s comparatively high level of stillbirths, is related to other deep seated issues in the UK such as social deprivation, social, and health inequalities. This is a challenge for us all to come together to address. Mud slinging, blaming, naming and shaming really have no place in achieving better outcomes for mothers and babies… and I hope my next paper will encourage further conversations to address this.

Continuing to repeat the false message that NHS staff are ‘bad’ ‘wicked’ baby killers does not fulfill any area of public interest at any level. Furthering this conversation will only galvanize fear and misunderstanding.

Let us create a new conversation in partnership with each other.

We are on the same team.

(Fingers crossed that this paper is excepted for publication please)!!!

Denham C. (2007) ‘TRUST: the 5 rights of the second victim’. Journal of Patient Safety. 3(2) 107-119

Haigh, R. (2013) ‘The quintessence of a therapeutic environment’, Therapeutic Communities: The International Journal of Therapeutic Communities, 34 (1): 6 – 15.