courage

Improving the NHS: with added tribute to Dr Kate Granger

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Last week I was introduced by Dr Kathy McLean, Medical Director at NHS Improvement to 180 people comprising senior NHS clinicians, managers, directors, chief executives, patient representatives and members of staff at NHS Improvement, including most of their executive team. And I wondered how my homespun talk about improvement, leadership, the universe and everything would go down.

As it turned out, quite well.

The cartoon above was drawn by Inky Thinking. I don’t know how they do it, but they capture everything you say that you want people to remember.

Here is a word-based precis:

  1. If you forget that culture always trumps strategy, your efforts to improve services will be ineffective. I’ve been there and occasionally done it the right way. But more often the wrong way.
  2. You can’t help others to improve unless you are OK yourself. I have form on not remembering this.
  3. Leadership in public services has never been harder with our 24/7 media, including social media, and the anti-public sector rhetoric that appears in most newspapers.
  4. Plus we live in a post-fact world – see this article by Guardian Editor-In-Chief Katherine Viner. People believe things that are not true, and don’t believe things that are. I’ve had personal experience of this. And it is horrible.
  5. Being an NHS leader is very lonely. Never more so than when you are awake at 3am. People get in touch to congratulate you when something goes well. But when things go wrong, people you thought were friends seem to melt away.
  6. There is never enough time to think when you are running NHS services because of competing demands, often from those who are meant to be there to help you make improvements. But you must create time to think or you will make bad decisions.
  7. Filling senior vacancies in the NHS is getting harder. And we should worry about this. Because if we aren’t careful, the only ones who apply to be in the firing line will be those who don’t care what others think about them. And that would be very bad for all of us.
  8. We cannot separate leadership from mental health. In my opinion, people who experience mental illness from time to time can make exceptional leaders. It is only one thing about them. Plus, they develop skills through therapy that are invaluable – such as managing their own mood, listening really carefully, and not making assumptions about others.
  9. I have experienced depression off and on since the age of 15. A nurse said something damaging to me when I was 22 and vulnerable which I absorbed deep into my psyche. For the next 36 years I stigmatised myself, despite being an active campaigner against the stigma of mental illness. It was when I finally came out about my experiences that I was able to address my self-stigma. I have made many friends since then. But if only I had done it before, I could have been a better, more authentic leader.
  10. Mental illness messes with your head. It affects 1:4 of us. But 4:4 of us should care about it, not just on humanitarian and economic grounds, but because almost everyone can be affected. We are all on a spectrum of resilience, and if enough bad things happen to us, especially at a young age, most of us will experience post traumatic damage.
  11. When I appeared suddenly to get ill with an acute onset of depression in 2013, it was a culmination of things. My own susceptibility, but also workload, loneliness, weariness as I approached retirement, not taking care of myself, listening too hard to my own negative voices, and putting a lot of energy into maintaining a positive front. It wasn’t caused by internet trolls. But they didn’t help.
  12. So please don’t do what I did. Get to know yourself. Talk to yourself honestly about how you are. Talk to your loved ones. Take care. Be the best version of you, but make sure that it is you. And try always to see yourself as an improvement project – this makes it easier to accept criticism without it cutting you to your core. I’ve only learned this in the last few years, and it is a revelation!
  13. I am lucky. I have dear family and friends. And I got great care. I was able to go back to a job that I loved, which was a major part of my recovery. I know it isn’t the same for everyone.
  14. Since the summer of 2014 when I finally hung up my chief executive boots, I’ve been helping others in various ways to be the best version of themselves. And I’ve written a book which I hope you will read when it is published later this year.

As I finish this blog, I think of someone who embodies improvement in everything she does. The talented, compassionate and extremely resourceful Dr Kate Granger. Kate is currently in a hospice in what are probably the final stages of a rare and awful form of cancer. But as well as sharing the intimacies of her progress through terminal illness via her wonderful talks and social media, Kate has also revolutionised the NHS and other healthcare systems around the world with her #HelloMyNameIs campaign. She has written several books, and completed amazing things on her bucket list. And not content with that, Kate and her husband Chris Pointon are urging people to make donations to the Yorkshire Cancer Centre, a small charity that helps improve the quality of life of people living with cancer. You can donate here.

Kate and Chris demonstrate that being a leader isn’t a job, it is an attitude of mind. That anyone can make a difference if they focus on something that matters, turn a great idea into an innovation and build support for it through honest endeavour. We can all learn about improvement from them.

May you go well, both of you.

25 July 2016 postscript: 

Chris has just posted on Twitter that his wonderful wife died yesterday peacefully in the arms of her family. 

I only met Kate once. I will never forget her. She had an extraordinary stillness and presence. I hope the knowledge of the difference she has made and will continue to make for many years to come will sustain Chris and all who loved her in the difficult times ahead. 

My heart goes out to all of you. May her lovely soul rest in peace.
 

 

 

 

What would Mary Seacole do?

Professor Elizabeth Anionwu and me

Professor Elizabeth Anionwu and me

On difficult days, I ask myself what Mary Seacole would do.

Those who seek to denigrate her memory are more than mean – spirited. They not only question her nursing contribution in the Crimea –  for which she was honoured by the British Army, the Times newspaper, Her Majesty Queen Victoria and 80,000 members of the public who attended celebrations in her honour. They also question whether she actually was a nurse. They say that she wasn’t really black. And having campaigned as hard as they could to undermine the Mary Seacole Memorial Statue Appeal, they now say that it is OK for there to be a statue to commemorate her, as long as it is small and not in a prominent position.

I will not stoop to naming these people nor to referencing the nastiness they have whipped up. Articles in The Independent and The Guardian have helped set the record straight. And today my dear friend Professor Elizabeth Anionwu CBE, Vice Chair of the Mary Seacole Statue Appeal, pictured with me above, will be on Woman’s Hour talking to Jenni Murray about the importance of Mary’s memory to all who believe in equality.

And today is the day that Mary’s beautiful statue, created by renowned sculptor Martin Jennings, will be unveiled outside St Thomas’ Hospital in London. Mary will proudly face the Houses of Parliament across the river. And she will be the first statue to a named black woman in the whole UK.

This is what will be written underneath:

“I trust that England will not forget one who nursed the sick, who sought out her wounded to aid and succour them, and who performed last offices for some of her illustrious dead.”

Sir William Howard Russell, War Correspondent, the Times Newspaper, 1857

We need Mary’s legacy now more than ever. The referendum campaign has unleashed xenophobia and racism. The poster of people with dark skin queuing for refuge with that hateful slogan underneath said it all. Some hoped such ugly days were over. Many knew this was not so. Fear and hatred for “the other” lie behind words such as “I’m not a racist but….”.

The NHS is not immune to racism. Or sexism. I have nothing against able and honourable white men. But when the NHS workforce is 70% female and 20% BME, why does the top look so male and so white?  This excoriating report by Yvonne Coghill and Roger Kline tells us a lot. About unfairness and disadvantage and about how NHS staff who experience these things can lose hope. It was published earlier this month. It is in danger of sinking without trace unless we do something different now.

I have no personal experience of racism, although I have seen it in action. Sometimes I have done something about it. And sometimes I have not. For this I am ashamed.

I do have experience of anti-Semitism, of being teased for having a “funny” surname, and of sexism. I know about the stigma of mental illness. And I know that, had I stayed where I started, at a London teaching hospital, I would not have become an NHS chief executive. My face would not have fitted.

It was for these reasons that I, a white woman, felt I had something to contribute to the Mary Seacole Statue Appeal.

Trevor Sterling, new charity chair, Leon Mann, ambassador and me last year at the site where Mary's statue will be unveiled tomorrow morning

Trevor Sterling, new charity chair, Leon Mann, ambassador and me last year at the site of the statue

And now, trustees of our new charity, the Mary Seacole Trust, chaired by the brilliant lawyer Trevor Sterling, will be calling on Mary’s legacy to inspire those at risk of disadvantage. In schools, universities, communities and workplaces including the NHS. We will encourage people to work hard and do their best. To be compassionate AND entrepreneurial. To aspire to great things. To speak up for what is right. And never to give up.

Despite not bring born in the UK, Mary Seacole never gave up playing her part in helping those from a country she loved. Throughout her life she remained proud of her dark skin and her heritage.

I urge anyone in despair or need of inspiration to visit Mary’s statue. It depicts her coat furling around her as she strides defiantly into the wind to meet her destiny.

These are very difficult times. Let us join Mary Seacole. And let us never give up.

An earlier version of this article was published in the Health Service Journal. I have updated it for my blog and to increase access beyond the NHS. I will update it again with photographs of the statue.

 

 

Beaten. But not broken

 

The Chattri, near Brighton

The Chattri, near Brighton

Dear Everyone

There are five stages to grief, as explained by Kubler Ross.

  • denial
  • anger
  • bargaining
  • depression
  • acceptance (sometimes called accommodation)

We do not progress through the stages in a linear fashion. Some may have to be repeated. If we are not careful, we can get stuck at any of the first four, and never fully achieve the final one, of acceptance.

Today, those of us who voted Remain are feeling some or all of the first four stages. Only a few have reached the fifth by now. Some never will.

We have a right to feel angry. The referendum was unnecessary. Some time ago, David Cameron made a promise to appease certain members of his own party. He probably never expected to have to keep it.

After the result, the only honourable thing he could do was resign. As he did so, he was trying hard to appear to have achieved acceptance. But the catch in his voice gave the game away.

And he may never achieve it. Political careers in high office almost always end in failure. But this is failure of a most awful kind. Perhaps we can be kinder if our current Prime Minister shows statesmanship over the coming weeks and begins to chart the way through unprecedented choppy waters.

The reason many voted Leave was not about immigration or perceived European bureaucracy. It was a protest vote against the greed of big business, the banking crisis which has affected poor and vulnerable people much more than those who caused it, and a political ruling class that seems dangerously out of touch.

Can we listen really carefully to those who feel this way? We need to heed their voices, as well as the cries of anguish from those who voted Remain. And listen to both groups above the triumphal clamour of the minority who believe we have “got our country back”.

It is going to be very hard. Once hatred has been unleashed, it is hard to put it back in its cage. The rise of far right politicians and alliances are real and present dangers.

The size of turnout demonstrates that when people feel their vote will count, they are more likely to use it. So maybe we have to rethink our position on our current electoral system that disenfranchises so many.

And perhaps those towards the centre or on the left politically, if indeed such definitions are even valid in this context, can stop fighting one another and think about what matters? And who our real enemies are?

In the early stages of grief, it is important not to make momentous decisions. Words or acts of anger, hatred and blame will not help us.

So let’s hold on. Let’s be kind, to ourselves and to others. We are beaten. But we are not broken.

Yours, in solidarity with the human race

 

Be inspired #Confed2016

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This time last year, I wrote a blog for newbies going to the NHS Confederation Conference. I decided to do an update for #Confed2016.

These are my top ten tips for having a fruitful time. By the way, you don’t have to be going to Manchester to make use of it 😉

  1. Don’t try to see and do everything. Be choosy. Treat the conference like a festival. By all means tweet about what you hear. But do also give the events you choose to attend your undivided attention.
  2. If you only seek out sessions and speakers to confirm your views, you will waste time and money. Arrive with an open mind. Ask questions. And be prepared to learn new things and to unlearn old ones.
  3. Some people need no encouragement to network. But if you aren’t confident about bounding up to someone you admire with an outstretched paw, don’t worry. Practice saying #HelloMyNameIs to people who look like you feel – perhaps a bit lost or lonely. And remember what Dale Carnegie said: You can make more friends in two months by becoming interested in other people than you can in two years trying to get other people interested in you.
  4. Dress for style AND comfort. These are not mutually exclusive.
  5. Never forget you are at work. Stay out late if you must. But if someone makes you an offer you feel you cannot refuse, say No. And mean it. What goes on at conference does NOT stay at conference.
  6. Take breaks. Go for a walk. Have a rest in your room. Do shopping or emails or visit the Lowrie. Drink coffee.
  7. At the same time, stay focused on why you are there. The NHS is in a bad way. It is not only being slowly starved of cash. Services are overwhelmed because current methods of doing things are unfit to meet the demands of so many people with multiple problems. We need leaders like you to find two or three changes that will make the most difference. And to devote their careers to making these things happen.
  8. Remember that innovation is as much about stopping things as starting them. That there are no quick fixes. And that culture eats strategy for breakfast*.
  9. You will meet folk having a hard time. Please don’t avoid them. Despite all the talk about compassion, our beloved NHS has become less compassionate. There is too much focus on inspection, compliance and performance. And insufficient attention paid to recovery, renewal and support. Please spend time with people working in very tough places. Listen if they seem angry or frightened. One day, this could be you.
  10. Take a look around you. Notice the top of the NHS. How very white and very male it is, despite the NHS workforce being 70% female and 20% BME. Ask yourself why this is so. And if you think it matters, do your bit to help to change it.

I’ve been to a few conferences. And been inspired. I hope you will be too. Have a wonderful time xxx

*This was never actually said by Peter Drucker or Edgar Schein, to both of whom it has been attributed. But it was what they meant. Sort-of.

Open dialogue

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I went to a conference in Nottingham yesterday to learn about a technique called Open Dialogue. I wanted to know more because of how it has revolutionised the care of people who are in crisis in parts of Finland and the US, reducing demand on mental hospitals and transforming lives.

I care deeply about mental health services, although I don’t run them any more. These days I campaign to make them better. I volunteer in suicide prevention. I chair the Time to Change mental health professionals project. And sometimes I need help from services myself.

I wish you could have been there too. Some massive pennies dropped, not just for me but for everyone who hadn’t already appreciated the possibilities. We learned that Open Dialogue is about being with people rather than doing something to them. And we realised that here was a way to mend things that previously seemed unfixable.

Let me explain.

There are some who say that the NHS is broken. And that mental health services are badly broken.

I’m not sure that broken is a helpful way to describe things. I prefer to think of them as badly wounded. And when someone is wounded, you take care of them.

I believe that people in highly influential positions do care about mental health. They are just unsure about what to to do, other than saying they care. They know that mental health services around the country are buckling under the strain of increasing demand. Referral rates have never been higher. And continue to climb. Services find it increasingly difficult to discharge people because there is nowhere for them to go. Staff are overwhelmed, and there is a growing recruitment and morale crisis.

Added to which, successive governments say one thing about the importance of mental health but allow the opposite to happen regarding funding. Despite the fine words and promises in the response to the Mental Health Taskforce report published in February, we heard just a few weeks ago from NHS Providers that mental health trusts are not seeing the promised investment and some are reporting funding cuts in 2016 – 2017. Parity of esteem? Actions speak louder than words.

How might Open Dialogue help?

Firstly, it isn’t simply a technique for listening really carefully to people who experience trauma and distress AND their families so that together they can work out their own solutions, with support. It is also an extremely respectful way for people to relate to one another, in teams, across teams, organisations, health care systems and society. Even the NHS.

Secondly, Open Dialogue is the antidote to what is sometimes called the biomedical model, when doctor knows best and patients are compliant. This works when there is a fairly simple problem and solution. For example, a broken leg. It doesn’t work for the vast majority of health conditions in which people need to become the expert themselves if they are to lead fulfilling lives. And it certainly doesn’t work in mental health. Mental health professionals know this. But we organise and regulate mental health services as though we were fixing broken minds instead of legs.

Open Dialogue builds on what some call the Recovery Model, based on hope and fulfilment rather than simply diagnosis and treatment. It provides a method to apply a recovery-based approach, involving the whole family and team. It is the antidote to outpatient clinics and ward rounds.

Thirdly, Open Dialogue provides the basis from which to challenge many of the perverse incentives and restrictive practices that have grown up in mental health care out of fear of incident, media criticism or what a regulator might say. Such as staff spending more time documenting care than in giving care. The absolute adherence to risk assessment even though successive independent investigations show it to have limited predictive value. And risk management, which taken to extremes means that those who might possibly pose a risk to themselves or others, are cared for in inhumane conditions with no privacy or dignity, no sheets, cutlery, shoelaces, phone chargers or indeed any other item that someone somewhere has said might pose a risk. And yet we know that ligatures and weapons can be fashioned from almost anything. And that people who are ill, frightened and alone can be driven to do increasingly desperate things. The greatest risk management tool available is compassionate, skilled attention. Open Dialogue offers high quantities of that.

Open Dialogue is being used in a growing number of services in the UK. A research bid has been submitted and passed the first round of scrutiny. If successful, it will explore human, clinical and cost effectiveness, as well as developing a model that is scalable and sensitive to local circumstances.

I want to thank everyone at the conference for opening my eyes. Including Tracey Taylor, Simon Smith, Pablo Sadler, Lesley Nelson, Jen Kilyon, Russell Razzaque, Mark Hofenbeck, Julie Repper and Steve Pilling.

And to Corrine Hendy, who I first met at an NHS England event about putting patients first last year: Your journey from being locked in a mental hospital to becoming a skilled mental health professional, public speaker and highly effective advocate for Open Dialogue, is more inspirational than any you will hear on X-Factor. I want to repay the inspiration you have selflessly given.

I’m going to do what I can to spread the word.

 

In memory of Sally Brampton. You are not alone

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I was saddened to hear of Sally Brampton’s untimely death after a long battle with depression. She was 60, the same age as me. From my own experiences of depression, I know a little of how things must have been for her. My heart goes out to all who loved her. May she rest in peace.

Next week is Mental Health Awareness Week.

For those who are struggling, I say this. Mental illnesses mess with your head. They make you believe bad things about yourself. That there is nothing wrong with you other than laziness, moral cowardice, being hateful and lacking what it takes to lead a normal life. That you are not worthy of help. And that you must face this awful, isolating thing alone.

But struggling on alone is not a good idea. Nor is pretending to be OK when you are not. I know this from my own past, effective but wrong-headed attempts to keep how I was feeling to myself. In the end, keeping secrets just causes more damage. It can be really bad for you and those you care about.

If you are overwhelmed by negative or frightening thoughts, if life feels grim or even just pointless, please, please ask for help.

  • Talk to a friend or someone else that you trust.
  • Make an appointment to see your GP.
  • Check out the Grassroots Suicide Prevention StayAlive app – available free to download to iPhones and Androids.
  • Phone Samaritans on 116 123 or one of the other helplines.

If you don’t know what to say at first, or feel embarrassed or tongue-tied, it doesn’t matter. If you are afraid that the words won’t come, try writing it down.

Social media has been a massive help to me. I have made friends online who always seem to be there. They have been to those evil places. Not the same as mine, because we are all different, but their own terrifying versions. They know how lonely it feels.

Contrary to what you may hear, there are wonderful services available and treatments – medicines, many different sorts of therapy and other practical techniques – that work for most people. It can take time to find the right ones, of course. And it will take a lot of courage and effort on your part. There are no miracle cures. But I promise you, seeking help really is worth it.

Believe me, you are not alone.

What mental health means to me

I took part in a Twitter chat recently on the above topic. Thanks to @AnthonyLongbone for encouraging me to join in. Below are some thoughts I shared in advance.

What does mental health mean to me?

  1. Mental health is the most important part of health. And it is integral to physical health. You can’t look after your body if your mind is in a poorly way.

  2. Mental health is a continuum with optimal wellbeing at one end of the spectrum and mental illness at the other. Some people seem to be able to take good mental health for granted. For others, maintaining our mental health requires almost constant vigilance and care.

  3. Facing up to my tendency to depression has been the most important self-help step I have taken in my life so far. I’m hopeful I won’t ever sink as low as I did in 2013. But I’m not making any assumptions. And I do not plan to judge myself negatively if I do experience another bout either.

  4. Judging myself – or indeed others who experience mental illness – is the least helpful thing any of us can do. Who knows why I or anyone else has this tendency? What does matter is what I do from now on to help myself and allow others to help me. Which includes understanding my own triggers and warning signs.

  5. All serious illnesses require some degree of courage, so that we can face the pain and the treatment required to help us get better. But mental illnesses can be harder to bear than physical illnesses . They mess with your head.  They make you believe bad things about yourself and others. They take away your hope and they affect your judgement and even your personality. They make you isolated and afraid. Some people hear the voices of others telling them bad things. In my case, I only hear my own voice. When I am poorly, my internal voice is harsh, judgemental and cruel. It tells me I am worthless and evil. I am still learning how to notice that voice when it starts whispering to me, and how to answer it.

  6. Since I decided to be more open about my own experiences, I have made some extraordinary friends. Our mutual support during rocky moments via social media undoubtedly saves and enhances lives. I love the equality and the loving kindness of these relationships. We all have something to bring.

  7. It’s because of all this that I know how amazing other people who experience mental illness are. How courageous, funny, honest, thoughtful and kind – hearted.  And this is how I know, beyond all reasonable doubt, that people who have had such experiences have assets that should be applauded and sought by others. Rather than deficits to be pitied or avoided.

…………………………………………………………

After the chat, I felt a bit overwhelmed. The people who joined in were just amazing. Brave, honest, intelligent, thoughtful, generous and kind. I am in awe of them. They have far more of merit to say than I do.

In conclusion, what mental health means to me is being part of a group of wonderful people like the ones I was talking with tonight. They are helping me to become the best version of myself, which includes being kinder to myself. Through this, I can become kinder to others and do my tiny bit to help them too.

And I’m really grateful to be on that journey.

Cock-up or conspiracy?

Blogging can be addictive. I try to limit myself to one a week. But after the Secretary of State announced yesterday that a pay “settlement” will now be imposed on junior doctors, given that extended negotiations have so far failed to reach a conclusion satisfactory to all parties, I feel I have something to say.

I know many junior doctors, including the daughters and sons of friends plus those I meet directly through ongoing contact with the NHS. These young people, who hold other people’s lives in their hands on a daily basis, are sensible, bright, compassionate, committed and driven. I don’t understand how a Secretary of State who was brought in to settle down the NHS after the mess the previous one created can have allowed himself to get into an intractable dispute with so popular and articulate a group of NHS staff.

But nor do I buy into conspiracy theories about privatisation by stealth; there would be better ways to achieve this than by alienating an essential section of the workforce. It is far more likely to be a cock-up. Someone probably advised him that the existing contract was, as most senior NHS managers including senior doctors know, overly complicated and no longer fit for purpose. (If indeed it ever was. This is not the fault of the junior doctors, by the way.)

And so he decided to immortalise his legacy as a moderniser by spearheading the introduction of a new contract. But because he isn’t a manager himself, he set out without understanding that the only way to change the contracts of any group of public sector staff, especially doctors who have possibly the most effective union in the country to negotiate for them, is to improve on their current terms and conditions. There is nothing that upsets people more than attempts to introduce changes that significantly worsen their position. And at the heart of the dispute is the fact that for everyone else in the NHS, Saturdays are not part of the core working week. And although there is little choice for the majority but to work on at least some Saturdays, doing so incurs additional payment. (That people in shops and restaurants don’t get paid extra for working on Saturdays these days is of no relevance.)

The Secretary of State also fell into a communications trap by talking about a 7-day NHS, when the group he was targeting already work shifts across 7 days. He chose the wrong example. To get a true 7-day service, he needs to persuade all other NHS staff who don’t already do so to work shifts over 7 days. And to find considerably more of them because spreading 5 across 7 just makes a thinner spread. And that would cost a great deal of money, which he doesn’t have.

What I know from my junior doctor friends is just how difficult it is to get onto a training programme that takes account of personal circumstances. These young people are already in their mid – late 20s. They have slogged away for 10 years plus to get to where they are now. Only the most elite get the pick of training jobs in university teaching trusts; everyone else is bundled around the country with little choice on short placements that have to be filled, because they are the medical workhorses of our NHS. This plays havoc with personal relationships and family life. So they are not a group for whom losing what little control they had over their Saturdays was ever likely to go down well.

With all this in mind, chief executives of trusts work to a bottom line, which is to deliver safe services within the money available. And 20 of them have found themselves in an invidious position.  These 20 were asked whether the latest offer being made was, in their opinion given the circumstances, fair and reasonable. Having replied in most cases that on balance, they felt that it was, they found their names being included in a letter from the chief negotiator to the Secretary of State in support of something about which they had not been asked, ie an imposed settlement. For the sake of the point I want to make next, it doesn’t matter whether this was a cock-up or conspiracy. (I suspect cock-up, because they are far more common. And we humans make mistakes.) The letter caused a massive flurry on social media. And these people had to decide whether to keep quiet, incurring the wrath of their own junior medical staff and others who support the doctors, or come out and say that they had not agreed to the imposition, potentially putting their own careers at risk. That the majority did the latter fills my heart with hope for the NHS.

And my key point is this. To be a leader in today’s challenging NHS, there are seldom going to be obvious right answers. You will frequently be faced with dilemmas of this nature. If you don’t have the nous to work out when to put your head above the parapet and when to stay quiet, plus the courage to do the former at the very time it seems most lethal to do so, you haven’t got what it takes.

In other news, the Head of Google, Europe told the Public Accounts Committee yesterday that he couldn’t remember how much his own remuneration package was. Either he really couldn’t, in which case he is an idiot and has no right to be in charge of anything. Or he dissembled because he knew it to be a sum of many millions, embarrassing with Google under fire for paying so little corporation tax. Chief Executives of trusts have their salaries published every year and get pilloried for it in newspapers like the Daily Mail. And they all know exactly how much they earn, which is a tiny fraction of the forgetful man from Google. And yet each carries many times more responsibility than he would have a clue how to handle.

My worry is that there is a scarcity of people with the right attributes and courage to do these NHS leadership jobs. And we really, really need them. As we do our wonderful junior doctors.

Hello, my name is Lisa

We all have days that are hard. When what we need to do seems insurmountable, when we wonder whether anyone knows or cares about our efforts, and when we question our own plans, motivations and abilities.

As a writer and mental health campaigner who experiences depression from time to time, such days come along not infrequently. They also go away again, but only if I find ways to work through the negative feelings that beset me. To keep on keeping on, as Bob Dylan called it.

To do this, I deploy various methods. One of my favourites is to summon someone I admire, and imagine them watching me. Or I ask myself what they might do if they were in my position. It doesn’t make depression go away, of course, but it helps me face up to the difficult stuff.

It is a great honour to have met one of the people who, without knowing it, helps me on occasions to get over myself. And to have done so back in June 2014 when she spoke at the NHS Confederation Conference about the campaign she started which snowballed into the social movement Hello My Name Is.

I am of course talking about the indomitable, courageous and wise Dr Kate Granger, who has terminal cancer and yet as well as Hello My Name Is has managed to complete her medical training to become a consultant physician, get an MBE, bake amazing cakes, play the flute and tick off more things from her bucket list than most of us manage in many years longer than she knows she probably has.

In a tweet earlier this week to Kate’s husband Chris Pointon, who I haven’t met but I know must be a wonderful man because Kate wouldn’t have married anyone who wasn’t, I said I would write about why Hello My Name Is immediately struck a chord with me. This is it.

In my old life as an NHS mental health trust chief executive, I grew to learn that values mattered many times more than strategy. And that these needed to be simply stated, oft repeated and regularly practised by me and all our staff. We had five.

  • We welcome you – because first impressions really matter
  • We hear you – listening really carefully
  • We are helpful – being pro-active, flexible, creative
  • We work with you – sticking with people through the difficult times
  • We are hopeful – being optimistic for people – staff and patients – and our services

I love these values. You can find out how we developed them when eventually you read the book I have almost finished (hint). For now, I’d just ask that you notice the first one, We welcome you. It links closely with Hello My Name Is. And with name badges.

Name badges really matter in mental health and related services. Because patients can be confused or experience hallucinations. Because services can be scary, for real or imagined reasons. And because no-one wears a uniform so you really can’t tell who is who. And you need to know.

So when I first became CE, the executive team agreed that we would always wear badges and that all our staff would always wear badges, as these would help us to introduce ourselves to each other and to patients. And then however stressed or forgetful someone was and however many people they met, they would always know who the other person was.

During my time as a CE, for the most part, people wore their badges with pride. But not always. You’ll have to wait for my book to hear some of the excuses I came across during 13 years on why staff, including extremely senior ones, were not wearing a name badge. And why I take ultimate responsibility for this.

But what I will tell you is how, back in early 2014 when Hello My Name Is was beginning to gain traction,  I wrote about it in my weekly blog, and asked our people to think about incorporating it as part of We Welcome You. And I got some really nice responses. But also one or two dusty ones. Including from one senior person who said that they were deeply insulted that I was suggesting such a thing, because of course they always introduced themselves to their patients and didn’t I have something more important to write about. This wasn’t the same person who had previously told me that they didn’t need a name badge because everyone knew who they were and anyway they didn’t work in Tesco. But it could have been.

I believe that people like this are, at heart, good and caring and that they are not untypical in any part of the NHS. But they have some way to go to understand that the Hello My Name Is campaign is about seeing the patient and not just their disease, and about bringing your whole compassionate self to work, rather than just your intellectual self.

Kate, your inspirational campaign is still very much needed. It will remain topical and relevant for many years to come. You have set a standard for how we work together to which we can all aspire. You are a shining beacon whose work will live on long after we are all gone.

Hullo, my name is Lisa. Thank you for inspiring me on my difficult days to keep on keeping on.