Sunday, 21 July 2013

Walking the Great Wall of China and Other Ambitions

I was once given a book for Christmas that had a title something along the lines of 500 things to do before you die, I recall leafing through the book and being mildly surprised at the number of things I could already tick off: flying down the Grand Canyon, coffee at the top of the Eiffel Tower, riding a Japanese Bullet Train on the way to Mount Fuji, hearing the cry of your own peacock in the early morning; seeing the onion shape topped buildings at the Kremlin, taking a smoke sauna, riding on the Maid of the Mist under the Niagara Falls, seeing the big five animals in the Serengeti; paragliding in the Lake District; making my own goats cheese and so on.

One ambition I hadn't fulfilled when reading the book was walking on the Great Wall of China. I finally had the opportunity to do this back in 2009.  I can remember the sense of history that pervaded the wall, the stones worn smooth by the marching of thousands of soldier’s feet, the sheer size of the construction and the skill and imagination to both conceptualise and bring the project to fruition. Although these days parts of the wall are in disrepair many sections have survived well since it was first constructed in the 16th century. It was a fantastic experience and one that I can recall with great vividness, and that’s what realising ambitions should be about.

I mention ambitions as last Monday the Keogh Review Report was published. The review was commissioned in February this year following the publication of the Robert Francis Public Inquiry into the poor care provided by the Mid Staffordshire NHS Trust. The review was led by Professor Sir Bruce Keogh, a former Cardiac Surgeon and now National Medical Director for the NHS in England. His review looked at the quality of care and treatment provided by 14 trusts identified as having higher than average death rates in the 2 years prior to the start of the review. 11 of the trusts reviewed are to be put under ‘special measure’ in order to improve governance.

The report has been described as 61 pages of common-sense, truth, courtesy, concise and clear analysis, doable fixes, and ambition. And I would agree. It’s a great read and shows what can be done with the right data, commitment and conviction. There are 8 ambitions outlined in the report: a new national indicator on avoidable deaths; more informed (by data) commissioning; increasing patient and public involvement in the design and assessment of local NHS provision; increasing confidence in Care Quality Commission assessments; ensuring that all health care services are fully professionally, academically and organisationally integrated; nurse skill mix and numbers to more appropriately reflect the severity of the health care need in the patients being cared for; reposition medical leadership at all levels of clinical experience and knowledge; developing a culture that results in happy and engaged staff.

I welcomed them all, but perhaps like you might have felt when reading about my ambitions at the start of the blog, some of Keoghs ambitions resonated and some didn't – I am not sure, for example we are ready for any more medical leadership, although perhaps this ambition is about the medical profession benefiting from recognising and harnessing the energy and enthusiasm of some of its more junior member’s. Likewise, I am sure as a School we will be asked to take even larger numbers of students for pre-registration nursing programmes, although goodness knows where we will put them! However, I did like the ambition of creating a culture that resulted in happy and engaged people. Mind you if you want to see just how big an ambition this might be, spend a few moments looking at this happiness map