I see that last week the Institute
and Faculty of Actuaries revised their life expectancy prediction for British
men. It’s not good. They predict that men are expected to die at 86.9 years
old. This is lower than the 87.4 years they predicted in 2017. If they are
right with their predictions, it means I have just 209,364 hours to live. A
sobering thought and one that made me think that I cannot afford to waste even
one of these hours by doing something that’s unnecessary, not enjoyable,
productive or satisfying.
So last week I had someone fit a
log-burning stove in our lounge, something I might have done in the past without
thinking about it. I had Ash (yes, that was his real name) come and take down several
trees in the back garden, something just a year ago I spent a whole summer doing
in our previous house. My Husqvarna chainsaw stayed unused and lay contentedly
in the shed. Even my Amazon delivery (sometime between 08.00 and 14.00) came at
08.30, freeing up the rest of my day!
Sadly, it wasn’t quite the same
for some of the other activities I was engaged in last week. In fact, as I
started thinking about this week’s blog, I played with the idea of substituting
the word NOD in the blogs title with NED. Yes, I know, my reasoning is slightly
hard to follow here, but stay with me please. The thought about substitution, perhaps
reflected my end of week low mood. For me, it had felt like a tough week, characterised
by several early morning and late evening long car commutes. After what feels
like a lifetime of early starts and long commutes, it’s not my favourite way to
start the day nowadays. They were hours spent in a car that I am never going to
get back again. These lost hours certainly weren’t satisfying. At the end of
each morning commute were a series of meetings, some of which were immensely interesting
and productive, whereas others seemed rather pedestrian and pointless.
One of the better meetings
involved a feedback discussion by one of the Trust’s lawyers on our position
regarding a major contract we were negotiating with our local commissioners. The
lawyer was a partner from a major law firm. He was at the top of his game. He
clearly knew a great deal about procurement law, and what he didn’t know about NHS
regulations could be put on the back of a postage stamp. For younger readers,
this was something your parents would have used before email, Twitter, Facebook
and so on to send something called a letter to someone they wanted to communicate
with. The lawyer’s presentational style and his communication skills were superb.
He had one of those soft, but compelling voices. I could have listened to him
making his arguments all afternoon. But I was already conscious of those
precious hours slipping away, so was thankful that the meeting finished as scheduled.
In contrast, on a different
afternoon I attended a meeting characterised by the lack of compelling voices
and a distinct lack of any informed decision making. It was an expensive
meeting too. In attendance were two Chief Executives, two Chairs, a range of Executive
Directors from three major organisations in the local health and social care economy, several Non-Executive Directors (NEDs) and a sprinkling of other senior managers. I
wondered at the collective cost of bringing all these people together for an
afternoon’s meeting. The meeting’s purpose was to deliver the transformational objective
of bringing together all these agencies and organisations into a single integrated
care system (ICS). Integrated care systems allow for new partnerships to be
developed that bring together NHS organisations, local councils and others, to collectively
manage resources in delivering NHS standards and improving the health of local
populations.
Locally provided integrated services
can ensure that more joined-up care is available to individuals and communities
and that folk only go to hospital when their health needs can be best met
there. It is an exciting time in the history of the NHS. Which is more than can
be said for the time spent at the meeting. Yes, there were some interesting updates
around some of the developments in mental health care, care in the community
and so on, but the meeting didn’t really get anywhere near the positive decision-making
focused approach that I think was required. The discussion was rather
rhetorical. Agreements felt as if they were as valid as a nod or a wink to a
blind horse, and I slowly came to realise that once again some of my precious
remaining hours had been lost to too much enthusiasm and not enough substance.
On reflection, it may be that my
expectations of the progress that could have been made were too high for the transformational
stage all the organisations were at. And, on reflection I have also changed my
mind about substituting the NOD for NED in the blog title. My first thought had
been a consequence of the popular (intuitive) interpretation of the 16th
century phrase – that is, to the blind horse (or person) a nod or a wink has very
little purpose, both being equally pointless. However, the original use was ‘you
may nod or wink, I will take your meaning either way’. So, while my frustration
at the ‘nodding and winking’ going on at the meeting, which seemed to reflect the
slow progress being made towards developing our ICS, we are at least making
progress. But the hours are relentlessly ticking away…
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