Yin and Yang: County Halls and Garden Centres

Some weeks can be fun, others a challenge, but as I grow older, I find every week interesting. Last week was a Yin and Yang kind of week for me. Yin and Yang is the concept in Chinese culture that captures the balance and harmony of two opposite and complementary forces or energies in the universe. I experienced a mixture of both last week. On Thursday, I was down in London to attend the NHS Providers’ inaugural Quality and Improvement Conference. I have to say I really enjoy these sorts of events. Not only do I learn something new, I very often get to people I perhaps haven’t seen in a while, or have only met on social media.

This was the case on Thursday. One of the first people I bumped into was my former colleague, Maxine Power. It was great to be able to catch up on what we had both being doing, since last seeing each other a few years back. Tori Cooper tapped me on the shoulder and said hello. I didn’t recognise who she was, as her name badge said Victoria! Tori has long supported my weekly blog and I always welcome her insightful comments. It was lovely to meet her in person. Then there was  CharlesKwaku-Odoi who was speaking at one of the breakout sessions. I had never met him before, but felt I knew something about him as I have read his CV twice now in the last three years. It was a great pleasure to be able to shake hands with him and introduce myself.

The conference was at the rather splendid County Hall, right by the Thames and across the way from the Houses of Parliament. The conference started with a brilliant paper from the equally brilliant Charles Vincent. I have heard him speak before and he always uses real life experiences to illustrate his points. In this paper, he spoke about the importance of open communications when standards of care fall short of what is expected and/or required and adaptations get introduced. He also challenged us to look at the way in which safety checks can evolve and mutate to become more of a hindrance then a helpful tool.

This was a theme that came up again in one of the breakout sessions that looked at identifying and calibrating organisational risk. I took away four ideas to ponder upon. (1) being a custodian of a set of values and principles required to protect patient safety and improve the quality of care (2) the often laziness of language used when considering risk and how to respond (3) the bear trap of the normalisation of the unacceptable and (4) the importance of curiosity, underpinned by compassion. Although these ideas were predominantly set in the context of acute care, I was struck by how closely the ideas resonated with my current experience of being Chair of a mental health NHS Trust.  

These are not necessarily new ideas. Indeed, listening to the discussion, I was struck by how familiar they felt. In a previous life, I would start of many of my presentations or lectures by telling the audience how I saw the world. Somewhat pretentiously (hindsight is always good) I would declare these as being ‘my postmodernist Machiavellian manifestations’. I rather grandly talked about the ‘panacea of evidence-based health care’ of ‘rhetorical prescriptions of professional practice’, the rise of the ‘calibrated organisation’ and the ‘rituals of verification’. With my long-term co-author, Professor Sue McAndrew, I published many a paper exploring these ideas and the often perverse impact they can have on both organisations and on the folk receiving care. These days I spend much of my time trying to navigate my way through impact of these challenges. So, it was wonderful on Friday, to find myself in a very different place with folk who thought about mental health care in a very different way.

I had been invited by Paul Baker, Co-Founder of CHARM (Communities for Holistic Accessible Right-based Mental Health) to a meeting with a group of mental health workers from Brazil, who had been visiting mental health services across Manchester. Their visit had been arranged and organised by CENAT (Centre for New Approaches in Mental Health) in Brazil and CHARM. The meeting was held in the Hulme Community Garden Centre, in Manchester. I was delighted to be able to attend, and blown away by the setting for the meeting. If you happen to be visiting Manchester, take time to have a look at this wonderful place. It is not County Hall, but goodness, I knew in which I preferred to be, gardens will win every time.

The meeting was truly an exchange of learning and sharing. I was last in Brazil 30 years ago, so was keen to hear how things had progressed. There were many innovative approaches that were not hospital-based, but were person and family-centred and approaches we should consider building into our place-based ambitions for future care provision. I was challenged by what I heard at both events, but for very different reasons. What I would say though is that in both events there were many people passionate about make a difference to the life and wellbeing of others and that, I find, is reassuring.

The last word, is rather poignant. Two of the visiting colleagues from Brazil, live and work in the areas currently being devastated by catastrophic floods. I hope you will join me in keeping all those impacted by this disaster in your thoughts and prayers.