Shifting left: challenges we can all relish!

It is thought that the phrase ‘a legend in your lifetime’ was first used to describe the life and work of Florence Nightingale. She was, of course, a nurse first and a medical reformer second. It was said that Florence Nightingale ‘combined the intense vitality of a dominating woman of world with the mysterious and romantic quality of a myth’ - a description that reflects her passion, knowledge, courage and determination to make a difference.

On a slightly lighter note, Peter Hawkins, in his 1969 play ‘The Dynamic Death-Defying Leap of Timothy Satupon the Great’ describes his hero as a ‘legend in his own lunchtime’. In the play, Timothy, although being a reasonable and a likeable lad, day dreams of future greatness, but in reality, he never quite makes it or indeed, ever makes a difference.

Now I’m proud to be a nurse, albeit I stepped off the register a while ago now and no longer practice. Although I never attained the greatness of Florence, equally, I don’t think I’m a Timothy either. There is, perhaps, a legendary place somewhere between the two. My musings over Florence and Timothy arises from where we find ourselves as a national health service since Friday. Once again, resident doctors have chosen to take industrial action. It is, of course their right to do so. Their reasons for doing so this time, however, appear somewhat contestable. It was something I touched upon in a previous blog, posted just 14 days ago. 

However, it is not my intention to argue whether the industrial action taken by the resident doctors is justified or not. Currently, most doctors, including Resident doctors in the NHS work in hospitals. Inevitably despite what both sides of the dispute might say, harm will occur to individuals, families and the wider NHS. When that happens, it will be an outcome that is sad. The recent publication Fit for the Future, the Government’s 10-year health plan, provides a unique opportunity to change the UK’s approach to how we approach health care. And in my view (and the view of plenty of other folk I think), an absolute paradigm shift for good.

Whilst Florence was busy establishing a fully trained and regulated nurse profession, she was also reforming the function and practice of hospital-based care; moving it from a place of last resort and despair to somewhere people trusted and where they would receive safe and consistent care. Ironically, perhaps, one of the major so-called ‘left shifts’ outlined in the 10-year health plan is to move care from the hospital to the community, and in so doing make hospitals a place of last resort, but for different reasons!

A second ‘left shift’ is from illness to prevention; moving help upstream and earlier to prevent folk needing to access more expensive secondary care services. This will have an enormous impact upon the ever-increasing demands asked of health and care services. Florence recognised many of the underlying detriments that give rise to health inequalities, and poor life opportunities. Her ideas around the importance of good housing, sanitation and nutrition are ideas which continue to be built upon by others and which have helped societies around the world reduce the number of life-shortening diseases and avoidable health issues – but there is still a long way to go.

The third ‘left shift’ in the Fit for the Future plan -  ‘analogue to digital’ - would, I think, have enthralled and inspired Florence. She was a great statistician and knew how to use data to ensure informed decision-making and promote evidence-based care. Increasingly we will want (and probably need) to use data to fully gain the benefits of the many emergent digital developments, certainly in how we use artificial intelligence (AI).

As I write this blog, we are still anticipating that the industrial action will continue until 7am on Wednesday. I would like to say a big THANK YOU to all those nurses, porters, midwives, catering staff, occupational therapists, managers, doctors, and many other colleagues who will have stepped up during this strike in order to minimise any potential harm to patients from occurring. Alongside our communities and neighbourhoods, it is these same folk who, in the coming months, will also be called upon to take the ambitions of the 10-year health plan forward – I have great confidence they will rise to, and relish the challenge.