Small is beautiful

I remember my friend Phil passing me this book to read during our university days.

Lots has changed since then.

The planet has become smaller.

This is perhaps best described as the world on a macro level – the big, big world.

Then we have the world I inhabit on a daily basis – the micro world. For me this is my family and friends and biggest, towering over everything, is work (which I like, which I love, which for me is becoming fun again).

Since moving to Rotherham, my world has to some extent shrunk; the organisation is smaller, it employs a few thousand less staff than Doncaster and there are fewer wards.

Personalities aren’t necessarily smaller, but the egos have shrunk.

Yet, I have found that Schumacher’s notion likely applies better to hospitals than global economies. The frequently painful processes of change that were central to much of what I did back in the day in Doncaster have become slicker, smoother; things happen.

Voila, day one we are working this way, tomorrow, all change and we are trying something new.

(‘Trying’ being the prime word – we accept that we will not necessarily succeed first time around – we are on a journey to better.)

This came to me yesterday when we were meeting to discuss how to re-design the clinical assessment document of the admission ward (in case anyone missed-it, I have become lead for acute medicine in the hospital – yes, where I was back in 2009) – nevertheless… the old document was a classic example of not-applying person-centred principles to pathway design. Essentially, it is a thick booklet, about 35 pages which most people don’t use and those who use it only complete about 10 of the pages with any regularity.

Needless to say, I found it bad bad bad and suggested a silent uprising against it when I first arrived.

We met yesterday having brought together the talents and experience of those who are keen to see change, there has been consultation and engagement with colleagues – in the QI world, they call this co-creation, doing with instead of doing to.

And thanks to some magical graphical design skills by Dr Ellen, we are on the cusp of releasing a new document.

I think I’ll leave this blog short, to be consistent with the title.

My belief is that health and social care is quite easy. Sure, there are workforce and financial hurdles, but, the most valuable resources are people, and, by, supporting and nurturing their emotional, intellectual and experiential capital things happen.

Here we are, there we go.