Coming of age in the NHS

The NHS has just celebrated its 65th birthday and this month I have been working in the NHS for 21 years. Where did that time go?! I joined in 1992 straight after my degree. The Conservative party had recently won their fourth consecutive election and Erasure were no.1 in the charts with an EP of Abba covers, which included ‘Take a Chance on Me’.

That song lyric aptly captures my start in the health service. My grandmother was a nurse and my mum a social worker so perhaps working in the public sector was in my blood? But if I’m honest, when I joined as an information officer in sexual health services, I was trying the NHS out as a potential career and didn’t know where it might lead.

I had no concept of the breadth and complexity of services and systems as I walked into that clinic in Paddington on day one. Working as part of the clinic team, I spent much of my time in the outpatient setting, working directly with the doctors, nurses, pharmacists, health advisers and administrative staff. But more importantly, I spent time talking and listening to patients. 

As I reflect now on the past 21 years, I realise how seminal that initial experience working in genito-urinary medicine was. The NHS was a whole new world opening up before me and I loved it. It gave me a great start and a grounding which has served me well since 1992.

Being part of that frontline team has informed and influenced my leadership as I have progressed in my career working in acute, community and mental health services. It has been a privilege to work and learn with so many inspiring staff and patients across those different organisations and communities.

Now the NHS faces considerable challenges. Just recently, the NHS has been headline news again for key issues such as mortality rates, weekend working and the challenge of meeting the £30bn funding gap. NHS England says that fundamental change is required to meet the rising demand and that reform will require political courage to tackle the thorny issue of service reconfiguration, including hospital closures.

So how do these stark messages translate to the clinical front line? How best can we engage and support our staff and patients to lead the necessary redesign to achieve quality, reliability and the required efficiencies?

Bringing my own story up to date, I am honoured to be a Health FoundationGenerationQ Fellow and now lead a small team of improvement specialists in my organisation who support teams to achieve measured quality improvement. We encourage them to actively involve patients in their improvement activities and to use patient experience and feedback in redesigning services. Ownership is critical here, not simply asking staff to ‘buy-in’.

Last week on my anniversary of joining the NHS, I was a patient myself for a follow up appointment following a retinal haemorrhage. My vision was blurred due to the dilating drops and I sat for over an hour in a packed corridor waiting to see the doctor. The value to me as a customer was only 10 minutes in total.

It was a vivid reminder of how vulnerable patients can feel in our care and the importance of seeing the whole patient experience to explore ideas for change. I had a great consultation with the ophthalmology senior trainee who explained everything thoroughly. Furthermore, his curiosity about my role as Service Improvement Director allowed me to use my ‘elevator speech’ to introduce him to continuous quality improvement and the concept of staff having two jobs: ‘doing your job’ and ‘improving your job’. 

A close colleague recently said to me, ‘we may not be the best but we are going to be the best at getting better’. A simple message. There is so much to improve every day.

So after 21 years, I guess this is my coming of age.

Suzie Bailey is Service Improvement Director at Sheffield Teaching Hospitals NHS Foundation Trust, www.twitter.com/bailey_suzie