David Griffiths: Amazed and Confused

Amazed at the planning, execution and care across every part of the machinery that goes into keeping a large organisation like Medequip operating efficiently and effectively.

Amazed at the partnership working with voluntary, community, and social enterprise organisations that is improving the rates of recycling and reuse of equipment, and is developing the stronger connections needed to underpin the NHS vision for neighbourhood working.

Amazed at the impact of our Wellbeing Committee, awarded Team of the Year at the recent BHTA Awards for their work in supporting everyone across the organisation,

But mostly just amazed at the resilience of people who keep going. The people who use our services, and the people across all the different organisations who work in the system.

As a part of my job involves planning a future course for the company, I balance my views on where we are now with the future opportunities advertised by the statutory sector. That means keeping up with, and taking part in, the wider debate about what sort of future is envisaged for the NHS and Local Government.

This is where it gets confusing.

At the last conference of this season, arranged by the LGA for Directors and LA councillors in social care, I felt and heard what seemed like opposing views.

There was a consensus that the social care system is in crisis, but a mix of views on how this should be communicated. Social care is still not a political or financial priority for Government or the majority of the population, and as an alternative to the message of crisis and emergency there is an emerging focus on social care as the glue that helps everyone who needs it, and that means most of us at some stage in our lives.

I heard that the current form and function of the NHS will not work in the future, but I also heard a lot of people expressing doubt about the capacity of the NHS to change itself, especially its challenges in working with local government, communities and people……..as individuals, not patients. Neighbourhood Health Centres do not seem to equate to what Stephen Kinnock, Minister of State, Department of Health and Social Care, refers to as a neighbourhood health and wellbeing approach.

Then there’s the role of local government. It’s seen as fundamental to the success of any future model of the NHS. Yet it’s being reorganised, often against local wishes. It’s been progressively underfunded and undervalued.

At the same time a regulator, too stretched to perform its role assuring quality in the provision of health and social care services, has been tasked with assuring those same Local Authorities are making proper arrangements for adult social care.

And don’t get me started on whether commissioning is part of the procurement cycle or procurement is part of the commissioning cycle. I am very interested to see how the public sector responds to the challenge from Julian Blake, co-author of "The art of the possible in public procurement" and others that it has not made use of the flexibilities offered by the previous and current procurement legislation.

A new National Care Service is on the cards but it seems to me simply like a headline for a properly trained and paid workforce without reference to all the reasons we don’t have that already.

And everyone seems to think “Personalisation”, particularly as expressed through the use of Direct Payments in social care and Personal Health Budgets in health care, should be at least equally, if not more available, than traditional models of care. But can’t work out how to safely and supportively get out of the way to make this a serious option for people.

But we haven’t even come to the most amazing and confusing thing of all.

Despite the doom-mongering, nearly everyone I met or heard from during this conference season had something positive and optimistic to say about the future.

• NHS and private provider staff affected by organisational change and redundancy.
• National and local politicians working with a rise in populism and voter apathy.
• VCSE staff being told they and their organisations are key partners, whilst they are not funded enough to pay their front-line staff the Living Wage.
• And people. People who rely on care and support to live their lives and who aren’t getting what they are legally entitled to, are turning up at all manner of meetings, groups and projects to help make things better by sharing their experiences and ideas.

I am not an expert on government reviews of policy, especially when they are framed as independent and cross-party. But I am old enough and cynical enough to be wary of anything that aims to make things better in “the future” in the face of our election cycle and the oppositional model of politics that seems to be getting more divisive with every headline.

So, although I know many people have a high regard for Baroness Casey and high hopes for her review, I found the conference experience of hearing directly from people who use services, together with the messages from Steven Kinnock, Sally Warren, Jess McGregor, and Steven Hubbard more helpful in charting a course.

A course where Medequip continues to work towards excellence, with high social values.

Where our national and regional reputation and capacity is built on local knowledge and connections.

Where our transparent and proactive approach to building partnerships and better use of narrative approaches lead to more focus on people as individuals.

And if I can be so bold, where our attention is always on that extra indefinable something that turns the ordinary into something extraordinary.

Wow. Turns out I was more amazed and less confused than I thought I was.