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Challenge top down change: what readers have said

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So far 1,455 people have gotten involved in the Nursing Times, HSJ and NHS Improving Quality campaign on enabling bottom-up change.

The anonymous online format has meant we’ve received suggestions both from within the NHS and outside of it – with contributions coming from across Europe, the US, and the Middle East.

The most popular idea was that the NHS should borrow more from the knowledge and expertise of front-line staff, and empower them to make changes rather than relying on the ‘management speak’ of external management consultants.

Those who agreed and commented felt the problem was about skills and fostering talent in the NHS.

“In some NHS organisations we have people who are great at managing projects, auditing practices, managing change and supporting redesign…in some NHS organisations we don’t,” said a contributor.

“It is interesting that people doing some jobs are de-humanised by lumping them into the category ‘management’ and then vilifying them as one”

Change Challenge contributor

Leadership and management were recurrent themes within the ideas shared and it divided those who took part. A popular suggestion was that the word “management” should be banned as it was “alienating” with “tainted” connotations. Instead managers could be replaced with “team leaders”.

But others felt managers and leaders were equally needed.

One contributor said: “It is interesting that people doing some jobs are de-humanised by lumping them into the category ‘management’ and then vilifying them as one. We would not tolerate this for the people we care for, so why is it considered acceptable in this context?”

Other popular ideas related to time constraints – providing clinicians with the proper support to do their work and to take up innovative ideas and implement them.

 “I can’t tell you how many good ideas I’ve seen fall by the wayside due to ‘lack of time’ or because there is no platform or commitment to take them forward” said a contributor.

Another suggested: “there needs to be a change in working patterns to allow for staff to see each other as part of their working day rather than having to come in on a day off to attend a meeting”.

Collaboration was also important to contributors, people and departments needed to work together with a duty for NHS organisations to work as one team and not “a collection of silos”.

“The cutting of admin and secretary roles across the NHS is a false economy”

Change Challenge contributor

The NHS also needed to give greater support to its administrative and IT staff. They needed to be as valued as clinicians. “The cutting of admin and secretary roles across the NHS is a false economy. There is more and more admin that removes clinicians from doing the job they are trained for”, said a contributor.

Another added: “Every day I have colleagues asking me how to do IT tasks that they don’t understand, that intimidate them, and which they waste hours trying when I can do it in minutes”.

The second phase of our campaign launches today and readers will receive an email inviting them to share their ideas on solutions to the most popular barriers discussed via the Clever Together website. The site can be accessed from any computer or mobile device at any time and all comments and ideas shared are anonymous and so treated equally.


Take part in offering your solutions to the problems discussed go

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