This morning I was up early (for a Saturday), scrolling through twitter, wondering how to kick start my weekend. Last weekend wasn’t my best one and I was hopeful for something to set a different path. Jodi Brown and friends didn’t disappoint:
Genuinely killer question. I don’t know Jodi at all well, we’ve exchanged tweets occasionally but no more than that, Annie C had shared this and so I thought about replying and decided to jump in. The first point of reflection is that I did think about whether to join in, a couple of years ago I’d not have engaged in any thought, I’d have just jumped into the mix and saw what came from it, but these days I tend to be a bit more cautious about engaging in #NHS chat online.
A truly fantastic conversation followed, Jodi, Annie and I were joined by about ten others, including @ @ @ @ @ @ @ @gleefulkaz @carollread @NHS_rants. Not surprisingly we didn’t agree with each other on everything, in fact there were some of us who probably didn’t agree with much that others were saying, but it was respectful, challenging and for me personally a reassurance that it was still possible to have a non-scheduled, chat on twitter and have your mind stretched with multiple perspectives. Here’s an excerpt from this discussion where Jodi and I were disagreeing over what/who counts as ‘radical’:
Our chat continued, others joined in, think we were at it for about an hour in total. Really made me think and question, what I consider radical and what it must be like to work in a system (the NHS) that was repeatedly described as, without putting too fine a point on it, toxic. Lots of talk about cultures of repression, fear and hierarchy. We all went about our ways, Jodi had to take her kids swimming, Richard was off to a food festival and I hit the gym.
I left the gym an hour or so later, grabbed my phone and was bouncing home to the weekend and was hit with this tweet:
Booooooooom, smack, bang. Sorry, what just happened? I looked around for further discussion, NHS_Rants had questioned this but there had been no response. I checked the sender’s stream, they hadn’t joined in on any of the rest of our hour of conversation, just singled in on my one comment about NHS Change Day and decided that I was wrong. Not just wrong, but obviously wrong *and* stupid or deaf – I need to be told that BOTH of the previous change days had been groundbreaking.
I lost my cool, didn’t ignore this (which I probably should have) and questioned how they could be so rude. Thing is I think social media is a conversation, and when there are ten people talking, I imagine in my head it’s a bit like we’re all sat around in a room trying to understand each other, the reality could be far from that, some were travelling, others juggling family commitments, no doubt there were PJs and gym gear worn alike – so, unconventional, but still we’d had a great conversation. How I experienced this tweet was that the sender listened into our conversation, picked one bit that they had an issue (or pride about), walked into our room, shouted their opinion (literally in those capitals), in no uncertain terms and then walked out again.
This was the exact sort of conversation I’d been nervous about getting involved with first thing. You see there are loads more NHS people on social media these days, and that’s a great thing. It also means it’s much harder to hear balance, and to truly discuss things without being shouted down by the party line. In the context of our conversation about cultures of control and challenge this was a perfect example. The sender’s biog is clearly claiming expertise in this area, they’re a ‘Social Media Innovator – NHS Change Day 2014 Social Media Lead. NHS Leadership Academy SoMe tutor. Passionate SoMe practitioner’. Their response perfectly embodied what I’d been querying in the first place. Whether all of these NHS initiatives are now seeking to use #socmed and indeed the initiatives themselves to control and centralise the messages. Ironic that the very strength of social media could be lost in so many ways. As ever I wasn’t claiming this to be an absolute truth, or even a truth at all, hence my delight at the genuinely open conversation earlier in the morning.
When I got this tweet though, it’s safe to say I didn’t feel I’d been listened to. The sender hadn’t engaged in our conversation and didn’t seek to understand where I was coming from. They just let me know that I was wrong. I don’t want to make this about the tweet though, and the lovely Anne Marie pulled me up on ‘public shaming’, which wasn’t my intention at all, hence no identifying features on this blog post. I could have exercised more tact, but I also (strongly) feel that the tweeter was incredibly selective in what they picked on, and incredibly blinkered in their engagement. This was exactly the type of conversation that is all too familiar on social media these days, and precisely what I wanted to avoid.
The NHS seems obsessed with Cs at the moment, but rather than the #6Cs that are admirable yet seemingly a distant ambition in these cultures of ‘repression, fear and hierarchy’, I’d like to reflect on a few Cs of my own – I’m not offering an opinion, just a few (deliberately loaded) questions. I’d love to hear your thoughts:
Control: Are leadership programmes/away days/initiatives provided to help sustain and support weary folk in (toxic) cultures to really bring about change, or are they used to control and pacify?
Construction: Social movements are by their nature fluid, open and dynamic, has the new obsession with initiatives killed the very essence of these strengths through overly constructing them with approved hashtags, conversation times, and self-appointed experts?
Centralisation: Is it possible to develop and improve practice in one area, then try to roll it out centrally, without losing why it worked in the first place?
Challenge: When was the last time someone challenged you? Outwardly, openly and in public? Are the social media conversations of today vanilla in colour, weak in strength and just affirming our own biases?
Conformity: How many dissenting voices feed back into your viewpoint each day? How many patients or citizens are involved and attending the many leadership courses, initiatives and awards ceremonies that you frequent?
Candour: I’ve been elbow deep in redacted documents of late through JusticeforLB, I’ve seen the inner workings of the NHS Spin Machine at its worst, I honestly think there is a long way to go before candour becomes meaningful within the NHS; that said I’ll be eternally grateful to those medical professionals (especially our GP) who showed an extraordinary level of candour (and compassion) when Dad was ill. I’ve spent years praising the NHS and all it stands for, but if we can’t criticise openly we’re never going to improve anything.
Courage: It’s hard to be a lone voice, it’s even harder to be a lone voice when your voice can be taken out of context or one thing you say can be pounced on for someone else’s agenda. I’ve learnt so much in the last 9 months about courage from Sara Ryan. I’ve also experienced first hand how utterly exhausting (and pointless) it is to be a lone voice in the face of the NHS spin machine.
I understand why people are proud of the NHS, it’s care and it’s staff. I am too. That said, if people like me need to psych themselves up to engage in conversations, something is very, very wrong. I think it’s time we had some courageous challenge, I think it’s the only way the NHS will survive and people will retain their confidence in it. I remain grateful for the chat first thing this morning, and would love people’s views on my deliberately loaded questions, because I’m genuinely open to challenge and want to learn. Thank you.
PS Thought it was worth adding a note on here that I should have included when it was first published. I know it may take courage to disagree with me (not sure why but guess we’re programmed to avoid conflict or challenge), and I know sometimes adding a blog comment feels more finite than a tweet or an email or a DM, but I really *really* would like to develop this conversation further. Since I’ve been involved with JusticeforLB I’ve had more DM/email traffic of support, and less public agreement although not necessarily less challenge. Given the actions of the Trust where Connor was ‘cared for’ before his preventable death, I feel I have had to criticise the NHS, and I’ve been exposed to the worst of spin and poor manipulative communications; but I am not for a minute ‘tarring everyone with the same brush’, nor do I doubt the good intentions of most people (even some of those who seemingly lack competence or skill or support), so please, please do disagree or agree or comment or whatever, or don’t if you’d rather not, but please don’t feel afraid to do what’s right for you.