4 more Cs: callous, cruel, calculating and cowardly #6Cs #JusticeforLB

I’m on holiday at the moment, enjoying being sporadically connected, but today I found myself lost for words again. A couple of weeks ago I blogged a post about challenging anything NHS and the difficulties of doing so. In it I suggested 7Cs that I think I observe in communications around the NHS: control, construction, centralisation, challenge, conformity, candour (lack of) and courage (in daring to question and challenge the NHS) – an intentional play on the #6Cs currently doing the NHS rounds. Today I’m adding four more: callous, cruel, calculating and cowardly.

Last week Sara Ryan had a phonecall with the Chair of Southern Health NHS Foundation Trust Board, to discuss the awful missive sent by the CEO of the trust, to her, a grieving mother. It took me four blogs posts to deconstruct that letter, they’re all available here, here, here and here. In the call the Chair, Simon Waugh, categorically reassured Sara that there had been no surveillance of her blog – this was offered in response to Sara questioning the bizarre communications around social media.

Today Sara received an FOI/personal records request response that categorically showed this to be a lie. Either Simon Waugh is woefully incompetent or intentionally misleading. I have no idea which, but it is hard to see any other interpretation. The most agonising thing of this interaction is that if the Trust had acted on what they surveilled Connor may not have died, instead they produced a dossier/briefing about Sara’s blog, and shared it amongst staff the day after LB died a preventable death to help shape ‘a tailored media response’.

If I retain some semblance of rational thinking about LB’s death I can see that Sloven’s communication professionals were doing their job. I can’t quite yet comprehend how so much focus and attention to detail can be shown after LB’s death, when so little was shown before. I also can’t quite comprehend why such a response should kick in to manage the ‘media response’ when so little attention was given to engaging with family members or those that knew LB in the run up to his death. How can it be that reputation management gets more attention than epilepsy assessment for example?

Of course cynical me would suggest that Sloven are solely interested in their reputation, that they are experts at covering up bad news and spinning a new line. Last week they ‘launched’ yet more nonsense about staff engagement, I can’t bring myself to link to it here suffice to say the video quality is dire, the messaging sloppy, the staff unconvinced and the Chair claiming it’s ‘going viral’ with less than 40 views (most of them from JusticeforLB supporters who needed a good laugh and loved the video bomber). This week we hear that there’s a new app to help them listen:

Screenshot 2014-10-08 20.08.53

All of this appears to miss the point that you need a humility and openness and culture of transparency to learn and respond to feedback. Southern Health also use Patient Opinion to ‘listen’ to feedback. Their listening appears to amount to a Complaints and PALS Officer thanking people for their feedback and promising learning. In over 3 years, there have been 146 stories shared by people using their services, 2 people have listened and 1 change has been made:

Screenshot 2014-10-08 20.34.17

This doesn’t fill me with confidence. At all. Rather than spinning more process, more procedure, more ‘ways of listening’, why not focus on actually improving things.

I’m reading a great book at the moment, really quite thought provoking, not exactly trashy holiday reading but feels a bit relevant ‘What about me? The struggle for identity in a market-based society‘. Verhaeghe discusses neoliberalism, market economies and uses the example of healthcare and a focus on procedure and measurability over quality and care:

‘a neo-liberal organisation invariably creates a non-productive top layer whose main task is to maintain its position by monitoring others, resulting in ever-proliferating rules and regulations. Performance measurement is fostered in the name of ‘transparency’, the idea being that the criteria are clear and apply equally to all. However, studies show that they only apply to those who do the actual work, not to those who do the measuring — that’s the difference between the worker ants and the manager queens…In no time, staff at all levels adapt their behaviour, ceasing to do things that ‘don’t count’. Everything is sacrificed to the juggernaut of measurability. Unfortunately, the unquantifiable nature of care can’t be demonstrated through figures, so actual care is fast vanishing.’

I’ve a dirty taste in my mouth this evening, as yet more Sloven callous, cruel, calculating and cowardly communications are unearthed by Sara. 16 months after her son died, and yet another smack in the face and another mountain of bull to climb up. How can this be allowed? At what point will someone step in and stop this? When will someone focus on what actually happened, and not how to manage/spin/claim learning from it? It’s not like Sara hasn’t done more than I’d consider humanly possible to explain her perspective.

Final gem of context, this wasn’t shared via Southern Health themselves, despite them responding to a request from Sara, this came via the same request to the CCG.

How’s that duty of candour shaping up?

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