Today the Health Secretary Jeremy Hunt speaks at a health
conference in Surrey on standards in the NHS, the dangers highlighted by the
Francis report and of the risks of mediocrity or aiming simply not to “come
last”.
In his speech he uses one phrase (originally coined by NHS
Chief Executive David Nicholson) which particularly resonates with me, and
regardless of political persuasion, I think is a pretty good sound bite. He suggests “Hospitals are hitting targets
but missing the point”.
Clinical performance and safety are naturally amongst the
highest priorities within the NHS, and I think that is where the Minister’s
sentiment may be directed. However it
can also be applied as a warning to the world of membership and engagement in
the NHS. MES was set up to help
organisations develop and deliver meaningful engagement and that is a core part
of our day-to-day ethos. But does it
feed through into the increasingly busy and stretched membership offices of NHS
Foundation Trusts? Is the focus on
hitting targets and as such misses the point?
And what will new CCGs focus on given they too have a clear remit to
engage with local health communities and the public.
Last year I wrote a paper exploring the Foundation Trust
sector’s impact on engagement and the two forces – external regulation
and self-governance – that have made, in my view, the sector potent and
innovative when it comes to membership engagement. I suggested that whilst light-touch
regulation has in fact provided the right climate for such innovation, the risk
is that “trusts will approach engagement as a ‘tick-box’ exercise, lose sight
of the aim, and instead focus on the process, the bureaucracy and the fear of
the regulator”.
So does the Health Secretary’s warning apply to membership and
governance departments of NHS Trusts? We
work with many Trusts and see a lot of different approaches, priorities and
angles when it comes to membership engagement. Aspirant FTs in particular are
under huge pressures to get through their application, and attention in newly
formed membership offices can undoubtedly be skewed towards membership size and
working towards a target figure. What we
generally see is that once an FT is authorised and starts to mature into a
membership organisation, it starts to relax a little about the numbers, and
looks more at the “point” of what it is trying to do with members and
Governors. The focus moves from how many
people are engaged to the quality of the engagement that takes place.
But the risk is undoubtedly there – sometimes it is too easy
to just do the basics and think that is good engagement. Send a newsletter out, have some members,
send the odd invite out – it’s not really enough. Jeremy Hunt’s warning is probably worthy of
note in our arena too then – not just for the clinicians but for the membership
managers and trust secretaries when it comes to their membership, public and
patient engagement.
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