I’m not certain what a blog is. At 500 words it’s too short to be an essay, offering a well reasoned argument, aimed at persuading the reader to adopt a new course or prescription. It’s certainly too short to warrant attention for any serious peer review. Likewise it’s too long to smack you in the face like a twitter or sound bite. So what is its purpose; an advert, a critique, a rant? My observation is it is too often the latter. So how about having a blog that is a compliment instead?
As we reflect on the success for the country of the recent Olympics, I’d like you first to reflect on another ancient Greek concept we seem to have perfected in the UK better than them, “Governance”. The historical route of ‘governance is indeed Greek, coming from the word used for the “steers man” Kubernan (or gobernante as the Romans translated it and hence governance). To steer, drive and pilot a vessel on the open seas, following a safe course is a great skill and one our top Olympians of today have taught us deserve acclaim, indeed a Gold medal. Awards in this craft have come to Team GB not due to any God given right, but due to the considerable hard work, commitment and capability of those athletes who have managed to get to the top of their competition. My compliments go out them all.
Getting to the top spot however is not always down to these key attributes. Some times, to corrupt Shakespeare, ‘greatness is thrust upon’ some people. This happened in 2002 when the then Health Authorities handed over reign to the new kids on the block, the PCGs. The result was four years of painful learning and the realisation that some of the new governors were not fit for purpose. History often repeats itself and there is considerable concern amongst many that 2002 is about to repeat itself in 2012 with GP Commissioning. In my belief however the NHS is, in good part, a learning organisation. The paradox of the NHS is, despite what many might believe to the contrary, both inside the NHS and out, that in many of its organisations, the NHS is well governed when compared to other similar sized organisations.
The Francis recommendations are about to teach us important lessons, on safeguarding, patient focus and good governance. We can learn as much however, from catching organisations in the act of doing ‘good’, as we can from catching them doing ‘wrong’. The challenge is, can the NHS evidence where it is well governed and do it quickly enough, spreading this recognition as best practice and ensuring the learning is totally, not partially, deployed. Much evidence suggests the NHS currently takes around 15 years to make best practice, common practice. This clearly isn’t good enough. We need a ‘Gold Medal’ governance Olympian. The NHS Confederation has recently signed up as Founding Patron of a new European wide initiative, EIGA (the European Institute of Governance Awards). Maybe our Olympians are about to emerge.