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The Gary Test


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Friday, 6 September 2013

The Gary Test

It was all going very well. Giles Wilmore from NHS England acknowledged that the NHS often failed to take people with it, tended to “do” engagement when it should be talking to people, didn’t involve them properly in decisions, got the language wrong.

“This should be about participation rather than engagement. The latter can sometimes feel quite passive rather than a conversation,” he said.

Giles is a former history teacher, he is also very tall - both potential qualifications for talking down to people.

But he wasn’t going to do that. Instead he showed some slides of NHS England’s new guidance. It doesn’t look much like the usual guidance; it contains useful stuff, short case studies, easy to follow advice.

David Colin-Thomé, the event’s chair, liked the new guidance. “I think it’s actually rather good, which is not something you’ll hear me say very often,” he admitted.

Don Redding from National Voices got to his feet to explain how his organisation had developed a new narrative to get away from the meaningless idea of “integration”. “Person-centred care” was something we could all sign up to, a way to agree what was really important to people, stick to the same story and check that we were doing the right things.

Robert Varnam from NHS Improving Quality talked about the commissioning cycle. Engagement should be part of everything we do, he said. Dr Varnam is a GP. He knows a thing or two about people. Not only that, he knows a thing or two about slides. No Powerpoint here. He was using Prezi. Powerpoint is the old world. Prezi is the smart presenter’s tool of choice, a helicopter for traversing a landscape we used to cross by bicycle.

It was all going very well indeed.

The venue was The King’s Fund in London and the event hosted by Primary Care Commissioning and NHS IQ was on the theme of “building public support for change”.

Time for some questions.

“My name’s Gary and I used to work in the construction industry…” began one of the delegates.

There was a moment of anxiety:  had he wandered in by accident, perhaps taken the “building” of the title literally?

No, Gary is a CCG lay member. “I genuinely do not understand what you are talking about – you are using words and phrases that seemingly go together but that mean nothing to me. Think about the language,” he said.

It was a bitter blow to those who had already thought about the language and thought they were speaking plainly.  The organisers had stripped all the usual ugly clutter from the agenda, banishing “engagement”, “collaboration”, “coproduction” and other disengaging claptrap.

The speakers were just as careful, stepping gingerly over NHS jargon, brushing aside acronyms and swatting buzzwords.

But Gary wasn’t happy. Later, some wag asked him how he felt after a presentation about Patient-reported Outcome Measures  and commissioning dashboards. Gary shook his head sadly without bothering to look up from his iPhone. Googling PROMs? Playing Angry Birds? Booking an early train home? We shall never know.

Despite losing Gary, it was an excellent event. Delegates used to stodgy, traditional NHS fare got plenty of mental protein without all the usual carbs and trans fats. Presentations were short. The speakers were good.

Brian Fisher of the NHS Alliance argued for investing in the social networks that have the best chance of changing the behaviours that lead to ill health, making his case with logic and evidence but without resorting to tiresome appeals for people to be more “caring”.

Marc Bush of Healthwatch warned about a partially engaged public, which is as dangerous as a partially exploded bomb. We are creating more opportunities for activism, he said, but if we’re not careful this will be manifest only as the power to complain, criticise and object, the kind of activism that stops things happening, not the kind that makes good things happen.

The conversation has started. The question is whether we can make ourselves understood, make it relevant, keep it interesting.

Never mind the Friends and Family Test. We need to pass the Gary Test.

Events editor: Julian Patterson

barry fitzgerald
barry fitzgerald says:
Sep 06, 2013 05:40 AM
Referring to the script for Star Wars, Harrison Ford said to George Lucas "George, you can type this s**t, but you sure as hell can't say it." That's nearly how I feel about NHS jargon. They can write this s**t but I sure as hell can't understand it.
Anonymous says:
Sep 06, 2013 07:11 AM
Every system needs a language. The NHS is complex, its delivery systems more so and sometimes complexity is necessary. Business intelligence measures are syntax for large data. The NHS fits the big data bill,let's not dumb down our need to be accounatble to the public by making out it's easy.
barry fitzgerald
barry fitzgerald says:
Sep 06, 2013 08:15 AM
Using language that's understandable is not dumbing down our need to be accountable to the public.
Garrett Turbett
Garrett Turbett says:
Sep 06, 2013 09:36 AM
While renovating (ok, overseeing the renovation!) of my house I often had to go to Builders Depot and other such stores. Unlike Homebase where things are advertised in layman's terms, these builder's stores are filled with isles of goods that perform God knows whaty task, and descriptions of items that are fairly meaningless to those outside the construction industry.

Should every industry be so simplified as to be understood by the average person on the street?
Laura Blott
Laura Blott says:
Sep 06, 2013 10:01 AM
Delegates used to stodgy, traditional NHS fare got plenty of mental protein without all the usual carbs and trans fats.
Laura Blott
Laura Blott says:
Sep 06, 2013 10:02 AM
These blogs raise a smile from me every week!
Anonymous says:
Sep 06, 2013 10:08 AM
After 7 years working in the NHS, I would quite like a language to be developed where I actually understand whats being said!
Anonymous says:
Sep 06, 2013 10:09 AM
Dont even get me started on Prezzi presentations.
Clive Spindley
Clive Spindley says:
Sep 06, 2013 11:16 AM
It's fair enough, there's just far far too much of it within the NHS (or maybe not enough of IT) ...
Richard Bramwell
Richard Bramwell says:
Sep 11, 2013 09:13 AM
By engaging the right people in the right way in your project, you can make a big difference to its success - See more at: http://www.mindtools.com/[…]/newPPM_07.htm#sthash.dvPeM6Ks.dpuf
Maggie Whitlock
Maggie Whitlock says:
Sep 11, 2013 08:10 PM
Can someone tell me how 7 million pounds for A/E's will rescue them collapse due to this winter pressures on their service this winter?? (sorry about the post on here but can't find the way in to the soapbox)