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Time to dump the e-word


Blog headlines

  • Structuring a PCN Social Prescribing Service for the post COVID world
    25 February 2021

    This week we have a blog by Nick Sharples.

  • Community-Oriented Integrated Care
    18 February 2021

    The blog this week is a short extract from a paper considering an approach primary care networks could use to move towards community-oriented integrated care.

  • Strategy Unit releases opensource model for planning vaccine centre capacity
    11 February 2021

    This week's blog is from The Strategy Unit who are sharing an opensource model to help with vaccine centre capacity planning.

  • Time to talk day
    4 February 2021

    A small conversation about mental health has the power to make a big difference.

  • Supporting Staff: the emergence of ‘long-covid’
    28 January 2021

    As we are now well into a second, or is it now the third, wave of Covid-19 it is becoming apparent that Covid is something we have not experienced before and it has unique implications for staff management. It is not just the possibility that staff may become acutely ill with the virus, but that for some they may go on to develop persistent debilitating symptoms that will affect their ability to go back to work. This article looks at the implications of long-covid for HR and service managers when looking to support health care professionals (HCPs) return to work.

  • Link of the week: Clinically-Led workforce and Activity Redesign (CLEAR)
    21 January 2021

    This week we are sharing a link to the Clinically-Led workforce and Activity Redesign (CLEAR) site that is funded by Health Education England.

  • So much more than an extra pair of hands
    14 January 2021

    The introduction of the additional roles reimbursement scheme for primary care networks has started to grow capacity in general practice to address the unsustainably high workload that has put so much pressure on GPs.

  • Primary Care Networks – how did we get here?
    7 January 2021

    This week we are sharing a blog by PCC’s chairman David Colin-Thomé.

  • A year like no other
    17 December 2020

    On 5 July 1948 the NHS was born, over the last 72 years challenges and changes have been remarkable but the service has probably never been tested as much as in the last nine months. There have previously been numerous re-organisations, multiple changes to hospitals, mental health services and a shift from the family doctor towards more integrated primary care services delivered by a range of professionals. However, rapid transformation of services to embrace digital technologies, and a shift change to work differently has been forced upon all areas of the health service this year.

  • Guest blog: David Hotchin
    11 December 2020

    This week we have a guest blog that was submitted to us by David Hotchin, written by a retired friend....obviously, he's used a little poetic licence.

  • What now for commissioning?
    3 December 2020

    By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

  • What White people don’t see
    26 November 2020

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  • Primary Care: Why don’t we talk about Racism?
    20 November 2020

    Rita Symons is an ex NHS leader who is now a leadership consultant, coach and facilitator. Her work is mainly in the NHS and she is an associate for PCC offering facilitation, coaching, strategy development and team development activities. She is a concerned but hopeful world citizen and combines work in the NHS with a board role in a non for profit organisation and an interest in writing.

  • Primary Care and the Health of the Public
    12 November 2020

    By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

  • What now for primary care
    4 November 2020

    By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

  • Boosting your resilience
    30 October 2020

    The last year has been a difficult one, who would have imagined last Christmas that we would have been in lockdown, with the NHS seriously tested by a global pandemic. So much change has happened and the resilience of people working in and with health and care services has been seriously tested. Resilience is our ability to deal with, find strengths in and/or recover from difficult situations. Its sometimes referred to as “bounceabiliy” – but bouncing in what way?

  • Link of the week: National Cholesterol Month
    23 October 2020

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  • New redeployment service offers talent pool of motivated, work-ready individuals
    15 October 2020

    People 1st International have shared some of the work they are doing to support people displaced from industries due to the Covid-19 pandemic. There is an opportunity for health and care services to benefit from this workforce.

  • Link of the week
    9 October 2020

    Article published in the BMJ looking at the ability of the health service to quickly bounce back to pre-Covid levels of activity and considers if it is desirable.

  • Virtual Consultations– the patient perspective
    2 October 2020

    This week Jessie Cunnett, director of health and social care at Transverse has shared this article.

Friday, 28 June 2013

Time to dump the e-word

All over the NHS earnest, well-meaning people are busy engaging. Engagement is often “strategic”, always “meaningful” and mostly useless. Everywhere you look there are models, methodologies, frameworks and systems for something few people understand and even fewer want.

You can buy books about it, go on a course to learn it and make a living peddling it – not a bad living either, because there’s no danger that success will undermine demand.

As long as people are disinterested, preoccupied with their own lives and suspicious of solicitous strangers with clipboards and brown shoes they will remain disengaged. As long as there are Facebook, Eastenders and MacDonalds they will be hard to reach.

Try engaging with people in the street or the pub and at best you’ll get funny looks. Try too hard and you’ll end up with a thick lip or a caution for harassment.  It is no coincidence that engagement works best with the sick, the bedridden and the desperate – those who lack the capacity to get away.

Engagement is an industry with no products, a community where no one wants to live. So why do we persist in the belief that the NHS will fail without it?

It is a symptom of our inability to see the world from the world’s point of view. Like Victorian missionaries we need to save the savages from their ignorance. They had Christianity; we offer salvation through engagement. They will thank us for it later.

Engagement and its weasily little sidekick “patient-centred care” are admissions of failure. What does it say about a 65 year-old organisation that it has only just discovered who its customers are and is still struggling to talk to them?

Imagine Ford introducing a “driver-centred” car or Asda opening a “customer-centred” store. Would you fly with an airline for which being “passenger-centred” was still something of an aspiration?

In every other field, engagement is not a process or a tool but a product of good customer service, a station you pass through without noticing en route to satisfaction; it’s what you get when you give people what they want.

We even have a four-letter word for it: care.


Caroline Morris
Caroline Morris says:
Jun 28, 2013 11:45 AM
Refreshing to hear you spell it out so articulately ..
Dr. Chris Gillespie
Dr. Chris Gillespie says:
Jun 28, 2013 11:49 AM
As NHS psychologists we are very familiar with this phenomenon. We call it semantic satiation.
Garrett Turbett
Garrett Turbett says:
Jun 28, 2013 12:08 PM

Smart Guides to Engagement: http://www.networks.nhs.uk/network-resources

That's me confused!

Julian Patterson
Julian Patterson says:
Jun 28, 2013 04:41 PM
Garrett, well yes. That was then... :-)
Philip Coulthard
Philip Coulthard says:
Jun 28, 2013 12:20 PM
There was a banker called Dee Hock. He set up a little known organisation called VISA. His book on Chaordic organizations is available on line. Unless you are part of the community you are unlikely to engage with it. It seems the case that most large organizations sadly loose a sense of community. Chaordic structures are based on small self organising groups. Has anyone in your organization investigated such possibilities for change?


Paul Buchanan
Paul Buchanan says:
Jun 28, 2013 12:34 PM
Beautifully said - very few have the audacity to challenge the plethora of 'new-age' NHS Managers/CEO's/Engagement Specialists about spending such ridiculous amounts of time/energy/money on 'social media engagement' I was branded a pariah!

SociaMedia as a magic wand for 'engagement' - the Emperors New Clothes, how nakedly ridiculous!
Kate Thomson
Kate Thomson says:
Oct 21, 2013 08:31 PM
It is ridiculous if it is done badly and should be challenged. But if there are groups of people who only use their mobiles for communication then you need to communicate with them using mobiles.
Tony Lloyd
Tony Lloyd says:
Jun 28, 2013 01:43 PM
Engagement is more about giving patients and patient groups the power to refocus healthcare professionals away from targets and back to decent standards of care. If it's an industry then I've never been paid a wage. If people are disinterested it's because patient groups are patronised by healthcare administrators and their views and recommendations are routinely ignored if they are in conflict with what has already been decided behind closed doors. Good transparent engagement prevents abuse. Much of what now passes for NHS engagement is meaningless window dressing. Very few people have the faintest idea of how to go about engagement and the bulk of the funds spent on engagement are wasted. Unfortunately too many people have a vested interest in perpetuating this mediocrity.
Julian Simcox
Julian Simcox says:
Jun 28, 2013 03:50 PM
Engagement as a concept is fundamentally flawed. The only kind of engagement that makes any real sense is “self-engagement” for, to paraphrase the late great management consultant Peter Scholtes, it may be the very height of arrogance for any one human being to assume that they can engage another – in practice all they can do is disengage them!

For me, the only way forwards is for patients to self-engage, and put themselves forward for discovering: FIRST about how to take charge of their own care, and SECOND about how to take charge of their community’s care. In recent years much has been said about the conflict between clinical leaders and managerial leaders, but to my mind the time is ripe for the Patient Leader : Local Champions who know how to monitor local services and who with a little training can elicit improvement simply by ensuring that managers and clinicians have some real data – collected over time – to reference.
The new Friends & Family Test for example could help if the data is used on the frontline to identify daily variation in outcomes. Sadly the data is likely to be used largely as just one more quarterly target with which to beat-up middle managers, but even a lightly trained Patient Leader should be able to make it the basis for local improvement by those who actually work IN the system.. people who might with hindsight subsequently be described as “engaged” but who will actually merely have been infected with self-engagement by the self-engaged Patient Leader.

Anonymous says:
Jun 28, 2013 10:44 PM
let's bring in the f-word
the NHS was created to enable people to give a helping hand to other people, not to provide employment to talkers and academics - non doers belong in the word of politics and education.
Tom Bell
Tom Bell says:
Jul 04, 2013 09:26 AM
Let's put this conversation on the right foundation and acknowledge that the customer has been the funder and not the patient. The arrival of competition may start to change that; we can hope.

Then, let's get comfortable with the word "Marketing" and start to do it well.
Kate Thomson
Kate Thomson says:
Oct 21, 2013 08:27 PM
Engagement is a product of good customer service but I don’t think we are giving all the people what they want. The student wants reliable medical information, the housebound carer longs for interaction and advice, the businessman wants an email consultation. With Facebook etc. we have the ability to improve our engagement with patients. GPs need to stop thinking fax machines are the only technology they need to interact with the outside world.