TALKING POINT
John Launer: Rehumanising the NHS a day at a time
John Launer
GP educator and writer
I recently did some freelance teaching in a part of the NHS away from my usual workplace. When I sent my
invoice, I accidentally wrote my bank details incorrectly. Afterwards I got an email to say that the Supplier
Maintenance Team had noticed the error and had asked the Business Accounts Team to deal with it. I replied
with the correct details and conveyed my thanks to the Business Accounts Team, the Supplier Maintenance
Team, and any other teams involved. When life starts to imitate satire, responding in kind is sometimes best.
As well as having a funny side, there are some serious issues with this use of language in the NHS and the
bureaucracy that comes with it. When did doctors and other health professionals become “suppliers” (or,
as other organisations have designated me, vendors, providers, or contractors)? I don’t enjoy having my
identity distorted with the jargon of marketisation. I don’t know any educators or clinicians who do, or who
like being lumped together with suppliers of goods such as computers or printer paper.
One irony of this exchange is that most of the teaching I do is essentially about rehumanising healthcare:
being more responsive to patients and building professional morale, in a world where targets, budgets, and
transactions now drive our actions more often than relationships. I typically arrive at a teaching session to
find the group of doctors and other team members engaged in an introductory hour led by a senior manager,
with slides showing pathways and pie charts. Many of those present look anxious or bored. Anyone wandering
in from outside might think that this was an investment bank or a hedge fund.
The rest of the session is then usually mine. My aim is help people remember why their work is worth doing.
In time honoured educational style, I ask for the tables to be moved and for everyone to sit in a circle. I do
an icebreaker exercise to ensure that everyone knows each other’s name and role (often they don’t). I then
use other exercises in pairs or small groups, often based on people telling stories of work encounters that
have distressed them and considering what would empower them to deal with such events.
A colleague of mine used to call this kind of work “remedial therapy for selective brain damage,” although
the damage being repaired is probably to the heart and soul rather than the brain. There’s nearly always a
release of anger and sadness. People confess that they were sceptical about the session beforehand, but their
feedback is now positive. They use lots of “r” words: relief, recovery, and restoration, as well as relationships.
They seem to have acquired a sense of reconnection with the values inspiring their work—and the human
values that underpinned the NHS when it was founded 75 years ago.
Competing interests: None declared.
Provenance and peer review: Commissioned; not externally peer reviewed.
1the bmj | BMJ 2023;381:p1447 | doi: 10.1136/bmj.p1447
OPINION
London
Twitter @johnlauner
Cite this as:
BMJ
2023;381:p1447
http://dx.doi.org/10.1136/bmj.p1447
Published: 28 June 2023
on 27 August 2024 by guest. Protected by copyright.http://www.bmj.com/BMJ: first published as 10.1136/bmj.p1447 on 28 June 2023. Downloaded from
