Thread by @DrWallBolton

1/🧵about #NHS culture and being liberated;many of you know me or follow me for leading the #Bolton #covidvaccine programme. What many don’t know was that on March 23rd 2020 the day we went into first #lockdown I stepped up from deputy To interim clinical director @BoltonCCG

2/working from home armed with a laptop and a mobile like many I began to meet and run meetings with the ‘system’ to respond to the #pandemic. At the start we met daily. All of us apprehensive. First task? Empty the hospital beds. I thought it was all a bit dramatic. At first.

3/battled for #PPE we didn’t have,thought of imaginative ways to pipe more oxygen into wards, we increased homecare beds to get people moving quicker, planned for mortuary space we soon were to need; we were doing #NHS things we’d never imagined at a speed never before possible

4/was it unsettling? Tiring? Unfathomable? surreal? Most certainly but it was also liberating. For the first time in my #NHS forever we weren’t bound by forms, red tape, processes;we were doing quickly what was right for our population, right for patients. As @Nike ‘Just Do It’

5/over time things waxed and waned and in the latter times we promised ourselves and each other we’d learn from this new found speed and momentum didn’t we @Andyennis2 ? Something positive would come out of the ashes. So has it? If not why not? #pandemic

6/yes we built working system relationships in those challenging times that we absolutely won’t lose. This wasn’t just #NHS it was a union of social, health, public health, voluntary, NWAS and council colleagues on a journey we will never forget. Sadly some things have reverted

7/I’ve thought a lot latterly about why we haven’t managed to keep that promise to ourselves to ‘just do it’. Yes we know many organisations are bound in red tape and process not just #NHS but I can’t help wonder if our blame culture society has gotten us in a viscous cycle?

8/it’s not unusual to meet older clinical colleagues who’s clinical notes are half that of mine, mine probably half that of my trainees. Each subsequent decade of clinician understandably taking on that bit more anxiety about being sued, complaints and the what If? Scared of risk

9/these aren’t unfounded concerns either. They are borne out of reality. Increasingly day on day year on year clinicians are hauled over the coals by lawyers, regulatory bodies, patients, no win no fee teams, even coroners at times. Sometimes rightly often perhaps not so.

10/Of course we should hold clinicians and their teams to account. We trust them to look after our nearest and dearest we literally trust them with our lives and we rightly expect them to do that with their entire being, a vocation. Have we as a society gone too far though?

11/do we think we know so much now (thanks Google), expect so much (thanks partypolitics) that we forget these clinicians and their teams are human like you or I? I am one of these clinicians. I’m just doing my best in a challenged system. Like many others. #NHS

12/I spend so much of my clinical day filling in paperwork, proving I’m following process to prove I made an honest mistake even when I don’t. So many clinicians make decisions through a lens of avoiding risk but risk sometimes is needed to get the best out of a situation for all

13/it’s not just clinicians either its whole teams of people changing their ‘just do it’ attitude to fit in with the society we now have of blame and ultimately not be blamed. We removed risk and blame at start #pandemic because the alternative was so much worse-it was do or die.

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