A lot has changed since I worked as a Patient Care Advisor in 2015: one floor has become two, BICS has become Here, and a set of guiding beliefs and commitments have been articulated around the principle of ‘care unbound’.
Recently I took the opportunity to participate in a ‘purpose immersion session’, during which a group of colleagues both old and new reflected on how “to create more possibilities for care in every moment”. This session got me thinking: how do colleagues across the organisation – Team Assistants, Directors in the Enabling Team, Patient Care Advisors and Wellbeing Administrators, Team and Service Leads, Line Managers – respond to our purpose, beliefs and commitments? Which beliefs and commitments resonate with me the most? Which do I find easiest and more challenging to put into practice in my work as a Wellbeing Administrator?
My academic background in Social Anthropology means I am acutely aware of how everyday life – made up of the ‘ordinary’ practices and moments often taken for granted as simply part and parcel of living – is saturated with meaning. This insight significantly informs my understanding of our beliefs and commitments and, I think, is central to the translation of ‘care unbound’ into our day-to-day roles.
Our purpose of creating more possibilities for care in every moment suggests that ‘care’ can be generated in all kinds of interaction rather than simply in appointments or through ‘medical’ interventions. Care is not a concept exclusive to clinical expertise but can apply to all situations, even if they seem insignificant.
Practising care unbound requires what I like to call ‘ordinary leadership’, an everyday form of leadership that we can all demonstrate: it is about giving one’s full attention to the moment, taking responsibility, being proactive, and seeking solutions that generate care within the ordinary circumstances in which we work.
Administrators working at Here exhibit ordinary leadership all the time: it is a necessary aspect of effectively and empathetically responding to the needs and situations of our service users as they attempt to navigate the health system.
One of the most important aspects of the services delivered at Here is that patients are given a number to call so they can speak to someone who’s prepared to take the time to listen and help. Ordinary leadership, which is manifested through the act of listening, is central to our conversations with service users over the telephone.
As I have discovered during my work in the MSK and Wellbeing services, the act of listening manifests itself in various ways. Often it is as simple as giving reassurance and employing a sympathetic tone of voice when patients cancel an appointment due to illness or being a supportive sounding board while patients deliberate about which appointment to accept.
At other times, listening can lead to situations that require a high degree of creativity and collaboration with one’s colleagues. In MSK, responding to patients’ needs can lead one to liaising with providers across the country – I once booked an appointment at a hospital in Cornwall – and researching whether specific hospitals offer particular services. The most complicated telephone calls in Wellbeing are usually with patients who are distressed or anxious, requiring us to make immediate evaluations of risk while maintaining a calming influence. These situations can necessitate explicitly ‘medical’ interventions, but sometimes they ask us to think of solutions outside the official parameters of the service, such as when a patient, anxious about moving house, requested that a colleague provide a number for a local removal company. While simply a matter of searching on Google, it was a socially powerful act that, at least partly, helped to mitigate the anxiety of the person at the other end of the line.
As with many large systems, there is a risk that people are transformed into numbers in the health economy: patients become NHS numbers and are often known by their position on a waiting list, our services are audited according to ‘key performance indicators’, and we are funded to treat target numbers of people. Moreover, the volume of referrals that I deal with on a daily basis and the repetitive nature of some of my responsibilities can certainly test my ability to feel connected to patients’ lived experiences.
This is why care unbound is such a provocative, and challenging, concept, and why those moments when, through the act of listening, we can exhibit ordinary leadership are so valuable. Above all, these moments remind us that, to create possibilities for care in every moment, we must always bear in mind that behind the NHS number is not simply a ‘patient’ in need of a ‘medical’ intervention but a person to be listened to.
Tom has worked in the role of Wellbeing Administrator for the Brighton and Hove Wellbeing Service since February 2017. Previous to this, he worked as a Patient Care Advisor and a Learning Development Assistant for Sussex MSK Partnership East (January – August 2015).