Posted by: ayrshirehealth | May 1, 2013

Don’t Panic by @CameronASharkey

Sharing some reflections

There are a few moments in your life when a wave of blind panic washes over you. For those couple of seconds that you are caught in its swell it is all consuming. I can think of three. panicAs an eight year old boy I once managed to get my knee stuck in playground railings. As a teenager on a school trip I awoke from a nap on a cross-channel ferry to find I was the only passenger left on the boat.

Most recently, in my first week on NHS Scotland’s Management Trainee Scheme- without the excuses of childhood curiosity or cross-country travel induced fatigue- I stood on a ward in the State Hospital, Carstairs and realised my security pass was no longer attached to my jacket.

The Management Trainee Scheme [c1] has been around in one form or another since the 1950s. In its current embodiment, the scheme is run for NHS Scotland by NHS Education for Scotland.  NHS Scotland by boardEvery year, thousands of applications are taken for the General Management and Financial Management streams.

After a competitive recruitment process, up to eight successful trainees are each placed with a territorial board for a period of two years.  An initial three month national and local induction is followed by two nine month placements at strategic and operational levels and a three month elective spent outwith the host board.

After a busy six months with Ayrshire and Arran, the space provided by this blog offers a welcome opportunity to share some reflections. It has been a step into the unknown. While the complexity of the system hasn’t yet pitched me into a playground/ ferry/ Carstairs level of panic, the more I learn, the more I realise the daunting extent of what I still need to learn.

A system brought into focus

The induction itself was a unique experience and a privilege. For those three months I spent time with clinicians, support staff and managers right across primary and secondary care in order to better understand the way that the whole system functions. What I saw left a deep impression.

NHSaaaDuring a morning spent with Addiction Services I was moved by the compassion and professionalism on display during interactions with clients. This resolve helped to ensure that the foundations for recovery could begin to be built amidst lives which appeared so chaotic that it would be too easy to dismiss them as hopeless.

At a stroke rehabilitation centre, I observed a Speech and Language Therapist do far more than that merely suggested by her job title. To her patient- a previously active middle-aged man- she was not only a skilled AHP but a coach, a motivator and a tangible symbol of progress made and potential yet to fulfil.

I saw the difference a good District Nurse can make to the quality of life of an older person and how a friendly word and a joke from a porter can put an inpatient at ease as they are wheeled between wards in an unfamiliar hospital.

It was inspiring to witness the passion, vision, leadership and dedication which was on display at all levels of the service. If I could have one wish for what I hope is a long career in the NHS, it would be to be able to hold onto these experiences and to use them to inform every decision I make and every discussion to which I contribute.

If person centred care is to become the lodestar of the NHS in the coming decades then it is vital that we never forget the real, immediate and long lasting impact that this sprawling, often faceless, sometimes frustrating institution has upon each one of us who come into contact with it. For those who spend their working lives removed from the frontline of daily patient contact, the need for cognisance of this fact is especially pressing.

Interesting times

People who I met kept telling me (often with a raised eyebrow or two and the hint of a smile playing about their lips) that it’s, ‘an interesting time to join the NHS.’ It didn’t take long to work out what that word ‘interesting’ is a euphemism for.

Niagra fallsEconomic and demographic circumstances have conspired to steer the NHS towards a precipice. To continue delivering services in the way that we have been is unsustainable and the consequences of such stasis unthinkable. However, the massive sunk investment (economic and otherwise) in the current ways of working, mean that effecting this change before the point of no return is reached is a herculean task akin to turning a container ship at the top of Niagara Falls.

Necessity, as the old adage has it, is the mother of invention. In an environment of finite and decreasing resources, so many innovations and novel ways of working must be met with a corresponding disinvestment elsewhere in the service. It is the steeling of the cultural and political will and ability to facilitate this process which makes the next couple of decades such an ‘interesting’ time to be part of the NHS.


  1. […] Don’t Panic by Cameron A Sharkey on the Ayrshire Health blog. […]

  2. Great blog! We’ve been facilitating the Citizen’s Panel for Social Services in Wales and its incredible how some personal experiences have come to almost define times in people’s lives. Its heartening to see such reflection on good practice and what what it means for the patient in this blog.

  3. […] Sharkey, in Don’t Panic, clearly was impressed by the compassion with which he saw people being treated by healthcare […]

  4. […] Ayrshirehealth were first of our cohort of bloggers for May with ‘Don’t panic’ by @cameronasharkey.  Cameron, who is an NHS Management trainee, writes about some of his […]

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