Posted by: ayrshirehealth | April 2, 2014

The Evolution of change by @sparklystar55

Nothing changes, you just get worn down

When I took up my Consultant post in September 2011 people were full of advice ‘say no to things for the first few months’ ‘keep a low profile’ ‘you’ll be busy enough in a years’ time’. Sage like wisdom from people who had been working in the NHS for a number of years.  Change3Any ideas for change were also met with ‘I used to be like that but what’s the point?

“Nothing changes, you just get worn down”

I couldn’t quite understand this attitude.  Now, I can appreciate this sentiment may have been somewhat naive.  However from my perspective I had worked hard through my registrar years to get to a point where I could potentially influence change instead of having it put upon me.  Why on earth would I just wait and see what happens rather than engaging?

However what soon became apparent when using the word ‘change’ was the negative reaction to it. There was bristling and recoiling followed by shut down and disengagement. I then began to wonder if what people were experiencing was change fatigue.  A sense of disillusionment. It became clear to me that at that point that if you are constantly telling people about change and the need to do it you start to imply that everything they do is wrong.  There wasn’t any audible sense of what was being done right. An acknowledgment of good practice. Of which there are many. What needed changing wasn’t the entire idea (or even service) but in a sense the idea needed to evolve and build on what was being done right….

If you bake it, they will come 

So driven by instinct coupled with an inability to say no to things I got started. I felt the main aspect was to engage with people.  Try to understand their perspective.  To not only listen but to hear.  CakeThis perhaps was one of my biggest challenges.  I have a short attention span – I can appreciate the necessity to meetings but not endless hours of which the only decision made is that ‘we should have another meeting’. Urgh!!!

So I felt part of engaging people was to make the meeting something you actually wanted to go to and so the ‘if you bake it, they will come..’ concept was born. Its my version of famous saying from the film Field of Dreams – except my version featured cake.  And coffee. Factor in ~10mins or so at the start for chit chat and then, get to work.

If you don’t care for each other!

And what a productive amount of work you can achieve if you spend time looking after each other. I’m very much a believer in person centred care but equal priority should be given for the people trying their best to deliver that.  Staff careIf you don’t care for each other then how on earth are you going to care about your patients? I have now been witness to people sitting around a table, coming up with new ideas and taking things forward that historically would never have happened.  We have the Delirium Pathway group now (I’m the Strategic Lead). A fully fledged, multi-disciplinary collaborative piece of work between Care of the Elderly and Elderly Mental Health.  We are sharing IT systems, delivering joint education sessions that are for all staff – medical, nursing or AHP’s.

That’ll never happen

What do you thinkIt’s about being told ‘that’ll never happen’ and ignoring it anyway.

It’s about asking ‘what do you think’ and making the necessary change required for the idea or service to evolve. One small step at a time.

It’s about challenging that sense of deep dissatisfaction and doing whatever is necessary to make it better. Taking people with you but allowing time to stop and reflect.

So in my third year as a Consultant I still have that excitement and drive because as Theodore Roosevelt said;

It is not the critic who counts; not the man who points out how the strong man stumbles, or when the doer of deeds could have done better.

The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause;

Who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly…..’

Now, where’s my chocolate brownie…..

This week’s blogger was @sparklystar55 (Dr Claire Copeland) who is a consultant physician in Care of the Elderly and Stroke Medicine, and Foundation Programme Director (W2) in NHS Ayrshire & Arran.



  1. Great blog Claire. Thats the approach we need, keen, innovative, challenging but supportive of staff. I have been stressing the value of good coffee and cakes for years – esp Tunnocks teacakes!! And the “Man in the Arena” quote is always good. Well done. Ken D.

  2. Claire, loved your piece – thank you for inspiring my Wednesday.

    Best wishes

    • Thanks guys for that, it’s very much appreciated. I do love a Tunnocks teacake too!

  3. Fantastic blog Claire. Integrated and collaborative approach works wonders in revolutionising the way we practice. Well done .
    Best wishes

  4. Wow, person centred care and person centred meetings – baking would make me buy in! Having worked in community engagement it’s striking how a small incentive like that can make all the difference.

    – Dyfrig

  5. Claire, really inspiring blog, the cakes are also fantastic.

    Best wishes

  6. We always have home baking at our Governance meetings. The Team feel appreciated and we can then have productive discussions.

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