Another one in my series of “Wot I reckon” posts based on no science or evidence at all, just me trying to figure stuff out. So proceed at your own risk.
This post is a bit more dangerous than the previous posts I wrote (for me, I mean) because it may get a little bit ranty in the middle (which I will try to avoid) but also because I don’t think it really paints me in the best light, or certainly the old me it doesn’t paint in a good light. And for all I know this perspective is unique to me and everyone else got it first time. If so, this is just a letter to my past self, but I can’t see the harm in that.
I worked for the same NHS organisation for a long time. Different jobs, same organisation. I should say this is not aimed at them or individuals there at all. I think I’ve observed this everywhere I looked, but I saw it closest in my old organisation. So from time to time my organisation would publish a “Strategy” and there would be all this hoo-ha about it and meetings and consultations (public and organisational). They would publish these incredibly concise versions of it that would basically say “We’re going to provide high quality clinical care- but not only that- in a cost effective way too!”. And my eyes would roll out of my sockets and under my keyboard and I would just carry on doing whatever I was doing before that had nothing to do with the strategy. I held the word strategy in complete disdain, it seemed to be a weasel word for “We’re going to do what we did last year but dress it up a bit”. For a long time the stuff I was interested in, digital, data, and analytics didn’t have a strategy. When it finally did it again suffered the same problem of just saying obvious stuff anybody would do. Upgrade the databases. Cross team collaboration. ChatGPT could have written it just as well.
-And going from the specific to the general other strategies I’ve seen haven’t engaged me at all. Most just seem to be obvious generalities dressed up, lowest common denominator stuff that will get through a committee. I’m going to make three criticisms of the strategers (them) and the stratagees (myself and colleagues).
+And going from the specific to the general other strategies I’ve seen haven’t engaged me at all. Most just seem to be obvious generalities dressed up, lowest common denominator stuff that will get through a committee. I’m going to make three criticisms of the strategers (them) and the strategees (myself and colleagues).
The first problem is that insufficient effort is made to engage people in the detail of the strategy. Nice headlines are shared, that I suppose are supposed to make you feel warm and fuzzy. And people who know about the strategy and care about it will think “Ooh yes, what a good strategy”. But all the people like me who don’t know anything about it and don’t yet care just see all this wooly jargon and wander off. More effort needs to be given over to why it matters- what are the alternatives? What will happen if we don’t do that? What data is there? I realise now too late that good strategies will have that in the background, but hidden away. Show it to us. Sell me on it. Don’t think that I’ll just fall in love with some cosy words and go back to my desk with renewed vigour.
The second problem is related to the first, which is that there is no frank discussions of the trade offs in the strategy. Everything is always optimal. Whenever we reorganised services so they cost less it was always (supposedly) true that this new way of working was more clinically effective. Be honest. There are trade offs. You can either tell me what they are or don’t and I’ll resort to guessing.
The third problem is people like me, and this is where it really is a letter to my younger self. It isn’t rational to suppose that a group of apparently intelligent people would engage in such a lot of activity if it wasn’t worthwhile. I should have had a bit of faith that there was a bit more to this process and tried to get at the detail that I wanted rather than just laughing into my latte and going back to writing code.