Tag: democracy

#nhscitizen and local involvement – Birmingham session, some thoughts.

NHS Citizen information flow
NHS Citizen information flow

This week NHS England has been in Birmingham picking many brains to try and understand how their #nhscitizen idea might work best at a local level.   Overnight I chewed over the things below but for context.  NHS Citizen is an attempt to encourage people to voice their experience and ideas about health care and for the NHS England board and other levels of the NHS to learn how to join, listen to and use that conversation.  It’s not a concrete thing at the moment and this video gives a sense of it…

Below are some of my slightly generic thoughts on what this might need to be like…

Is it a problem that this is about citizens talking to NHS England only, after all health and social care are experienced the same.

Err towards Solutions focus (not problems focus)

Focus not just on problems but experiments and solutions.   A process that channels problems up will not shift the way we deliver good or better health to each  other.  One that frames problems partly through things people have done to try and solve them will create:

  • a tone that encourages those at  the top to use (rather than avoid) the discussion and information.
  • a source of inspiration for people (citizens) and practitioners (also citizens) which includes new ways of fixing/doing things
  • room for those who act very differently from prevailing structures to share why they think what they do makes things better and then go an make things change.
  • a chance to celebrate people who act to make things better.

Use people’s stories to inspire fixes

When you make thing personal you want to solve it.  At the personal level solutions can be more practical than at a systemic level.

Don’t wait for change: 

Some traditional structures says tell us your problems and we’ll come back with our solution or reason why we can’t solve it.  that involves waiting for change.  If you send a problem to the top and wait for change until permission comes back it stifles innovation.  NHS Citizen should be able to track innovation, solutions and change – the board can learn faster from that and it will help shift the culture from what Steve Fairman,  Helen Bevan and other’s have described as a focus on the “disruptive troublemakers” in their paper on NHS culture change.

We are all citizens

So enjoy being one – whether the NHS pays you or not.

Don’t be an institution. 

The problem of being both a thing and not a thing.  Anthony Zacharzewski was quoted as saying “there will never be a chief executive of NHS Citizen”  and yet we still tend to think of things as things.  This is more like the internet –  few people ask who is head of the internet. yet we use it and trust it, accepting it as a platform we can shape.

To understand NHS Citizens more:

Watch the live stream of the discussions

Keep track of the development at http://www.nhscitizen.org.uk/

The four organisations managing the NHS Citizen design process: The Tavistock Institute, Involve, The Democratic Society and Public-i.

Declaration – we are currently working with NHS-Improving Quality plus a number of Clinical Comissioning Groups and a Clinical Support Unit and have/do work with Demsoc and Public-i

Public toilets and public interest and what it means for scrutiny

It was a toilet a bit like this, just without the sign. By Phinphonephotos on Flickr

This weekend I’ve had my head stuck on working out what I can do next on the digital scrutiny project. And then I remembered a toilet.

I used to be a local reporter in north London. Each week, after we’d put the paper to bed, I’d walk round my ‘patch’. It was a picturesque place called Highgate. I’d often need what one might euphemistically refer to as a ‘comfort break’. There was only one public toilet in the middle of Highgate Village, so it became a er, regular calling point.

Sadly for me, it didn’t take all that long before the local council announced its closure as part of a series of budget cuts. This led to a few protests from locals who were unhappy to be losing a treasured local service, but no one seemed to think it was that interesting a local newspaper story.

A bit of a story I and another reporter wrote about the toilet, taken from teh Ham&High website.

Well, that is apart from me. I was enraged. My own personal pit stop had been taken away. Where would I be going to the toilet now? I furiously filed story after story about the loo closure. I think at one stage I got the nickname ‘toilet boy’. I even filed a Freedom of Information request asking for any correspondence about the lost loo.

Splash
The mickey-taking, however, stopped when my toilet-based Freedom of Information request got a reply from the council. Contained in a bundle of papers was a gem: a letter from the councillor in charge of Camden Council‘s environment department pleading with Mr Livingstone to give him the money needed to keep the toilet open, for fear its closure would hurt his chances of being re-elected. It made that week’s splash, if you’ll pardon the appalling pun.

Flushed with pride
I was obviously chuffed: a story I’d chosen to work on that others felt wasn’t important had ended up being quite, well a little bit, important. The councillor did lose the next election – along with quite a few other Labour councillors. The loo earned a reprieve, when the new council was elected and, under the name Pond Squre, is still in the list of Camden Council loos.

But, in truth, I didn’t deserve that much praise. I’d only pursued the story because it mattered to me. Its closure was a pain in the arse and I was annoyed. The moral of the tale, of course, is that it doesn’t take much at all to find out what’s going on, if you care and ask the right questions.

Bog standard
Sadly, local reporters are rarely the people who can do this stuff. They have to worry about deadlines, filling pages of copy and often don’t even live in the area they report on (I didn’t). That doesn’t mean they can’t do important work, but it’s citizens, the people affected, who need to take the lead, because it really matters to them.

So the next bit of the project will be to try to isolate a question – almost certainly about swimming pools on Where Can We Swim? – and pursue it with similar vigour to the toilet issue. I’ll have to care about it, but – importantly – I need to find others who do, too. There are a few that spring to mind – not least whether Birmingham really needs a 50m pool – but I’ll be trying very hard, very soon to work out what it is. Then it’s a matter of applying the skills I’m picking up through the project to see just how well this sort of stuff can work.

Scrutinising sporting facilities – and why it matters

Following my blog post about scrutinising swimming pools I’ve now got myself a website that I hope can act as a place where I can gather information about how good/bad swimming facilities are and how they can get better.

The Where Can We Swim website

I’ve started blogging on the site, but I’ve also put together a wiki – that still needs some work – where anyone can contribute to a debate over the condition of swimming pools in the city. I’m hoping I can also collect some basic information about swimming pools in the city and use this to compare it to other cities.

I’m interested in seeing how these two very simple tools can add to a debate over the provision of swimming in the run up to the 2012 London Olympics. It seems a long time ago now, but when the bid for the games was made its strongest suit was the sporting legacy it would leave behind. That wasn’t just in London; there was a commitment to improve facilities across the UK.

What’s this got to do with scrutiny?

It seems to me that we should all be involved in evaluating the sporting legacy that the Olympic Games in London is providing. In Birmingham, for example, there was a lot of noise about a project to build an Olympic-sized swimming pool for the city that would be in place before the 2012 games. That noise hasn’t amounted to much at the moment, except a lot of people who are unhappy about where it’s going and others, including the Amateur Swimming Association, who are peeved that it has been held up.

What did the Olympics ever do for us?

Imagine, for a moment, what will happen in two years’ time when the Olympics is all over. We’ll be left with a few gold medals and – perhaps – some nice new facilities. But will the legacy, trumpeted by the Olympic Games bid team, have been fulfilled? And who gets to decide whether or not it has been?

Since the facilities have been built for us, I reckon that we should be the ones who get to decide. But how on earth does one go about that? A big survey? A phone vote on Radio 5? And what, exactly, will be the point? If we’ve missed the boat and we don’t get the legacy we think we deserve and were promised who can we blame?

That’s why I think the idea of scrutinising the Olympic legacy ourselves (and when I say ‘ourselves’ I mean anyone who cares) is so crucial. How should the funding we’ve got be spent?  What is wrong with the facilities we have and how would you build new ones?

In a sense, bodies like the Amateur Swimming Association and our own politicians will do this anyway. But surely interested citizens, who care about the facilities they use, could become involved in that kind of scrutiny at a local level. Given that we’re about to get a new government and there’s been a financial crisis, there’s a lot to be vigilant about. That’s what I hope the Where Can We Swim site can start, in a very small way, to be about. It’s really just a very modest exploration of what happens when one person asks a question about one particular aspect of a local service.