History teaches us that working together works

It’s useful, now and again, to look back on our past successes. 

This is not just to make ourselves feel good – although a little bit of that now and again does no harm – but to learn the lessons of the past.

To twist a phrase, those who don’t learn the lessons of history are doomed not to repeat them.

Almost at random, let’s look at three different successes which NHS Wales (and its partners) can justly claim from recent years, and see what they might teach us about the future.

First, learning disability services:

Almost a generation ago, the NHS and social services in Wales changed the face of services for this client group. Working together, they moved people out of Victorian institutional warehouses into housing in normal streets up and down the country and put services in place to support them there.

At the heart of this success was the sort of genuine joint working that we need now across most of health and social care.

The agencies overcame their many differences and worked together on a common goal because the Welsh Office (as it then was) made joint working all but compulsory and provided clear cash incentives to do so.

Secondly, the abolition of waiting times:

This massive achievement in our current decade is of historic proportions.

Within a few years, people’s biggest and oldest bugbear about the NHS – inordinate waits for treatment – was ended. Why? Because for once we bent every sinew to the task, we matched this with resource and we stuck at it until the task was achieved.

Thirdly, the 1,000 Lives campaign:

This is still very much in progress – in the guise of the five-year, 1,000 Lives Plus programme – but it has already achieved impressive improvements in the quality and safety of care in pretty much every hospital across Wales.

The lesson here is that if you can find a cause which unites both the professionals and the managers, you’ve got a good chance of getting somewhere.

The win-win – better care and greater efficiency – must also be good news for patients and taxpayers too.

You could also add to this happy trio the huge improvements in dental health we’ve seen over the last couple of generations – most children now have no fillings, compared with the serried rows of grey metal in their parents’ mouths – and the huge growth in GP and community services.

These two examples show what can be achieved when we get patients and services to work together, for example applying fluoride each day and regular visits to the dentist, and by lining up the resources and incentives in GP services.

So what does this teach us for the future?

Five lessons of great relevance – make joint working unavoidable; get patients and professionals to work together; find common ground for clinicians and managers; line up incentives and resources; and choose a small number of priorities and stick with them.

History tells us this is all possible.

A quick glance through the rest of this newspaper tells us that it’s now more necessary than ever before.

Written by Professor Marcus Longley, Director and Professor of Applied Health Policy

This blog is reproduced from Marcus Longley’s column in the Western  Mail on 7 February 2011


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One Response to History teaches us that working together works

  1. Michael Davies says:

    Regarding the dental aspect of this article. I recently visited my dentist, who is one of the ever decreasing number of NHS dentists.

    Without going into the full account of how this conversation actually came about, he was bemoaning the way the NHS treated registered members of this profession. On asking the obvious question “why don’t you all get together and protest”. He replied “we’ve tried that and they couldn’t care less. In my opinion they’d be glad to see the back of us”.

    So, it appears that not all is rosy in the garden.

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