Malcolm Lowe-Lauri on the role of FT governors
The old station building at Denmark Hill in south London is an elegant testimony to Victorian transportation. Sadly, the larger part of it was either sold or leased two decades ago. That bit is now a pub. This leaves a small ticket hall and two narrow entry and exit points, one onto platforms, the other to the road outside. I avoid peak periods at the station like the plague.
Others, including hospital staff, patients, relatives and carers don't have that luxury. Picture a scene of trains arriving and disgorging passengers while a late and anxious group rushes for the platform. What is surprising is the good nature and forbearance of so many in the face of such user unfriendliness.
With the help of Transport for London, local MPs and our local Greater London Assembly member Valerie Shawcross, in 2006 we secured a priority position in the schedule of station refurbishments. But that did not make things certain. The removal of all doubt has been the effort of our transport working group of governors.
Chaired by one of our public governors and supported by our communications team, the group has mobilised our foundation trust membership to successfully lobby to upgrade the station. So the future of Denmark Hill station is no longer a matter of correspondence between two sets of bureaucrats but a concern of the local community.
As part of the deal the station will get a decent-sized lift - quite important when you see fracture patients with external fixators or mums with buggies grappling bravely with the stairs. Not bad for a board of governors whose formal powers are actually quite limited.
It is witness to the extraordinary energy and enthusiasm of King's College Hospital foundation trust membership. I don't think this is unusual. Colleagues in other foundation trusts have mentioned the role of their governors in local opinion leadership during difficult periods of service change. It puts a different perspective on the simplifying tendency towards "cuts and closures" thinking and helps get a different message out there.
There is a big internal opportunity too. As they become confident, public and patient governors may develop a habit of asking penetrating questions about why services and thus patient experience are organised as they are.
Boards of directors, staff governors and stakeholders, including commissioners, will need to respond positively. It is challenging to institutionalism and professionalism, but perhaps also a chance to rethink service models and take some of the hassle off the consumer's back.
It is interesting to think back to a session I had with some policy advisers in 2004 where they expressed concern that, as in some failing schools, governors would go native and overlook poor quality. No evidence of this so far!
Mobilising the people we serve has a bit of a history to it. For some years the King's in the Community project has worked with Jobcentre Plus to take local people on a journey from unemployment to qualified profession. The tendency had been to see us as the local hospital but not the local employer. In parallel our academic partner King's College has been taking A-level students from local black and minority ethnic communities on the basis of potential rather than actual results and putting them through its extended medical degree - part of a widening participation programme.
This was an exciting way to curtail the dash to the developing world in search of professionals it could do with keeping. That issue has resolved in other ways through EU citizen arrivals and increased production by UK educators (though you don't go long before the "shortage" word makes a comeback).
But it is also a wonderful opportunity to exploit the potential of local people. Over time we may even roll back the tendency of training health professionals in London to qualify then disperse around the UK.
As I write, a new round of meetings with the trust membership starts tonight. For those used to testing times when dealing with their publics these do not go as you might predict. Last year I got a round of applause as I got up to speak! (Nothing to do with me, a lot to do with King's.)
That was followed by an interesting range of questions, from ones on the dental hospital environment to ones about financial management capability and investment strategy: an interesting mix of enthusiasm and criticism.
This year we can pick up on the innovation theme. However well we think we are doing the patient experience remains too much a test of attrition in acute services. Getting blunt descriptions from patients or relatives who at the same time value the institution is a rewarding dialogue which we must prize; vastly superior to focus groups or questionnaires. And we do have some leading edge developments to put on the table. All trusts usually have a good story to tell somewhere.
To see real public enthusiasm hold an open day. It makes a day out for thousands and a showcase opportunity for staff. There is apparently no shortage of local people willing to try simulated liver transplants, understand what a brain feels like, or learn just how unwashed our hands can be after we have, er, washed them.
And if exhausted with that why not watch the chief executive and chair abseil down one of the trust's taller buildings? There can't be many abseilers who have turned up in a suit as our chair Michael Parker did a few years ago (the sight of me in shorts was probably more appalling).
This is about showing off again but more importantly it is about providing a window into the trust. Beyond that it helps build a relationship with the public which demonstrates accountability beyond the formal constitutional position. As with meeting our members it turned out to be much more fun than we originally thought.