Comment: Why I am a born-again buddy-ist

When Jeremy Hunt announced in September 2013 the buddying concept in the NHS, whereby trusts that were struggling would be buddied up with a successful trust, I was agnostic on the concept.

My views were influenced by my frustration over the years as both a former NHS trust CEO and as CEO of the Royal College of Nursing, where the ability to share good practice appeared so hard to achieve. Although I am a long-term admirer of the NHS, I have lamented the fact that many of its constituent parts suffer from a condition known as “pilotitis”.

Unnecessary reluctance

By this I mean that so often when people are informed of a new concept or approach, the response is, “OK, but we were developing something different here.” Why some organisations seem reluctant to take a tried and tested approach and simply implement it is beyond me.

I am now far from agnostic but an avowed protagonist of the concept of buddying.

My views have been formed as a result of my five months as the interim chair of the Medway Foundation Trust between November 2016 and March 2017.

I was hugely impressed but also intrigued that someone with such a distinguished career would be so enthusiastic about the challenge at Medway

Many readers will be aware that Medway is a trust with a troubled history. At the time of joining the trust it had been in special measures for nearly four years. It was one of the original Keogh trusts and had been in special measures the longest of any NHS trust.

When friends and former colleagues heard I was going to Medway I received comments ranging from “You must be mad” to “Do you realise what you’re letting yourself in for?” Others are unprintable.

The Medway story is one that is worth dilating upon.

When I was approached by NHS Improvement to see if I would be prepared to be interim chair it was first arranged that I would speak with the medical director, Diana Hamilton-Fairley. The CEO, Lesley Dwyer, was in Australia as her daughter was about to give birth, but my discussion with Diana was illuminating to say the least.

She explained that her substantive post was as a consultant obstetrician and gynaecologist at the Guy’s and St Thomas’ FT and her involvement with Medway came about as part of the buddying scheme. She spoke with enthusiasm about the work at Medway and the need to recruit an experienced chair to help the trust get out of special measures.

I was hugely impressed but also intrigued that someone with such a distinguished career would be so enthusiastic about the challenge at Medway.

I then had a telephone conversation with Lesley and again was very impressed; this was followed by a face to face on her return from Oz and I commenced on 1 November.

Although I have been to Kent on many occasions it quickly became apparent that the Medway part of Kent is a highly deprived area that has never recovered from the closure of the docks in the 1980s and the demise of traditional industries. A GP said to me, “Well, if Kent is the garden of England, this part must be the compost heap.”

Despite such an unpromising setting, I was soon to discover that Lesley had recruited an almost entirely new team and their enthusiasm was palpable. I should hasten to add that there was a large number of staff that have worked at the hospital for many years that are highly skilled and totally committed. I enjoyed getting to know them and was struck by their warmth and their sincerity.

Hurdles notwithstanding

There are, however, two areas that I wish to concentrate on. The first is in relation to the CEO. Lesley was recruited from Australia and had never worked in the UK. Imagine the hurdles she had to overcome: First, coming to a foreign country; secondly, the NHS, an almost impenetrable system; third, the most testing time in the history of NHS finances; and fourthly, Medway, with a dire reputation and in special measures.

Lesley overcame all of these hurdles and is testament to the fact that with the right leader, even the most testing of challenges can be overcome.

I’m so proud to have in some small way contributed to the Medway journey, and my conversion to buddying is complete. I would unreservedly recommend it to the wider NHS

The second is the buddying scheme. In addition to Diana a number of other staff from GSTT were seconded in. They brought with them a breath of fresh air and contemporary clinical skills.

Of particular note is Karen Rule, the director of nursing. Karen, like Diana, has spent most of her career in London teaching hospitals and brought an enlightened approach to nursing in Medway. She was appointed substantively in October 2016, having been part of the buddying team for several months.

Had it not been for the buddying arrangement, could you seriously imagine that Diana (who was appointed substantive medical director in January 2017) and Karen would have applied for the jobs at Medway? I think not. Why would they have moved from the rarefied atmosphere of GSTT to what was regarded as one of the poorest performing trusts in the country? This would hardly have been an attractive career move.

There are other staff from GSTT that have contributed to the progress at Medway, all of whom have enjoyed the experience. Some have asked to continue their secondment.

In March of this year, following a thorough inspection from the Care Quality Commission, Medway was removed from special measures. I can recommend watching the reaction of the staff on YouTube; it is truly heart-rending.

As for me, I’m so proud to have in some small way contributed to the Medway journey and my conversion to buddying is complete. I would unreservedly recommend it to the wider NHS.