Suspicious minds

I am off back into the fold of the NHS for a secondment. I feel excitement, aniticpation and a little fear.

I have worked as a consultant for nearly four years and it has huge benefits but also drawbacks. I love working with someone and not for someone but it can be a lonely and stressful path. In order to win business we often need to work alone and that doesnt suit me at all and never has. Winning business equates to paying essential bills and in the months when clients are scarce or organisations are cutting back and paying late it can be incredibly stressful. There are high prices to be paid for leaving a service which cushions you from some of the pitfalls and stress of managing money which is never certain.  I acknowledge that managing budgets and financial pressures are stressful but they cannot be compared to knowing that you are a step away from bankruptcy or from problems putting food in front of your kids and the joy of knowing my salary for the next four months is safe and secure is unbelievable.

 On the plus side being a consultant and running a business has taught me a self suficiency which the NHS never could and has enabled me to say and do things which were certainly impossible within the precious fold of the department of health. I have been more honest about the reality facing a service I love and a profession of which I am proud to be a member.  I have sat in front of senior people who have listened to me properly because they have paid for my advice and have taken that advice and made improvements to their organisations and to the nurses working in them.

Going back may mean that I am not listened to in the same way and may shed some light on why organisations cannot solve their problems themselves by listening to the clinical voice telling them things which are clear, practical and often simple common sense.

I am looking forward to really getting my teeth into something. A consultant has a severely limited timescale for making judgements and improvements and is under delivery schedules which often are based on money rather than on what would be best. I am excited at the prospect of a full four months in one place and a feeling of belonging somewhere and being part of a team and an organisation.

And my fears? Ahhhh, already the slimey hand of bureaucracy is crying for attention and the noose of conformity is shrieking but the policy says in my ear. Of course those who know me well are looking forward to my expliots and are eagerly awaiting my downfall in the face of these foes but it hasnt happened yet and I have worked in the NHS since 1984 so I am certain four months wont do it now.