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We made it. I'm not sure how but we did!
Fuelled on caffeine, encouraged by well wishers and a tide of support on social media (trending No2 on Twitter) our mammoth, Change Day marathon, visiting 12 health and care venues in 24 hrs, is over.
We set out at 9am from the NAPC conference in Brum on the 19th and in the shadow of some of the most iconic buildings in London, we finished at the Royal London Hospital, part of #BrilliantBartsHealth exactly on time; 8 o'clock in the morning of Thursday 20th October.
Primary care, secondary care, third sector care, unplanned care, out-of-hours care, loving care, careful care, care swamped by demand, care unlimited. Care interrupted by daft ideas, fragmentation and policy makers without a clue. We'd seen it all.
Care grinding to a halt, code-black on a mild October evening. Care fragmented by policy and glued back together by perspiration and sheer bloody-mindedness. Care delivered despite... care delivered against all odds.
Care delivered by people on the ground who know, so much better than the rest of us, how the job should be done and how the job could be a million times better with a few moments thought.
Care hammered out of shape by austerity, regulation and unnecessary complexity. Care, seen up close, a miracle of determination despite everything, not because of anything, just good people doing great things.
Seen, up-close, it is clear the system is about to fall over.
It's not the money; there isn't any and people know that. They've moved beyond that. There's nothing they can do until politicians wake their ideas up.
It is the remnants of contracting and competition, the detritus of political interference that litters the landscape of care that causes the problems.
It is the legacy of Lansley's lunatic reforms that suck money into contract management and petty administration than makes end-2-end care all-but impossible to plan.
It is the quality regulators that distract organisations, terrified of failure and drives them into spending millions, (yes millions) in preparing and rehearsing for worthless inspections that the CQC can't afford to finish.
It is the totally hopeless data governance arrangements that have turned sharing information into a labyrinth of permissions and agreements. Fiona Caldicot's opaque reports have done nothing to help deliver a common-sense solution to delivering what every living English family assumes must be meat and two veg' of health and social care... sharing stuff.
I'm left convinced there are three NHS's.
First; the NHS that the DH press office inhabits. The world of more money, extra this, people, political perfectness and general Walter Mitty. Best to ignore their entire output.
Second; the world of the think-tanks, analysts and the likes of the Nuffield, the King's Fund, Reform and Jennifer's Club. This world exists in a parallel universe. Their penetrating analysis, forensic examination of policy and its implications are totally, utterly and completely irrelevant to people working at the sharp end of care.
Indeed, in many cases you'd struggle to find people who've ever heard of them and certainly not in any practical context. They are the policy bubble, floating around Whitehall.
Finally; the real NHS, where managers are pole-axed by Locums not turning up, patients obliged to wait for a bed to become vacant only when the previous occupant is moved to the morgue.
The real NHS where interoperability of systems is bogged down in procurement complexity that ignores the common sense of ; 'if it don't work with the other stuff, we ain't gonna buy it'.
Where organisations are frozen by the glacial effect of regulatory nonsense that no business would put up with.
The real NHS that is brimming with good ideas, overflowing with passion and innovation and where people come to work because they want to do something noble and right and worthwhile.
The real NHS that needs decluttering, the undergrowth hacked away, management and systems re-oxygenated.
The real NHS is alive and well, full of great people doing fabulous things and in the 24hrs of Change Day, we saw them. Now it is time to turn their optimism into a year of action.
For the full Change Day story follow the link below. Thank you to everyone who helped make it happen. The Hubbies, the Ambassadors, IMS-Maxims, KPMG, Coloplast, NHSE, the Horizons Team and most of all, you.
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