On 5th July 2024, the day after Labour won a spectacular election victory, the new Secretary of State for Health Wes Streeting said: ‘From today, the policy of this department is that the NHS is broken’.

Mr Streeting indicated that ‘patients are being failed on a daily basis’. ‘That is the experience of patients who are not receiving the care they deserve, and of the staff working in the NHS who can see that - despite giving their best - this is not good enough’.

His first step for ‘saving our NHS’ was to announce talks to end the Junior Doctors’ industrial action’ and these have been confirmed this week. He has committed the Government to ‘hand in hand with NHS staff to deliver the shortest waits and highest patient satisfaction in history’.

We have seen many reviews and reorganisations within the NHS; indeed many of us have lived through many including abolition of Regional Health Authorities, Primary Care Trusts and Family Health Service Authorities, Fundholding by GP’s, Clinical Commissioning Groups, creation of NHS England and the new Integrated Care Boards. It is hard to conclude that any organisational changes have significantly improved the NHS.

A quote attributed to Petronius Arbiter, one of Nero’s acolytes, seems appropriate to NHS staff - ‘We trained hard-but it seemed that every time we were beginning to form into teams, we would be reorganised. I was to learn later in life that we tend to meet any new situation by reorganizing; and what a wonderful method it can be for creating the illusion of progress while producing confusion, inefficiency and demoralization’.

The last thing the NHS needs in 2024 is an illusion of progress which produces confusion, inefficiency and demoralisation.

I am pleased that at the start of his term as Secretary of State, Wes Streeting recognised the importance of the Staff within the NHS in delivering the service. In seeking to end the Junior Doctors dispute without delay he indicates this understanding. But as the Junior Doctors themselves have repeatedly stated, their dispute is not just about money. Working conditions have deteriorated, newly qualified Doctors are choosing to go overseas for better pay and conditions, rotas remain incomplete resulting in additional work when they are already overstretched, and time becomes unavailable for training or career development.

Mr Streeting recognised that for many working in the NHS ‘despite giving their best, this is not good enough’.

Patients face growing waiting lists for appointments and procedures. At the same time NHS staff face a perfect storm of challenges following the stresses of the Covid pandemic, including:

• Workplace bullying and racism

• Persecution and hounding of whistle-blowers

• 170,000 professionals leaving the NHS

• A crisis of recruitment to vacancies

• Staff having to undertake additional work because of unfilled posts

• High levels of stress and Burnout in Senior staff

Another reorganisation will not fix these issues.

Prof Lord Darzi, a former health minister, well-respected Surgeon and Healthcare Leader, has been charged with investigating the performance of the NHS. He will ‘delve into the issues’ of long waiting lists and pressure on services to ‘examine the root causes and solutions’. Prof Darzi says: ‘My work will analyse the evidence to understand where we are today – and how we got to here – so that the health service can move forward. This is an important step to re-establishing quality of care as the organising principle of the NHS’.

My advice to Prof Darzi is to start with the Staff. Many feel broken and burned out. Those who are not, feel stressed and many are ‘smouldering’ towards burnout. It may take months or years to recover from burnout and we need to intervene before it happens.

Having worked in the NHS for over 40 years, as a Clinician and a Board Member, I know that Senior posts can be lonely places. Senior Staff need the opportunity to talk about the issues that are affecting their ability to perform to the best of their ability – many of which are external to themselves.

Many are wondering what the future holds – they may feel lost, stressed, or even burned out. Many are working extended hours trying to cover for absent colleagues or vacancies. Many are considering leaving healthcare altogether. A common complaint, acknowledged by Wes Streeting is that, despite their best efforts, the care they are able provide no longer seems to be good enough.

As an Executive Coach, I believe that Coaching can provide a solution to the stress and burnout that inevitably result from working in the NHS. Whatever else Prof Darzi recommends, I would respectfully suggest that he asks Wes Streeting, as a matter of urgency, to establish a new, independent National NHS Executive Coaching service for Senior NHS Staff.

A Coaching Service will engage with those who are considering their future, and considering alternative career choices within or outside Health Care. It will support their impatience to provide a better service and will provide a clear view of the steps needed to make changes. It will provide an opportunity for those who are stressed, lost, or approaching burnout to check their goals, consider their options and understand the next steps. It will re-engage staff with their careers. Senior Staff should be able to use their CPD Budgets to access this Coaching service if they so wish.

It is essential that the National Coaching service is provided externally to the Employing trusts and by Coaches who are independent of the employment relationship. Staff exposed to racism & workplace bullying, whistle-blowers and those having to cover for absences, even when they know it is adding to their stress, will quite reasonably feel unable to engage with Coaches from within the workplace. Goodwill, Trust and Confidentiality are essential starting points for effective Coaching and in many cases, these can only be experienced externally.

There are many experienced, qualified and highly skilled Executive Coaches who offer their services to NHS Staff just waiting to provide this service.

Fix the Staff, Fix the NHS.

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First aid for doctors with burnout - a new book by Dr Claire Davies.