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Only a revolution in listening and responding will improve our nation’s health

July 3, 2017 | Filed under

This blog is the 2nd of two linked blogs and was written on 2 July 2017

In the 18 days that have passed since the awful disaster of Grenfell Tower we have learned that the type of cladding used to refurbish the block was to blame – that and a faulty fridge on the 2nd floor. We now know that the Public Inquiry will be focused on the technical aspects; how the fire started, how and why it spread so quickly and what internal precautions were in place for alerting residents. And the incompetence of the local leaders (and national policy-makers) whose watch this happened on is revealing itself daily.

No wonder people are angry.

What the authorities are failing to grasp is that Grenfell was the result of a monumental failure in listening and responding. The residents of Grenfell Tower knew there were issues with fire safety and raised them repeatedly … but they weren’t listened to. Not only was nothing done about the fire issues they knew about but decisions were also made to make their homes even less safe by fitting less expensive and flammable cladding. This ignore-ance (as opposed to ignorance) had led, over time, to a culture of indifference and contempt for people and their wellbeing and the consequences are continuing after the event, with very painful consequences. This is what people are angry about.

The real cause of Grenfell is a culture among those in positions of power, of ‘not listening’ which led to a lack of understanding and a lack of trust. This is a common problem – more common in places or professions where the differential in status between those who do and don’t hold the power are stark.

If there is just one thing that the NHS must learn from Grenfell, it is how to listen and respond, not just to the main arguments but to the nuances of what people are saying. The health sector badly needs a revolution in listening not just to prevent a large-scale incident but to improve people’s lives and health on a daily basis. Here’s what needs to happen now.

First, we need to acknowledge that indifference to the realities of people’s lives and not addressing the root causes of their health issues or distress is harmful to them. The NHS’s indifference comes from it’s almost total focus on fixing the illness, rather than on addressing root causes. An extreme but not uncommon example is discharging a rough sleeper back onto the street following treatment, rather than collaborating with housing services to provide accommodation with support.

Second, NHS frontline staff must be trained in how to hold a different sort of conversation with people. Genuine listening is critical because it enables trust to be built and that leads to a greater understanding both about the underlying problems and of what potential solutions.

Third, we need to work directly with people and their networks and communities to find different types of solutions – because given the right conditions people are infinitely resourceful and can solve many issues themselves and they can tell service providers precisely what they need to enable them to do that.

And finally by changing our systems so that NHS staff can act to meet their requests in an equally nuanced way. This is the most difficult bit, because it requires systems to be flexible and this doesn’t fit comfortably with a rigid guidance-led approach to service delivery. But it’s also the thing that makes health creation possible!

Merron Simpson is Chief Executive of  New NHS Alliance and its National Executive Lead on Housing.