Posts

Why Apathy is Bad for the NHS

Image
  At the recent start of the football season, comedian and ardent Wimbledon FC fan Geoff Norcott remarked that it was “time to put my mental wellbeing back in the hands of some blokes I’ve never met.” Like many football fans, Geoff’s emotions will rise and fall as he follows his team in another rollercoaster season. Such fans will get angry when their team loses. Angrier still if defeat follows defeat in a downward spiral of sub-par performances. In time though, that anger might become apathy . The lack of emotion arising as a form of mental self-defence as fans’ brains seek to protect them from misery. Experience taught them that their anger achieved nothing. I have observed something similar happening with our NHS. In recent years we have seen a steady downwards trend in NHS performance being met with anger from those that use it. Media headlines have decried appalling standards while highlighting particularly egregious examples of failure. That anger in the media and from pa...
3 comments
Read more

When Reality Changes, Hope Can Too

Image
  A quarter of a century or so ago, I was the junior doctor tasked with explaining to an elderly man that his prostate cancer had spread extensively through his body and that it would probably end his life within the year. Sensing my discomfort as I stumbled over explaining the scan results, the man said, “it’s ok son, you’re doing a good job”. You see, he was trying to comfort me, even though he was the one receiving terribly bad news. A humbling experience, but one that taught me much about compassion and helped shape my career approach to such profound moments. Over time, I realised that my job isn’t to rescue someone from the reality of a painful moment - it is to be honest and help them face it instead. Such moments represent immense change for someone. Whether it’s health to illness, certainty to uncertainty or comfort to discomfort. What these changes have in common is that a new reality is emerging. In the past I perhaps assumed that new reality means that hope must fad...
Post a Comment
Read more

Ignoring the Warning Light: 5 Signs You Might Be Closer to Burnout Than You Think

Image
  Speaking to healthcare professionals who have recovered from burnout, one theme keeps recurring. It’s along the lines of: “looking back on it, the signs were obvious”. The warning light was blinking on their dashboard, but they carried on at work, perhaps even convincing themselves that their exhaustion and pain demonstrated commitment and loyalty. Burnout is rarely sudden. It is usually the final stage of a process that has been quietly building for a long time. The problem is this chronic, damaging kind of stress rarely announces itself as stress. In my A&E work, I’ll often see younger and middle-aged patients presenting with a symptom like chest pain. All the tests and investigations subsequently carried out show there is no heart problem, or other serious issues. It’s only when I dig a bit deeper that I find the punishing work routine, the relationship catastrophe or the social nightmare. Stress, not serious organ pathology, is the root cause of the symptom. Her...
Post a Comment
Read more

The rules in healthcare that nobody teaches you - but everyone follows.

Image
  Busyness = Value Exhaustion = Contribution Pressure = Legitimacy Suffering = Loyalty You might not hear these said out loud, but many of us act as if they’re true. How many of these have you seen this week—or done yourself? • Staying late to “just finish one more thing” • Apologising for being off sick • Taking quiet pride in “just getting on with it” None of this is accidental. These beliefs are reinforced every day—through praise, through culture, through what gets noticed and what gets overlooked. So, people adapt and over time, it becomes the norm. From the outside, this can look like a strong work ethic. A culture that delivers. But I would argue that it’s short-term thinking, because there is always a cost. Exhaustion becomes baseline, compassion fades and cynicism creeps in. So, what if these rules are wrong? Busyness ≠ Value → Clarity and prioritisation create more impact. Exhaustion ≠ Contribution → Sustainable clinicians contribute more over time. P...
Post a Comment
Read more

24 Hours in A&E - What that really means today.

Image
When 24 Hours in A&E first aired on Channel 4 in 2011, the average length of stay in a UK emergency department was just over two hours. In 2026, “24 hours in A&E” is no longer a television concept. For many patients, it is a painful reality. NHS figures show that last year alone, nearly half a million people spent more than 24 hours in A&E. Just this week, BBC News shared the story of a 77-year-old lady ( I waited 46 hours in A&E on a plastic chair, says Skegness woman - BBC News ).  Forty-six hours . It’s hard to imagine what that must have felt like: discomfort, fear, pain, hunger, cold, a creeping sense of abandonment. What is perhaps most sobering is how little shock such stories now generate. We may be becoming desensitised. But we also need to talk about the staff who were there. In a department where waits stretch beyond a day, every clinical space is full. Trolleys line corridors. Ambulances queue outside. There is no slack in the system — only ...
Post a Comment
Read more

“Needs Healthier Staff”: An Essential Strategy for Fixing NHS Performance

Image
  The UK spends billions every year training, developing, and recruiting staff for the NHS. This eye-watering amount grows year on year. So, are we getting value for money for this huge investment and is the NHS performing well? When we think of NHS performance, we tend to look at metrics such as waiting times or access to treatments. These numbers make for grim reading. In Accident & Emergency, for example, only 70% of patients in Scotland are currently seen and sorted within four hours—down from 95% a decade ago. But what do we mean by ‘high performance’ in healthcare? Is it hitting a target, or is it delivering safe, compassionate care day after day? Trending upwards however is NHS staff sickness absence. Scottish Government data show that 6.4% of NHS Scotland staff are currently off sick—that’s over 10,000 people. So, we have a more expensive service, with deteriorating performance, delivered by sicker staff. Performance, it seems, is inseparable from staff wellness. ...
Post a Comment
Read more

Trouble with Self-Discipline? A Modern Problem with an Ancient Solution

Image
'I just can’t seem to help it!' is something I hear often in coaching. Whether it’s checking your notifications or 'just one more' chocolate, the impulse feels familiar. In a world of dopamine loops, doom scrolling, and 15-second video distractions, self-control is under siege. Like a muscle that isn’t used and becomes flabby over time, our self-discipline can waste away if not regularly exercised. The opposite holds true too: self-discipline isn’t a fixed trait, it’s trainable. But unlike motivation, which comes and goes, self-discipline is consistent and reliable. It’s the scaffolding that holds behaviour change in place. So, how can we train and develop it? This same question was considered more than 2000 years ago by Greco-Roman philosophers known as The Stoics. They recognised how crucial self-discipline was for thriving and happiness in life, along with “virtues” such as wisdom, justice and courage.  As the philosopher Epictetus said, “No man is free who i...
Post a Comment
Read more