It was not a particularly busy shift. The patients were not any more sick than other evenings I have worked. I may have been a little more tired than normal, I don’t think I was anymore distracted, but as I walked out of the consulting room I realised I hadn’t #hellomynameis.

I’m pretty thorough by nature. I have always felt my communication skills were at least ok and I certainly think I’ve introduced myself to patients/parents since being a junior doctor. I actually felt everyone else did as well. It wasn’t until Kate Granger‘s #hellomynameis campaign really took off that I realised this might not actually be common practice. It’s interesting what is perceived as common practice or ‘assumed’ to be normal. You would think most people or systems would deliver at the minimum a style of care that at least doesn’t harm people but we know from some tragic events this is not always the case. We know for a fact that there must be pretty huge differences in the way things are done from variation in many healthcare outcomes (atlas of variation in care in children being one example).

It always upset me, and the term upset is correct, when I was a trainee representative for the RCPCH and AoMRC and senior medical leader or educator made a pronouncement on what trainees must be able to do. “It’s ridiculous trainees can’t get their WPBA signed off by consultants. At my hospital there is always a consultant available” Yes – at your hospital perhaps. Your world and training environment is very different from others.

And so I raised a wry smile at this tweet this evening

Appreciate NHS pledge day work but some of them are bemusing…raises the qs why it needs a pledge to do something you ought to do anyway 😉

— Partha S Kar 🇮🇳🇬🇧🏏🎥 (@parthaskar) February 22, 2014

I’ve never met Partha but he sounds like a pretty awesome bloke. Cruelly overlooked in the HSJ Rising Stars awards he clearly has a great vision and passion for health care. He also seems to insist on calling NHS Change Day – pledge day but I’ll let him off that. It’s worth following the chain this tweet produced. I make no secret of my support for NHS Change Day and I’m happy to accept and defend criticism about it (Partha – I know your weren’t criticising but your tweet was perfect for this blog!). “What’s the point?” is a common question. “You had 3500 people pledge to smile last year. Don’t they do that anyway?” is another. For the answer to the latter reflect on when was the last time you spent an entire shift in public view and at no point looked like you weren’t upset, annoyed, bored or frustrated. How do you think your patients felt when they saw you looking like that?

Yes someone has pledged they want to keep patients safe. And yes this is a fundamental part of a healthcare professional’s role. But, unfortunately, sometimes the healthcare service doesn’t always keep patients safe. Yes – its fairly obvious that you should introduce yourself at the beginning of every consultation. But, unfortunately, even someone who has been supporting #hellomynameis passionately can fall short.

In some ways it is a shame it is ‘change’ and it is ‘day’ because it’s not always about ‘change’ and hopefully its not about one ‘day’. But if you can find a better mechanism that brings the NHS together and say look – lets just think about this – then please let me know. Because until I find one I will continue to support people pledging what they feel is important to them however obvious that might seem to you.

Post Blog Note (23.2.14)

A subsequent comment from @parthaskar following this post deserves mention as it is something I strongly support and given I gave the poor chap no notice about using his original tweet think it is only fair I utilise his wise words!

Make a "pledge" if you mean it. Don't do it because it sounds like a bandwagon to join. Make things change, don't pay lip service. 2/2

— Partha S Kar 🇮🇳🇬🇧🏏🎥 (@parthaskar) February 23, 2014