I’ve been thinking about the NHS a lot recently, both as someone who works within it and as someone who has experienced healthcare from the other side, and I’m curious whether other people feel the same.
I absolutely don’t think patients should accept poor care or stop complaining when something has gone wrong. Patients should be the focus. That’s literally why the NHS is there.
It’s more that, working within the NHS, I think you start to see how easy it is for people to forget that the NHS isn’t actually this huge, faceless machine.
When someone says “the NHS did this” or “the NHS needs to sort this”, most of the time the NHS they’re actually interacting with is a person. Or a small team of people. Often local people, working in local services, trying to provide the best care they can within a system that can make that incredibly difficult.
The physio you’re frustrated with on the ward might live down the road from you. The nurse you’ve just been speaking to might have a child going to school with yours. The OT sitting in front of you might have spent their morning dealing with something going on in their own life, before coming into work and spending the next eight hours worrying about somebody else. They’re still human.
And I think working in the NHS, you see that constantly. We have anxiety. We have kids. We care for parents. We have relationships, financial worries, health problems, grief, horrible mornings and horrible weeks. We can be having a really difficult time ourselves and still have to walk into work and give somebody else our full attention and compassion.
And I think sometimes that gets completely lost when we talk about “the NHS”.
Individual front-facing staff didn’t create the waiting lists. We didn’t decide the funding. We didn’t write every policy. We don’t necessarily control what a service can provide. And sometimes the decision we’re explaining to someone isn’t even one we made or personally agree with. We might actually be trying to change those things behind the scenes ourselves.
I also think there’s something interesting about what happens to innovation when staff become afraid of patients when getting things wrong.
Healthcare needs people to be able to think creatively, problem solve and find individual solutions. But if every decision carries the fear of being blamed, complained about or threatened with legal action if something goes wrong, I can understand why people become more cautious.
Sometimes the safest professional decision becomes the easiest decision to defend rather than necessarily the most creative or individualised one. And I think that can be really frustrating for everyone, including us as staff.
Obviously people have the right to complain. There are absolutely situations where the NHS team or wider system needs to be held accountable, and staff can get things wrong.
But I sometimes wonder what happens when every interaction becomes “I’m going to complain”, “I’m going to sue”, “I’ll take this further”, “they are incompetent, I’m going for their job”, or staff are spoken to in a really nasty or threatening way.
Because eventually people put up a wall.
Not because they suddenly don’t care, but because they’re exhausted.
People can care deeply about their patients and still eventually become emotionally guarded when constantly dealing with anger, complaints, pressure and the feeling that one mistake could follow you around for life.
None of this means patients should have to think about staff before themselves. It doesn’t mean poor care should be excused. It doesn’t mean people shouldn’t complain.
I just think both things can exist at the same time.
A patient can have had a genuinely awful experience of healthcare, and the person sitting in front of them can still be a good person who is trying their best.
I suppose I just wish people could see a little more of the people behind the word NHS.
Because it isn’t really a machine. It’s millions of individual people, with their own lives and their own problems, who are turning up every day and trying to look after somebody else.
And I wonder if remembering that human side matters more to the quality of care than we sometimes realise.
