American football can seem a little odd. On first glance, it looks like lots of fat men bumping into each other and falling over. And then after a while Diana Ross or Lady Gaga gets up and sings.
In fact, it is quite a tactical game. The basic aim is clear: you must get the ball across the opposition’s goal line. The main player in a team is the quarterback. He holds the ball and tries to get as far up the field towards the goal line as possible. And the quarterback can make it look very easy, eating up the yards with no one getting near him.
But the key players are the ones in front of the quarterback. These are the guys who play what is called “running interference”. Their job is to keep the opposition at bay; to stop their quarterback being harassed, to give him the time and space he needs to do his job. If they run interference well, you don’t actually notice them but the quarterback looks good.
The fans worship the quarterback; his is the picture on the bedroom wall. But the guys running interference make a huge contribution to every single goal.
The NHS has got lots of highly skilled quarterbacks. They are essential and in my experience provide an excellent service to patients. But the NHS also has lots and lots of people who run interference. They do the work behind the scenes; maybe not the sexy things, but the necessary things to make things happen. They can create the space for the quarterbacks to do their thing. You don’t often see them, and patients often won’t even know that they’re there, but they are a crucial part of the modern NHS.
No one can doubt the basic premise of the current NHS reform proposals: we need to save money, and we need more clinical involvement in decision making. All good and sensible policy objectives. But let’s not ignore those running interference.
One of the stated aims is to cut management costs by at least 30%. This will not be without impact. The danger is that without those running interference, the quarterbacks will not get the same support, will have less options to reach the goal and are far more at risk of being got at.
And the quarterbacks are quarterbacks for a reason. They don’t want to run interference. A survey in Pulse magazine last week, highlighted in the excellent Roy Lilley’s NHSManagers.net blog, shows that 60% of GPs do not want to be involved in commissioning. They want someone else to run interference for them.
I think the NHS is still the crowning achievement of our society. And it is packed full of deeply committed people doing all they can to give patients they very best they can. But I want to wave a flag for the managers, the supporters, the back office staff, the people who may never have their picture on a bedroom wall. Yes, we need the quarterbacks, but we need someone to run interference too.
Mark Wall is Director of Mark Wall Communications and an Associate at The Campaign Company and can be followed on Twitter @markwallcomms. If you want to see what your own primary values set is, why not take the simple Values Questionnaire here.
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