“It’s about unleashing, not controlling” 2.0

William writes about his roles in Dementia Carer Voices and Scotland's House of Care over the past year at the ALLIANCE.

I started my first opinion piece – two months into joining the ALLIANCE’s Dementia Carer Voices project – with a quote from Don Berwick, President of Institute for Healthcare Improvement: “The heart of improvement is not in controlling, it is in unleashing.” In the proceeding eight months much has happened – Dementia Carer Voices has received 17,000 personal pledges to make a difference, produced a report and I have moved within the ALLIANCE to Scotland’s House of Care programme– all the while I have been thinking a lot about this quote. For me, it really captures the work of Dementia Carer Voices, the House of Care and the ALLIANCE more broadly.

I was especially thinking about this quote when I went to hear my colleague, Tommy Whitelaw, speak at Wishaw General Hospital in Lanarkshire on the 19 December. In my role with DCV I have heard Tommy speak at least half a dozen times, but it always moves me to hear about the compassion and commitment to quality care showed by the nurse he met when he was at his lowest. He asks the health professionals present to “Be like that nurse” and says they do the best, most important job ever invented – caring for people, day in, day out – getting up yesterday to care, getting up today to care, and getting up again tomorrow to provide invaluable care.

It always moves me – even though I’ve heard it many times, even though I know this story, I have read it, or versions of it, many times. I had the pleasure of putting together the report Dementia Carer Voices – Rights and the Carer Voice and when I was reading through the pledges from health and social care professionals I realised how much care and compassion there is out there in the profession. If it were possible to boil down the message of the health and social care professionals we spoke to one line it would be to emphasise the need to move away from a time and task approach to care and towards caring with care and compassion. The health and social care professionals often expressed frustration that systems got in the way of them fulfilling their pledges to show more care and compassion in the work they do. A typical pledge reads:

“I pledge to always treat people in my care as individuals and with respect and compassion, in spite of the time pressures of the ward environment”

This, to me, shows the kindness, compassion and warm-heartedness of the people in our health and social care profession.

I have now moved on to a new role within the ALLIANCE – I have become the Development Officer for House of Care. There is a great continuity in the work of Dementia Carer Voices and in the work of House of Care. An important part of House of Care is about emphasising the humanity of the people delivering care and support. The right hand wall of the House of Care model is ‘Health and Care Professional team committed to partnership working’. It struck me at this talk in Lanarkshire that a large part of what Dementia Carer Voices does, what House of Care does and what the ALLIANCE more broadly, seeks to do, is to unleash the care, compassion and kindness of those in the health and social care profession. It’s not about controlling, it’s about unleashing and ensuring that structures and processes don’t get in the way of this care and compassion.

The House of Care serves as a great model for what we do, not only in Dementia Carer Voices, but throughout the ALLIANCE. Without a strong right hand wall there, the house cannot stand and we cannot achieve person centred care and supported self management approaches, based on meaningful conversations. It comes back to the idea of what we do being about unleashing, not controlling. If Dementia Carer Voices, the House of Care and the ALLIANCE more broadly can unleash compassion, care and consideration in to every one of the human contacts in the health and social care system we will make our health and social care system better for all who engage with it and work within it.

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