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Above the parapet

Why should clinicians put their heads above the parapet and try to change the NHS? Practical Commissioning editor, Sue McNulty, may have found some inspiration in a parochial feature

I keep thinking about Steve.

His nickname is Village Big Man and he was the subject of a 6-page feature in the FT weekend magazine a couple of weeks ago.

Steve was a city exec who retired to the country and found a new lease of life keeping the local pub open – he and a few friends bought it. He sits on the church committee - the journalist was roped in for the churchyard mowing rosta. It is cricket though that Steve has really made his mark. When he arrived the cricket club had one team playing friendlies on a Sunday. Now Steve has arrived and it has 17 teams and professional coaches from New Zealand and South Africa driving around in sponsored cars. On the club's website there is a 1200 word paper detailing the club's five year strategy.

What I liked about Steve though is that while he's achieved a lot, reading between the lines it looks as if he had to take a fair amount of flak for what he was trying to do, but he hung on in there.

He says people mutter about his ubiquity and a friend at a recent meeting criticised him for treating the cricket subscription rates in a too business-like manner. Steve says he knows some villagers are asking ‘is this a takeover?'

Reasons for not becoming involved with clinical leadership chime with what Steve has experienced.

Why should clinicians come out of their silos and try to change the NHS?

It's not in their job description, they must get better offers than attending PCT meetings and managers are often very scared of doing something brave and innovative.

I spoke to a pharmacist the other week who was setting up a onsite family planning/sexual health service. To get a clinical waste bin sorted took six weeks and being passed around between three different managers.

I would say it's about the eyes on the prize. I asked one GP who I won't embarrass why he was so passionate about PBC. ‘Look, I'm retiring in a few years and my patients might say he was a good GP which is very nice, but I want to feel I've actually changed something before I go'.

Most clinicians I speak to are on the other side of having achieved something and are very proud of what they've done.

For those of you still chipping away, stick with it. There are no obstacles, only objectives I keep quoting to myself – not when I'm at work mind, but usually when I'm organising the craft stall for my children's school summer fayre! Heavy stuff.

The DH is sponsoring a session 'Driving change from the coalface' at the forthcoming NAPC annual conference

Editor, Sue McNulty