I am sat here with my morning coffee just reflecting that the Corona challenge has shown some brilliant strengths in the NHS culture and operations and character of staff, right alongside some typically British/(or perhaps English?)/NHS-y traits. I will try to explain

extraordinary just how quickly staff in acute (& primary) care have completely reorganised workstreams, wards, nature of work, location of work, created extra capacity out of nowhere, signed off and implemented escalation plans. Much of this well before any directives from NHSE/I

equally extraordinary to see how even in the face of personal risk (and sadly risk to own families) and some fear/anxiety/moral distress people have just cracked on with it out of professional values, loyalty to patients, organisation, NHS and solidarity with colleagues

the mutual support, information & good practice sharing, free education, and fantastic resources, guidelines, on healthcare social media and from colleges, speciality societies has been fantastic and with great receptiveness to learning from colleagues overseas

and although our systems are sometimes criticised (rightly in some regards) for being over-centralised too "top down" our existence as a genuinely national health service (yes yes, i know all about the recent critiques but..) has enabled national initiatives, national guidance

if you think about how quickly we have produced a suite of NICE guidance, PHE and NHSE/I resources, resources and guidance from colleges and specialist societies, the key UK medical journals repurposing their work etc in weeks, emergency legislation etc it has been v impressive

so what would be a downer? I won't dwell on the obvious trickiness around responsbility/power/alignment betweeen politicians Vs scientific advisors, vs SpADs vs Civil Servants vs senior management of NHS and PHE and sometimes poor and inconsistent comms. That is a given

or the well documented issues re responsiveness, preparedness, supply lines, learning from previous pandemic exercises which highlighted unmet need. Or underlying structural issues round beds, ICU beds, workforce gaps, social care and public health funding, We know all that

No. What i mean is that the v same discretionary effort eye rolling, shoulder shrugging, piss-taking, gallows humour, banter, "importance of not being earnest" attitude that has NHS frontline going beyond call of duty, sustaining one another through doubled shifts & scary times

that very same attitude means we all kinda slightly fatalistically, slightly resigned have a "there is probably a virus with my name on it whatever i do" vibe where we know we don't have enough PPE or tests or enough ability to do social distancing or obsessional surface cleaning

and i sometimes wonder if that very NHS/very British combination of "make do and mend" "It is what it is" alongside that tremendous team effort and flexibility and committment we have shown, where we play down probs and make a joke of them to get through, is an issue

my wife thinks i should be far more angry than i am and less resigned/fatalistic e.g. about the inevitability of staff teams who have to work closely together and share some of the same spaces being at risk. She is all "Don't just *tell* me about it! Stop it"

or perhaps she has gone all Eliza Dolittle "Don't talk of gloves! Show me!"
ENDs

One more! We cannot and must not tolerate a culture where trust bosses and NHSE/I/PHE are so concerned about news management/reputation that frightened or angry shopfloor clinical workers who speak out in public are threatened or gagged.Or where they feel they have no alternative