It’s my fourth month working for public health in the local authority and I’ve had yet another request to join a stakeholder meeting. This time it’s from NHS England to hear about a new immunisation pilot … and the meeting will be held in Wimbledon. Wimbledon? We work 30 miles away in Havering… I have a real practical problem in releasing one of my few staff to travel long distances at some financial and time expense to attend a meeting. We have small teams dealing with large agendas and need to use our time carefully.

The default pattern for new initiatives is to invite large numbers of people to a face to face meeting, often where we and our teams sit through a number of power points and do questions and answers afterwards. This is the kind of engagement that can be done online. I am really struck by how the use of staff time is just taken for granted here. This would just not be acceptable in the private sector where time actually is money, or in other settings where distance really is a problem (e.g. my three years in NE Queensland managing a multi centre new medical school, where a face to face meeting required an airplane, thus sharpening the criteria for calling one).

We are no longer in NHS land where it was considered normal to summon large numbers of people to big meetings for what was called consultation, but often was simply information being passed down or views being sought. Folks got a bit lazy. Need to get word out to lots of people? Stick on a workshop, gather key people to make a presentation, have a rather lame discussion, perhaps with breakout groups if you really want to be innovative, then type up the flip charts and tick the box that says consultation and engagement. The best bit was the coffee and lunch breaks where you could chat.

For the Wimbledon invite, a fellow Department of Public Health colleague negotiated a satellite meeting, 10 miles away in Newham. Somewhat easier, but I am now thinking we should go a step further and ask—why is this meeting needed at all? What will happen at it that needs to be done face to face? Is there another way of engaging with stakeholders that would better match the new world? How much would we save in time and money if we worked differently? What would we lose—the intangible benefit of seeing colleagues in another part of London, a shed load of powerpoints, and the chance to catch up on emails during the boring bits.

I think our national bodies, and in particular NHS England and Public Health England need to appraise how they engage with us and with other stakeholders. I encourage all signs of interest to come out to local authorities and understand this new environment. I encourage them to think how they move away from disease or initiative based engagement into other ways of engaging with us, on lots of things from data to programmes. And I encourage everyone to tot up the cost of a large stakeholder engagement and ask—is this really the only way to do this?

Time for a rethink.

P.S. I have nothing against Wimbledon.

Mary E Black is a director of public health in London. Twitter:@DrMaryBlack