When was the last time you had a proper lunch at work? I bet you are reading this munching a sandwich at your desk, or squeezing in a bit of reading in the 30 seconds you have between appointments. The reality of the modern NHS, or indeed, a busy private practice is that it’s often a treadmill of patient after patient, and meeting after meeting. With commissioners, managers, or insurers on your back wanting an ever tighter focus on outcomes and patient numbers, is it no wonder that all of us become narrower in outlook, self-siloing, concentrating on getting the job done. Whilst there is a certain amount of hairshirt credibility and self-justification to be had, this presenteeism is at the cost of relationships, creativity, and flexibility.
An answer, albeit maybe just a tiny part of an answer, is to reclaim lunch for us as human beings, our services, and most of all our patients. How so, we hear you cry? Even if it’s not every day, lunch has the potential to give birth to great ideas, solve intractable problems, and sort apparently irreconcilable differences.
Institutions of all sorts have maybe had their day, but they certainly knew how to do lunch. The older reader may remember oak panelled doctors’ messes; a later generation will remember the proper canteen. Lunch was often at a set time and almost enforced…well, if you wanted to get on in your career, it was. Empires, real or imagined, began and flourished at those lunches. You could approach a manager, sit down with them, literally break bread. Lunch was a place to do business. Non-UK cultures still place great store by doing business over food.
Lunch can be a place to do strategic service development. A kind of clinical companionship. An invitation to lunch can disarm even the most evasive and defensive commissioner or manager. Lunch has a comfortable ritual about it as well as being a necessity. It can be the “nice warm social bath” that Michael Argyle the eminent social psychologist used to describe. It’s a place where you can ask about the kids, what you’re going to do at the weekend, where you’re going on holiday. Outside the starchy and stressful confines of that windowless office, and inside a shared humanity, maybe defences can be let down, maybe you can chance your arm…”remember that service we were talking about. How can we make it work?”
At lunch, you can catch up with that colleague of yours. At lunch, you can bounce ideas off each other, create that small acorn. At the same time, you could ask, “I’ve got this patient who’s really complex…. what do you think?” Finishing their mouthful, maybe because they’re polite, but maybe also to think a little, they try out an answer. Nobody else is listening; they’re not going to be judged. Maybe something creative and not a little magical might emerge? It can also be just as effective when addressing a tricky issue with a colleague. “I need some help with this dilemma. Can you help?” Maybe in that warm social bath even long standing enmities can lessen. There’s nothing to prove there. “Perhaps we can work something out…this has gone on too long.” Maybe the most important thing is that lunch is kind, fair, and caring. It’s the place where we might relax just a little and rediscover even just a little of our humanity. We’d all benefit from that surely?
Gavin Newby, Consultant Clinical Neuropsychologist, Newby Psychological Services Ltd.
Helen Bichard, Rehabilitation Assistant, Cheshire & Wirral Partnership NHS Foundation Trust.
Niall Campbell, Psychiatrist, Cheshire & Wirral Partnership NHS Foundation Trust.
Mahesh Odiyoor, Consultant Psychiatrist, Cheshire & Wirral Partnership NHS Foundation Trust.
Colin Pinder, Consultant in Neurological Rehabilitation, Wirral University Teaching Hospitals NHS Foundation Trust.
Competing interests: None declared.