{"id":19924,"date":"2012-08-30T16:56:14","date_gmt":"2012-08-30T15:56:14","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=19924"},"modified":"2012-08-30T16:56:15","modified_gmt":"2012-08-30T15:56:15","slug":"pritpal-s-tamber-the-red-hand-gang-of-healthcare","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2012\/08\/30\/pritpal-s-tamber-the-red-hand-gang-of-healthcare\/","title":{"rendered":"Pritpal S Tamber: The Red Hand Gang of healthcare?"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/2012\/06\/21\/pritpal-s-tamber-soft-wiring-knowledge\/pritpal_tamber\/\" rel=\"attachment wp-att-18113\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-18113\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2012\/06\/pritpal_tamber.jpg\" alt=\"\" width=\"160\" height=\"130\" \/><\/a>I think I\u2019ve joined a gang. I\u2019m not sure only because it was first billed as a cabal. I\u2019ve since looked up what cabal <a href=\"http:\/\/en.wikipedia.org\/wiki\/Cabal\">means<\/a> and I suspect it\u2019s too private for what this gang\/cabal is wanting to do. Besides, I prefer gang, if only because it makes me think of the <a href=\"http:\/\/en.wikipedia.org\/wiki\/The_Red_Hand_Gang\">Red Hand Gang<\/a>\u2014inner city kids taking care of their own manor; it\u2019s not a bad analogy.<\/p>\n<p>Quite what the gang is, is best described by the invitation email: \u201cIt might be nice\/informative\/sinister for a group of UK health technology\/social media\/buzzword types [to get] together in a room to discuss some of the interesting developments that have been going over the past year or so. We\u2019ve had open data from the government (yay), an information strategy (yay), a clear vision of\u00a0 \u2018every willing patient a research patient\u2019 (yay), and a lot of rain.\u201d<!--more--><\/p>\n<p>When I first got the email, I was worried it would be the usual suspects getting together, rubbing their chins, quoting stuff they\u2019ve seen on Twitter (that they\u2019ve not remotely understood), proffering opinions, all while having little to no real life experience of what it takes to make any of this happen in the NHS. The next sentence in the invitation email, however, suggested it would be different.<\/p>\n<p>\u201cHowever it feels like those of us at the sharp end are now getting on with the hard bit: implementing the revolution.\u201d<\/p>\n<p>It was different. Most of the people in the room were entrepreneurs in one way or another. I\u2019m not talking about the glamorous world of <a href=\"http:\/\/en.wikipedia.org\/wiki\/Dragons'_Den_(UK)\">Dragon\u2019s Den<\/a>. These are people working hard to make their ideas a sustainable, commercial reality, whether it\u2019s for- or not-for-profit. It\u2019s often a hand-to-mouth existence and failure is far more likely than success.<\/p>\n<p>Quite what the gang is going to do is yet to be decided. However, one of the founders suggested it needed to be about helping each other to make their ideas the inter-connecting pieces of the jigsaw that are going to be needed if the information revolution is ever going to happen. There was also the suggestion that membership in the group needed to be restricted to those who really had skin in the game\u2014those whose rents or mortgages depended on it. This is best described in the illustrative story sent in the follow-up email:<\/p>\n<p><em>Pig and Chicken are walking down the road. The Chicken says, \u201cHey Pig, I was thinking we should open a restaurant!.\u201d Pig replies, \u201cHmm, maybe, what would we call it?.\u201d The Chicken responds, \u201cHow about \u2018Ham-n-Eggs\u2019?\u201d The Pig thinks for a moment and says, \u201cNo thanks. I\u2019d be committed, but you\u2019d only be involved!\u201d<\/em><\/p>\n<p>I like the idea that group membership might be restricted\u2014well, more proactively sought\u2014to those people that have a lot to lose. It reduces the rhetoric and increases the focus on what to do, and what ideas to test in the real world.<\/p>\n<p>I hope the group is able to add some reality to the recent good-but-impotent <a href=\"http:\/\/informationstrategy.dh.gov.uk\/\">Information Strategy<\/a>. Not talking about agreeing data definitions or experience design were massive failings, to my mind; the strategy\u2019s bizarre focus on &#8220;portals&#8221; being a clear indication of trying to scrape some value out of the disparate systems now a legacy of the National Programme for IT, rather than any true blue-sky thinking (or perhaps they succumbed to lobbying from <a href=\"http:\/\/www.intellectuk.org\/\">Intellect<\/a>).<\/p>\n<p>Normally I follow the Groucho Marx rule about clubs: \u201cI refuse to join any club that would have me as a member,\u201d he apparently said. I fear that clubs\/gangs\/cabals ultimately promote <a href=\"http:\/\/en.wikipedia.org\/wiki\/Groupthink\">group think<\/a>, no matter how disruptive or nobel their initial aims. For the moment, though, this gang has the potential to be something different. It has the potential to be about the real world of the NHS, about the true difficulties of getting traction with good ideas, and, hopefully, about being blunt with the NHS\u2019 leaders (some of whom already seem to be trying to co-opt the gang even before its first meeting).<\/p>\n<p>Bluntness is something I like. There is not enough of it in the NHS, or healthcare, in general. If there was it would not be ok to be performing as badly as we are (if you feel like defending the NHS at this point, take a brief moment to reacquaint yourself with the <a href=\"http:\/\/www.rightcare.nhs.uk\/index.php\/atlas\/atlas-of-variation-2011\/\">2011 Atlas of Variation<\/a>). It\u2019s for that reason that I applaud the suggestions from within the gang to disallow the <a href=\"http:\/\/www.chathamhouse.org\/about-us\/chathamhouserule-translations\">Chatham House rule\u2014<\/a>enough with the cloak and daggers, let\u2019s call a spade a spade.<\/p>\n<p>The Red Hand Gang is not a bad analogy because just like the resource-poor, inner city kids of the show, we\u2019re trying to create positive change in our back yard with a similar level of resources. I hope, though, the analogy doesn\u2019t prove too prophetic given that the show was cancelled half-way through its first series and two of the stars died by the age of 40. Then again, perhaps that\u2019s what\u2019s made it so memorable.<\/p>\n<p>I\u2019ll let you know what happens next.<\/p>\n<p><em><strong>Competing interests<\/strong>: I don\u2019t believe I have any competing interests in relation to this post.\u00a0<\/em><\/p>\n<p><em><strong>Pritpal S Tamber<\/strong> is the director of Optimising Clinical Knowledge Ltd, a consultancy that helps organisations improve how they use established clinical knowledge. He was previously the medical director of Map of Medicine Ltd, a company that creates clinical pathways to help health communities design services. He was the editorial director for medicine for BioMed Central Ltd and he was also the managing director of Medicine Reports Ltd. He has twice been an editor at the BMJ, the first time as the student editor of the Student BMJ.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>I think I\u2019ve joined a gang. I\u2019m not sure only because it was first billed as a cabal. I\u2019ve since looked up what cabal means and I suspect it\u2019s too [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2012\/08\/30\/pritpal-s-tamber-the-red-hand-gang-of-healthcare\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5680],"tags":[],"class_list":["post-19924","post","type-post","status-publish","format-standard","hentry","category-pritpal-s-tamber"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Pritpal S Tamber: The Red Hand Gang of healthcare? - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2012\/08\/30\/pritpal-s-tamber-the-red-hand-gang-of-healthcare\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Pritpal S Tamber: The Red Hand Gang of healthcare? - The BMJ\" \/>\n<meta property=\"og:description\" content=\"I think I\u2019ve joined a gang. 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