{"id":44857,"date":"2019-06-20T18:14:54","date_gmt":"2019-06-20T17:14:54","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=44857"},"modified":"2019-07-01T13:29:44","modified_gmt":"2019-07-01T12:29:44","slug":"katie-knight-mind-the-generation-gap","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2019\/06\/20\/katie-knight-mind-the-generation-gap\/","title":{"rendered":"Katie Knight: Mind the generation gap"},"content":{"rendered":"<p class=\"standfirst\">Generational representation should be seen as another important aspect of diversity, says Katie Knight<\/p>\n<p><!--more--><\/p>\n<p><span style=\"font-weight: 400\">I would guess there was over 1000 years of combined NHS experience within the room<\/span><span style=\"font-weight: 400\">. C<\/span><span style=\"font-weight: 400\">hief executives, career NHS managers, board members, professors, postgraduate deans, chiefs of nursing, heads of HR. And me<\/span><span style=\"font-weight: 400\">\u2014<\/span><span style=\"font-weight: 400\">a trainee paediatrician, who depending on which definition you use, just about scrapes into the \u201cmillennial\u201d category. Over a series of roundtable discussions we were asked to come up with \u201cnovel and innovative solutions\u201d to a range of issues relating to the NHS Long Term Plan. We were acting as the assembled representatives of the NHS, although we were nothing like as diverse as a random sample of NHS workforce would be. I listened, nodded, and silently fumed at some comments<\/span><span style=\"font-weight: 400\">\u2014<\/span><span style=\"font-weight: 400\">more than once, \u201cmillennial lifestyle choices\u201d were proposed as a main reason for the staffing crisis in the NHS. <\/span><\/p>\n<p><span style=\"font-weight: 400\">Once I\u2019d drowned out the impostor syndrome internal monologue, I dared to politely disagree on a few things and raise a new point here and there. My comments were warmly welcomed as a voice of \u201cyouth;\u201d some senior leaders seemed unusually interested in what I had to say&#8230; then I had the sudden and uncomfortable realisation that some of these vastly experienced people had just <\/span><i><span style=\"font-weight: 400\">never asked<\/span><\/i><span style=\"font-weight: 400\"> anyone in my relatively junior position what they thought about the systemic issues that affect all of us, or what we thought could be done differently. <\/span><\/p>\n<p><span style=\"font-weight: 400\">I wish this meeting was the exception. I\u2019ve spent the past few months away from clinical practice on a fellowship learning about NHS leadership and management. I\u2019ve frequently found myself in meetings where I am the only trainee, while issues are discussed, and decisions made, that might drastically change our experience of working on the front line of healthcare.<\/span><\/p>\n<p><span style=\"font-weight: 400\">The fundamental problem is this: the problems we face in the NHS today are complex and in need of radical solutions<\/span><span style=\"font-weight: 400\">\u2014<\/span><span style=\"font-weight: 400\">solutions which might completely change the landscape of the way we deliver healthcare.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Without the input of those who will be working and leading in this environment in the next five, ten, twenty five years, what bright spark of innovation could we be missing? Are we designing systems in which they could or would not want to work? Could \u201csolutions\u201d proposed by an unrepresentative group of individuals have the unintended consequences of making things worse for the very people they are trying to serve?<\/span><\/p>\n<p><span style=\"font-weight: 400\">There is no substitute for experience. The insight and knowledge of those who\u2019ve gone before, plus the wisdom of hindsight is absolutely invaluable. But if you genuinely want innovation, surely combining all of this experience with the fresh perspective and long term goals of people who will be working in the system for decades to come is the only way to truly change the status quo.<\/span><\/p>\n<p><span style=\"font-weight: 400\">The diversity and representation agenda within the NHS is finally waking up and stumbling towards the present. In 2019, I\u2019d argue that efforts so far are limited and have been muted in their success. <\/span><i><span style=\"font-weight: 400\">Some <\/span><\/i><span style=\"font-weight: 400\">medical conferences are actively trying to curate a 50:50 gender balance of speakers, and to avoid all-male panels (manels). The Workforce Race Equality standard (WRES) has been in action since 2015\/16; the 2018 report showed that the proportion of BME staff in very senior manager positions increased from 5.7% in 2017 to 6.9% in 2018. A very small shift, and still way off the mark in terms of the proportion of BME staff (19.1%) in NHS trusts. <\/span><\/p>\n<p><span style=\"font-weight: 400\">There is so much further to go for the NHS to achieve anything like the diversity it should for all protected characteristics, across all leadership and management structures. And while we double down on these efforts, I believe that generational representation should be seen as another important aspect of diversity. <\/span><\/p>\n<p><span style=\"font-weight: 400\">Younger generation representation can and should be happening everywhere. There is nothing to stop a trust board encouraging more junior clinical staff, or even undergraduate student representation, at executive or board meetings. Or for that matter, appointing a non-executive director who is under 30. How many consultant meetings or senior nursing meetings invite a representative from the junior ranks? <\/span><\/p>\n<p><span style=\"font-weight: 400\">Let us millennial(ish) and gen-Z&#8217;s into the room. Let us soak up the experience of those who\u2019ve been around the block\u2014but also hear our opinions and give us a say in how big changes are made\u2014after all we are the ones who will have to bear the consequences when we are (hopefully) still working within the NHS twenty, thirty years down the line. <\/span><\/p>\n<p><em><b><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/06\/KKpic.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-44858\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/06\/KKpic-150x150.jpg\" alt=\"\" width=\"150\" height=\"150\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/06\/KKpic-150x150.jpg 150w, https:\/\/blogs.bmj.com\/bmj\/files\/2019\/06\/KKpic.jpg 442w\" sizes=\"auto, (max-width: 150px) 100vw, 150px\" \/><\/a>Katie Knight<\/b>\u00a0is a p<span style=\"font-weight: 400\">aediatric emergency medicine registrar, National Medical Director&#8217;s Clinical Fellow at Health Education England, and Founder\/Lead Editor, <\/span><a href=\"http:\/\/www.paediatricfoam.com\/\"><span style=\"font-weight: 400\">paediatricFOAM.com<\/span><\/a><\/em><\/p>\n<p><em><strong>Competing interests<\/strong>: None declared<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Generational representation should be seen as another important aspect of diversity, says Katie Knight [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2019\/06\/20\/katie-knight-mind-the-generation-gap\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":38759,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[236],"tags":[],"class_list":["post-44857","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nhs"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - 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