Hospital bosses forced to chant ‘we can do this’ over A&E targets

Hospital bosses were forced to chant “we can do this” by a senior NHS official in an effort to improve their accident and emergency performance in advance of what doctors have warned will be a tough winter for the NHS.

Hospital trust chief executives say they were left feeling “bullied, patronised and humiliated” by the incident last week at a meeting attended by Jeremy Hunt, the health secretary, and Simon Stevens, the head of the NHS in England.

The leaders of about 60 trusts which NHS national bodies deemed to have the worst record on meeting the politically important four-hour A&E treatment target were called into a meeting held in London on Monday 18 September.

Chief executives present say that they were divided into four regional groups, covering the south and north of England, London, and the Midlands and east of the country, each of which held a separate session with a senior NHS England official.

Paul Watson, NHS England’s regional director for the Midlands and east of England, then encouraged those in the group he was leading to chant “we can do it” as part of a renewed effort to improve their A&E performance. Hunt and Stevens are not thought to have been at that session; nor was Jim Mackie, chief executive of health service regulator NHS Improvement, who jointly convened the meeting with Hunt and Stevens.

One chief executive said: “It was awful – the worst meeting I’ve been at in my entire career. Watson said: ‘Do you want the 40-slide version of our message or the four-word version?’ Everyone wanted the four-word version, obviously.

“He then said ‘I want you to all chant ‘we…can…do…this’. It was awful, patronising and unhelpful, and came straight after the whole group had just been shouted at over A&E target performance and told that we were all failing and putting patient safety at risk.”

According to the Health Service Journal, which revealed what had happened at the meeting, Watson told trust bosses that they were initially chanting too quietly and that they should chant the slogan again but louder, and “take the roof off” with the noise.

Watson’s use of the tactic has prompted complaints from within the NHS that the chanting was “Bob the Builder for NHS leaders”, after the children’s TV character Bob the Builder with his “Can we fix this? Yes we can” catchphrase. Another HSJ reader posted a comment on its website saying: “More akin to North Korea than the NHS”.

Anger and ridicule directed at Watson have prompted him to apologise for and explain his behaviour in messages he posted on the HSJ website since it published the story.

“If anyone found my session on Monday inappropriate in any way then I can only apologise – it was meant as light relief rather than brainwashing,” said Watson.

“As I said at Monday’s event, this can be done. If that seems cheesy or patronising then so be it but it does have the merit of being true – Paul”, he added.

He also repeated his claim that inadequate A&E performance endangered patients’ safety.

“It’s good to let off steam but let’s remember what’s at stake here: 1 Urgent care is the most basic service the NHS provides; 2 A badly run, crowded ED [emergency department] is a miserable experience for our patients; 3 These patients are often frail, elderly and frightened as well as very ill; 4 A crowded ED can be dangerous.”

If other trusts could provide excellent A&E services despite the rising demand for care, why could the 60 represented at the meeting not do that, he asked. He also angered trust bosses by saying that “the biggest single determinant of whether a struggling service is turned round is the confidence, optimism and determination of local leadership to do this and follow it through”.

The Guardian has approached NHS England and the Department of Health for comment.

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