How can I prepare for a general election?

Recognise that others may respond differently

Jason Hancock, consultant psychiatrist, director of medical education and clinical education researcher, Exeter, says, “For all doctors, our places of work, our teams, and our local systems exist in a wider context.

“Politics is an important part of this wider context and a general election represents the possibility that the context in which we all work and exist will change.

“As we prepare for this, it’s important to recognise that how each of us respond to this significant event will differ. For some the prospect of a change in government and the associated uncertainty might be a reason for optimism. Others may feel unsettled at the possibility of a period of prolonged uncertainty and change.

“Both as individuals and as members of the clinical workforce it’s important for us to recognise and acknowledge that these varying responses exist, and that our own response may not be the same as that of our colleagues or our patients.

“How we respond to uncertainty has the potential to influence the way we make clinical decisions, the way we behave, and the way we experience stress or anxiety in the workplace.

“Our research1 suggests that only through drawing conscious attention to and reflecting on our experience of uncertainty can we gain insight into our psychological, cognitive, and behavioural responses to this phenomenon. This becomes even more important as the uncertainty around us increases.

“Our research also suggests that as clinical leaders it may be helpful to share some of our own vulnerabilities and uncertainties with our colleagues and patients. This role modelling alongside good quality supervision can support more junior colleagues to reflect on their own experiences of uncertainty, and the impact these have on their emotions, thoughts, and actions.”

There won’t be drastic change

Sarah Woolnough, chief executive of the King’s Fund, says, “Anyone following the campaign would be forgiven for thinking the general election will be an epoch defining moment for the health service. In fact, history tells us that elections are rarely a significant inflection point for the NHS.

“If we look at the past few decades, particularly the elections that brought a change in party, the changes in government did not produce rapid transformation in the NHS. Instead, changes to ministers and subsequent general elections proved more important for the health service than the immediate change of government. The Blair administration illustrates the point neatly. Labour came to power in 1997, but it wasn’t until 2000 that the government published its NHS plan.

“It’s unlikely that things at work will feel drastically different in the coming months. Unfortunately, staff shortages, burnout, and low morale are all likely to continue to be evident in next year’s NHS staff survey results. Similarly, public satisfaction with the NHS is likely to stay at low levels for the immediate future.

“Having said that, I don’t think we should be too pessimistic. The NHS rarely experiences huge transformation around the time of an election, but there will be some government policies that soon become noticeable.

“The three largest political parties in England have recognised the need to bolster the health and care workforce and improve working conditions. The Conservative manifesto pledges to improve conditions for all NHS staff. Labour pledges a reset in relations with NHS staff and the creation of a royal college of clinical leadership. And the Lib Dems want to implement a 10 year retention plan for NHS staff.

“A key test for the new government will be how they balance these ambitions to recruit and support staff with their promises to eradicate long waits for care. Whoever holds the keys to number 10 must balance the need to support the already stretched NHS workforce with their promises of rapid improvement to services. We all hope they avoid the counter-productive temptation to reach for aggressive performance management.”

Health and politics are intertwined

Fiona Day, chartered coaching psychologist and medical and public health leadership coach, says, “Health is an industry—where there’s money there’s politics. If you work in the NHS it’s easy to forget you’re working not only for patients but also for politicians—the wider political context shapes every healthcare interaction.

“There is vast evidence that good (and equitable) health underpins all aspects of wellbeing for society.2 The Labour,3 Conservative,4 and Liberal Democrat5 parties explicitly include the NHS in their current pre-election pledges.

“Clinicians and health leaders are likely to be nervous about the outcome of the election. Assurances from party leaders in the past—for example, that ‘there will be no top down reorganisation of the NHS’6—do not always translate into reality.

“I remember when the coalition government’s health white paper was launched in 2010.7 Much of the local health community were together at an event, we were all on our phones in the lunch break trying to get our heads around the scale of the changes. Most of the next three years was taken up with planning (my team was split into three different organisations, two of which didn’t yet exist), and it then took several years to re-establish the system.

“We’re all likely to experience a range of emotions around an election, including disengagement, anger, disappointment, hope, and optimism. The political landscape following a general election is unknowable, and surprises can and do happen. Even if the party we personally ‘hope’ for gets into power, it’s a long road to effecting and sustaining positive change.

“The only real control we have is in exercising our vote for our local MP, so let’s hope that a ‘thoughtful analysis of what is needed’ occurs,8 whatever the outcome, and that whoever does wield power is adept in dialectical thinking and understands that there are no simple solutions for complex problems.”