23rd June 2023
Karen Pilkington

You could tell we were up for a party. Despite it being a baking hot evening, we crammed over 100 people together for food and relationship building. Young people and residents rubbed shoulders with practitioners working in the community, managers, and one or two senior leaders—although we consistently struggled to get them out of offices and meetings to come and join us.

In the room, the connections were obvious, and the chat happened naturally. Some of the key takeaways were:

"Be curious. It's ok not to have a concrete plan."

"Sometimes the best plan can be to keep an open mind, listen, and see where it leads you, rather than using a plan which has an anticipated defined outcome."

"Not knowing how change will happen is good, and leaves you open to real collaborative action."

"Forget about policies and regulations—start from the bottom. Simple little steps are more beneficial than very big words."

"Primary care really wants to support their communities, but there are many barriers, including funding and structures."

"Listening with like-minded people is good but needs to lead to joined-up actions with various organizations and relating this to those higher up in those organizations."

"I want to work with some of these amazing people for the benefit of service users, but how? Time and money are short for all."

There were some radicals in the room. We spoke of Gramsci and hegemony and how hand-holding and information sharing across services should be the norm. We called for one whole day a month for people working in services to stop and reflect with others. And we held a tension that we increasingly sat in between this and "less talking, more action."

However, in a room filled with people predominantly working directly with the people they support, it was clear that there was incredible capacity to "look, learn and listen"; "to offer positive but critical support and use your energy to help, not drag others down"; and to "be prepared to compromise, get involved and share ideas."

We recognized a need for urgent system change even though change is scary and unsettling, and the need to slow down to facilitate this. We defined the system as equalling people with a web of choices and decisions and felt an urge to "choose wisely."