The book takes as its starting point the crisis of healthcare in the UK: impossible health targets managed through command and control management and a stomach-churning rise in racism, whistleblowing and victimisation in the NHS. The use of nationally set productivity targets combined with austerity cuts have increasingly put clinical best-practice into direct conflict with funding. Health targets have become politically controlled, and performance has become a cynical exercise in ticking boxes, cascaded within trusts and bulldozed through frontline services. This has led directly to a precarious system of employment relations, subject to the continual restructuring of services rather than the goal of creating functioning interdisciplinary teams that stand a chance of capturing clinical excellence.
This book is written for workers and managers who are on the frontline of the battle for decent healthcare. The content of this book is based on the ‘ordinary’ expertise of the people who are actually surviving it and helpful ideas about making the best out of a bad lot.
Surviving Work in Healthcare will be of interest to healthcare professionals and anyone working on the frontline of healthcare as well as students of management, human resources and psychology.
Table of Contents
Preface Chapter 1. Understanding Healthcare Systems Chapter 2. Start where you are Chapter 3. Precarious Work Chapter 4. Precarious Workers Chapter 5. Walk the Line Chapter 6. Groups and Gangs Chapter 7. How to make friends and influence people Chapter 8. Making the best out of a bad lot Chapter 9. Helpful Stuff for Human Beings
Dr Elizabeth Cotton is a writer and educator working in the field of mental health at work. She teaches and writes academically about employment relations and precarious work, business and management, adult education, solidarity and team working. Elizabeth worked as an organiser and educator for the Miners' International and has worked with activists from thirty-five developing and transition economies. She has worked as a psychotherapist in the NHS and runs Surviving Work (www.survivingwork.org), a free resource for working people on how to do it. She has recently set up a joint resource with the Tavistock and Portman NHS Foundation Trust for people working on the frontline of healthcare (www.survivingworkinhealth.org) and is currently researching future trends in mental health services and jobs in the UK.
"The book provides concrete action items for solving workplace bullying, all while exploring pros and cons, what’s worked and what hasn’t, why something is or isn’t... The discussion is powerful and profound, while the action items are definite and palpable."
Catherine Mattice, MA, SPHR, SHRM-SCP, International speaker, consultant and author of BACK OFF! Your Kick-A$$ Guide to Ending Bullying at Work
"A wonderfully refreshing analysis that weaves a sophisticated and accessible analysis of healthcare, work relations, politics, and mental health while still managing to retain some optimism about the tricky task of surviving work."
Melanie Simms, Professor of Work and Employment, University of Leicester
"Elizabeth Cotton is an innovative, creative thinker who turns her 'talk' into 'walk'. She has immense experience of listening to and working with front line staff who are trying to grapple with the impact of workplace stress, bullying, harassment and discrimination. She is fortunate to ally that with extensive knowledge of the theory and practice of mental health. We have much to learn from her, not just as individuals seeking to demonstrate resilience in the face of toxic pressures, but in how to develop collective approaches to the challenges we all face at work."
Roger Kline, NHS Workforce Race Equality Standard
"This book is a must for those working in mental health services, either as clinicians or managers. Written by a clinician and trade unionist it provides a unique approach to understanding and addressing the pressures at the front line of care and how to survive in our working environment."
Clare Gerada, Practitioner Health Programme
"If you want to be informed about the general climate of the health and helping professions you could not do better than invest in this new publication. It is based on a wide range of in-depth interviews and research, and will put you fully in the picture of both difficulties and opportunities in this field."
Anton Obholzer emeritus Chief Executive, Tavistock Centre
"I am forever grateful to Elizabeth Cotton for the oxygen that her thinking and writing delivers. She understands those of us working on the frontline and can say the things we often can’t. This book is not just a survival manual for work, it takes us on a personal and relational journey. Food for thought and action."
Chris Manning, Action for NHS Wellbeing
"This is an innovative and important book based on an engaging and thoughtful approach to the question of healthcare work and its day to day challenges. It deals with the realities of work in a thoughtful yet hopeful manner, reminding us of our duty of care to each other as workers in such contexts. It is original, unique and ultimately helpful in showing the importance of alternative forms of solidarity in difficult circumstances."
Miguel Martinez Lucio, Professor of International Human Resource Management, Manchester University Business School
"This book makes uncomfortable reading because that is its intention. The text is polemical, closely argued, and carefully researched. It is disturbing because it is an intervention at a time when it is urgently needed. Elizabeth Cotton challenges the rhetoric of health policy with the reality faced by distressed 'users' and staff alike."
Julian Lousada, psychoanalyst & emeritus Chair of the British Psychoanalytic Council