The Blog

How the Harlem Shake Could Change the NHS

Providing health care is a tricky business. Those who have suffered ill health or accidents and needed treatment will know the experience can range from brilliant to botched. The NHS is under pressure financially and politically with recent reports, especially regarding the events at Mid Staffs, casting a shadow over the care it provides. Clearly none of this goes unnoticed by the staff actually working within it. Despite providing the best care we can, it often feels like we are constantly being told we are not working hard enough or showing enough compassion and that we're not valued. Unsurprisingly, this has created a situation in which morale in the NHS is at an all-time low. Staff surveys report growing disillusionment and in certain specialties there is already a recruitment crisis.

However, from this increasingly dire situation there sprung a belief last year that the solution would not come from more money, better leadership or a different political approach but from those disillusioned staff themselves. In 2013 a group of junior doctors, nurses and managers supported by a small group of experienced health care professionals with skills in social movement theory set about on an ambitious journey. Inspired by Earth Hour, a growing movement in which people in major cities around the world turn all their lights off for one hour on one day, we devised NHS Change Day.

It's a simple premise - any person can make a pledge to do something large or small which will benefit patients or the wider work of the NHS. Unlike the myriad of changes and targets imposed on the NHS from on high, there is no diktat, edict or 'top-down' pressure, the process is entirely voluntary. Despite this, 'change' remains a dirty word to many and there was initial resistance when we started. "We don't need more change" was a common rebuttal. But that missed the point. This wasn't structural or process change, this was an opportunity for people to pledge to do the things they'd already been thinking about. Things they knew they should do but didn't always get the opportunity, or feel they had the permission to. Like Comic Relief, there's no reason people can't take action - or 'raise money' - any day of the year but doing it together, on one day, makes it so much easier.

My own pledge in March this year was to try a selection of medications I prescribe as a paediatrician. It gave me fresh insight into the challenges parents face when giving some of these medications to their children. One antibiotic was so unpalatable I've started working with our hospital pharmacist to create a more child-friendly version. Without the funds for a large scale advertising campaign the team relied on early adopters to publically announce their pledges through Twitter, Youtube and facebook. The story of these public pledges served to engage and inspire others. From pledging to be in a wheelchair for the day to simply smiling more the numbers started to climb. A group of staff in Derbyshire even did the Harlem Shake.

Although cynicism and ambivalence were rife the open nature of the project and the focus on participants all being a vital part of the NHS won great support. In the past, the NHS hasn't been brilliant at capturing the innovation and enthusiasm of its staff, Change Day did this. The goal was 65,000 pledges, by the end there were over 189,000.

We want this year to be even bigger. With a goal of 500,000 we want everyone and anyone to pledge - not just staff but patients, the public, anyone working alongside the NHS. Today I'm talking to over 200 interested staff and supporters to start the journey to the next Change Day on 3rd March 2014. Staff who will go back to their organisations and spread the word. But, despite our successes, some of my fellow doctors remain cynical. What difference can the Harlem Shake really make to the NHS ask the naysayers?

My answer could be many things - I could point to the group of student nurses in York who created a mock ward which is now part of the curriculum. Or Birmingham Children's Hospital's "Feedback Wednesday", a now regular event where departments make the effort to genuinely engage with patients and their carers. There are literally thousands of examples of positive change. But, my actual response to the cynics is that what people pledge doesn't really matter. What matters is what that pledge represents. To me, it signifies the energy, enthusiasm, creativity and commitment of an NHS staff that many people have written off. So no, you don't have to sing, put on a wig, or redesign your hospital to take part in Change Day but, in the spirit of the movement we've helped create, even that remains entirely up to you.

Find out more and make a pledge at