The Last Five Months

I have made it to the end of my first five months of Year Here. Left behind are the barrage of patients’ requests, the administrative pressures, and the telephone calls of the Patient Assistant role — though I still have a strong urge to greet everyone with “Hello. Bromley by Bow Health Centre. How may I help you?” on the phone.

My placement has been an emotional rollercoaster. From the thrill of Kick-Off Bootcamp and the excitement of the first weeks of a new job, the energy petered out and was replaced by boredom and frustration. ‘I’m supposed to be a social innovator,’ I thought, ‘What on earth am I doing sat behind a front desk for eight hours a day? I should be out innovating, changing things, solving all the problems I see.’ As time passed and the banality continued, the existential crises abounded: ‘What am I doing here? What am I gaining from this experience? I could be working anywhere as a receptionist and be paid for it!’ Finally came the brain atrophy. With eyes glazed over, I transformed into an automaton whose only function was clicking on a screen to mark patients in and welcome people with ‘Hello. Bromley by Bow Health Centre. How may I help you?’ or some variation thereupon.

I woke-up every morning, commuted for 50 minutes, and entered the clinic. I spent the first 40 minutes of my day listening to peoples’ health concerns or to people complaining about how they can never get an appointment.

Such was the case one Monday morning two weeks before the placement ended. A patient demanded a 24 hour appointment for their daughter and proceeded to shout at me for 20 minutes because none were available. There is little I can do if there are no appointments available. I looked for the next available appointment, misread the date, gave them the wrong date and then a second later had to back peddle. The patient was having none of it. Voice rising in an increasingly consternated Bengali accent, they continued to shout at me. It was only when a doctor, having heard me struggle for twenty minutes, came out to talk to the patient that they stopped. We cleared a slot for their daughter. Three hours later, she walked in all smiles and rainbows.

This is just one example of the weekly, if not daily, occurrences that frontline staff have to put up with. Frontline staff should not be the ‘punching bag’ of the patients. Maybe if people were to understand the impact that such behaviour has—hear the stories of fellow frontline staff who feel belittled, patronised, frustrated to the point of tears—they would think twice before screaming profanities down the phone or aggressively posturing at the front desk.

But this is what the insight stage of the programme is about. We were told at the start of the programme that this work would not be glamorous. Coming from a background in fundraising—attending functions across London, meeting interesting people from all sectors, talking passionately of my cause—to being stuck behind a front desk has been an unsettling and difficult experience.

I felt trapped. Not one to give in to my circumstances I scouted about the Health Partnership and the Community Centre for places where there was opportunity for change. In conversation with the Nurse Practitioner about an art project I wanted to run in the waiting room, I learned of a small team across the two organisations that focussed on diabetes management. I seized this opportunity and instead offered to do the art project for the Diabetes Day they were planning. A couple of meetings later and I had designed and planned my art project. The idea was simple in principle:

Step 1: Chose an image for the Diabetes Day and print it out on A0 paper

Step 2: Create flash cards on the back of which were key messages about diabetes management

Step 3: Laminate Step 2 flash cards

Step 4: Cover up Step 1 image with Step 3 flash cards

Step 5: Attendees take away the Step 3 flash cards, learning about diabetes and revealing Step 1 image.

Simple enough. Turns out I find laminating rather difficult, and I destroyed the clinic’s laminating machine. This resulted in dinner at a friend’s house being interrupted by my attempts at ironing together laminating sheets manually. If you’ve never tried it: don’t. It doesn’t work very well. So I packed it in and left the flash cards unlaminated. The project was still a success — people took the cards.

This rather chaotic event led to collaborating with a wonderful group of people. Diabetes management is a key concern for the Tower Hamlets community as rising levels of obesity are resulting in increased numbers of people suffering from Type 2 diabetes. Therefore, information about diabetes self-management is evermore important. Before I left, I invited attendees of the event to a feedback session. This was in order to inform and co-create the next diabetes day which will be taking place in the autumn. It was a great session, not only for the agency given to the patients, but also because we managed to carve out time in the day where patients and clinical staff could sit down and talk in a non-clinical environment.

Interactions like these are so precious, particularly in the professional context where often all that matters is getting the task at hand done. This is how organisations become faceless and anonymous. Although Bromley by Bow could never be described that way, there is sometimes a feeling of confusion about the different projects being run out of the centre, each with its own staff team and its own group of clients. That is why another fellow (Ayshah) and I set up the Faces of Bromley by Bow project. Styled on Humans of New York, Faces of Bromley by Bow seeks to shine spotlights on the people who work at and access the centre and clinic. For Ayshah and me, it has been a great experience taking time out of the day to interview these people and hear their words of wisdom, inspirational stories, and humbling life journeys.

At the heart of the Faces of Bromley by Bow project is communication, something I consider to be incredibly important. It is even more so if you live in a country whose native language is not your own, as is the case for many who access Bromley by Bow. To address this, Bromley by Bow offers language courses, such as English for Speakers of Other Languages (ESOL). Ranging from Pre-Entry Level to Level 2, these courses support people to develop their language skills. This helps with integration into the English-speaking community and enables employment.

As a student of languages, I know the challenges of learning a new language. For me, this required hours of learning vocabulary, getting my head round idiomatic expressions, and learning the contexts in which words are used. When exciting opportunities arise that offer a different approach to language learning, I pounce on them. After a chance encounter, I learned of the amazing work English Nation Opera carries out through their project Siren Song. Drawing on themes in an opera that is on ENO’s main stage—in this case Verdi’s Aida—the project supports ESOL learners in language acquisition through opera. Before I left Bromley by Bow, I organised the two starter sessions in which the ENO team worked with our learners, transforming their words about their homelands, about mango trees and cultural dress, about Bromley by Bow, into beautiful melodies.

There is a word in Arabic, al-ghurba, that is used when trying to express the feelings one has when separated from one’s homeland. Unfortunately, we have no equivalent English, but the words created by our ESOL learners resonated with this feeling. Their words transported me to the shores of Bangladesh and the colourful festivals of Ghana. The culmination of the project will be a performance of these songs by the ESOL learners alongside other members of the Bromley by Bow community and other ESOL communities from across London in the Victoria and Albert Museum in late November.

Alongside the above projects, I continued in my role as a Patient Assistant. As I spent time talking to my frontline colleagues about their views on the role and talking to management about their vision for the role, I realised that my remit was wrong. Rather than working on the relationship between the patients and the patient assistants, I would be better placed looking at the channels of communication between management and the frontline staff to ensure consistency. Only then would management be aware of the difficulties I have detailed above. So I organised a co-creation session on the Patient Assistant role between the frontline staff and management. Although the premise of the session was to examine the frontline role, the real beauty of the session was that it created a space and time for discussion between management and the frontline. Patient Assistants came out of the session saying that they felt empowered and that their voices were heard. Management also enjoyed the session and they hope to repeat such sessions on a quarterly basis.

It’s been a busy couple of months. I’ve learned a lot about myself, about perseverance, about lives vastly different from my own… This time next week I’ll be in the thick of it once again. I’ll trade the open space and fresh air of Yorkshire for the Big Smoke. I’ll be learning about consultancy and working with my Year Here Fellows on live briefs set by clients, receiving training from Big Three firm Bain & Co. I’m excited to be working with the rest of my cohort, acquiring new skills, and creating solutions that address the briefs we’re set—and of course the cakes!

After consulting, it’s onto the creation of social enterprise ideas, launching new ventures into the world at our Crowdbacker event. Who knows what the future holds for me after that. I can say for certain that I shall leave this programme with a more nuanced understanding of life on the frontline of the NHS, a group of like-minded friends who won’t accept the status quo, and a determination to carry forward all that I have learned. Here’s to the next five months!

Alex Peter, Spring Year Here Fellow 2017