Golden circles: the ‘Power of Why' in the NHS at 70


The Golden Circle was made famous by Simon Sinek, an author, motivational speaker and marketing consultant. His TED talk “How great leaders inspire action” has more than 38 million views. The essence of the theory is that people are good at focusing on the ‘How’ and the ‘What’ of what they want to do. But they often neglect the ‘Why’ and it is this component that inspires people, captures the imagination, engenders loyalty and creates a movement.

The ‘Why’ is the deeply held beliefs for why an individual or group are starting or running a business or organisation. My You Got This partner, Dr Becky Thorpe and I recently attended some health innovation training from the West of England Academic Health Science Network and we learned from the business gurus there about how important it is to ‘Start with Why’. It occurred to me that in our NHS we have institutions packed to the rafters with staff who know exactly why they are there. But perhaps the NHS as an institution should reconnect again in a stronger, more public way with its ‘Why.’

In our fantastic emergency department teams the elements that motivate and unite staff are self evident: a desire to alleviate suffering; to make people better; to help children and the vulnerable; to be with people; to support them at their lowest point when their physical or mental health is hanging by a thread; to work in teams; to overcome challenges; to pull together with brilliant people who share the same ‘Why’. This is what keeps staff coming back for night shifts or that gets them to work on foot through a blizzard or that repeatedly sends them back home to their families deeply tired or in tears from a traumatic day. All NHS staff can relate to this.

Don Berwick, Professor Emeritus and Senior Fellow at the Institute for Healthcare Improvement writes "What we in the healing professions get to do every day touches the highest aspirations of a compassionate civilization. We have chosen a calling that invites people who are worried and suffering to share their stories and allow us to help. If any work ought to give spiritual satisfaction to the workers, this is it. “Joy,” not “burnout,” ought to rule the day."

Perhaps NHS staff shouldn’t be so afraid to give each other (and themselves) more of a pat of the back every now and again for the amazing work they do. In the same way, maybe at an institutional level the NHS should make sure it is clear and proud about its ‘why’ to the millions of people – it’s ‘customers’ if you like - who interface with it each year. For 70 years now, the NHS has been helping to realise Bevans’s 1948 vision that a national health service should meet the needs of everyone, be free at the point of delivery and be based on clinical need, not ability to pay. But this has been underpinned by a multitude of staff who believe in the same and who give themselves entirely to the patients for whom the NHS cares.

Sure, there are dramatic challenges facing the NHS, there are cracks in the system and its staff are under enormous pressure. But NHS staff, including those in emergency medicine, can and should reconnect again with a huge and radiant inner sense of accomplishment and pride, not just about what they do, but about why they do it. This should continue to serve as a source of strength for all of us working in the NHS and help to support our wellbeing. We should talk about – even sing and dance about it because is it is special and it is something that nobody can take away.

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