Partnering up to get Eastern Cape healthcare delivery working.

889 December 2013, Vol. 103, No. 12 SAMJ Imagine trying to mollify 400 municipal health workers who have been told they will be changing employers, job descriptions and possibly workplaces – with only half their senior management in place. Imagine that, and you will have a picture of what the Foundation for Professional Development (FPD) and their partner, the newly formed Nelson Mandela Bay (NMB) health district management, took on – with amazing success so far – in the often strife-torn NMB (Port Elizabeth, Uitenhage and Dispatch) Health District in the Eastern Cape earlier this year. While national political battles about dismal Eastern Cape patient care raged on above their heads, the FPD quietly facilitated a pivotal three-day pilot workshop to 35 senior and middle managers of provincial and municipal healthcare facilities in the NMB Metropole. Its purpose was to turn around the high absenteeism, negativity, staff turnover and poor-quality service delivery by doing an almost unheard of thing – actually hearing the gripes of managers before getting them to identify what they were doing well, and what they could do better. Led by Dr Mothomang Diaho and lawyer, Ken Mtuma, both specialising in change management facilitation, the workshop began with participants displaying closed body language and complaining angrily about perceived loss of benefits (by municipal staff) in the new salary structure. On the first day, people sat divided on opposite sides of the room. Yet, as discussion opened up with information, challenges and benefits emerging, the two ‘sides’ slowly merged and became more animated. By the third day, there was no talk of ‘us and them’, and managers were enthusiastically identifying weak areas where quick, inexpensive solutions were most easily achievable. According to Suzanne Johnston, Cluster Head of the FPD’s Technical Assistance Division in Pretoria, by 4 pm on the last day nobody was ‘reaching for their bags’. Instead they were making appreciative speeches to the facilitators, noting how rarely such connecting and empowering events happened.