Another train journey and an opportunity to read around the subject as they say.  This time something from late last year by Professor Ken Young and Professor Ruth Levitt at King’s on developing a code of practice for Government Tsars.

Several hundred high-profile Tsars have been appointed by Government since 1997.  Two years into my own lower-league Tsarship, it seems worthwhile sharing some observations….

1) All Government Tsars eventually suffer the same end . But their manner of passing is an interesting subject for inquiry. Some are starved. Others poisoned. A few are shot. One or two get to seize their attackers’ weapon and turn it on them. For how long, depends on how fast they can run and how good they are at hiding. Very, very occasionally they outlive their appointees and are either pardoned or just plain forgotten.

2) Whatever the varied nature of our demise I can tell you we all begin life the same way. We are appointed because the Government hasn’t got a clue what to do about something which it knows is important. We are the human version of that most elegant feature of punctuation, the question mark.  It always takes a bow after receiving its sentence. As do we.  The question I own as National Director is: how do we make being part of research something that more citizens want to do?  Simple as that.  But I have to remind myself of it at least twice a day.  Only occasionally do I allow myself a bow.

3) Truth be told, your appointment does not mean the Government necessarily wants you to do anything. [Cue ‘Mash get Smash’ laughter from assembled officials.]  No, no, no.  It just wants to be seen to be doing something…and you are it!  For many tsars that’s when the penny drops and the trouble begins. Because everybody else outside Government thinks you are there to do something and are pretty impatient for action. They also assume you are loaded and have hoards of people working for you. See note at end of blog on this point.

4) Thankfully, NIHR is serious about doing things to help answer my given question.  But it sometimes finds it difficult to shift gear and show it.  And I can tell you that austerity has made Government’s gears work much more slowly and with less axle grease than ever before.  I have growing admiration for the civil service colleagues I work with in inverse proportion to the ridiculous rules and strictures they are increasingly put under. But that’s what you get when Government and it’s leaders have their shortcomings laid bare and turn passive aggressive.

5) Most Tsars begin life with responsibility but absolutely no power to do anything….apart from write occasional reports that put an issue to the wall. Earning, gaining the tools to make things happen is the biggest hurdle of all. Looking back, we have actually achieved a lot over the last 2 years.   I say ‘we’ quite deliberately because as a Tsar you have to lean on others to get things done: Ok2Ask, changes to the UK Clinical Trials Gateway (UKCTG), putting public involvement in the new Local Clinical Research Networks, focusing people’s minds on patient experience as something to care about in research, the greater profile of research in the NHS….they have all been a common (and commoners?) pursuit.

6) As a Tsar you are not part of Government but you are most definitely ‘in it.’ That distinction is lost on most people. Why would it not be? One of my worst experiences early on was going to a public meeting where people clearly thought I was some sort of lower-ranking Minister.  Politics is not for me, that’s all I will say.  You are there to bring focus, leadership, cajole, nudge, criticise around an issue or policy arena.  But represent ‘policy’……not necessarily.  Making that distinction plain is very important if you want people to talk to you openly.

7)  There is a decision to be made when appointed about which way you are going to fall. What is your focus going to be? Are you going to go for visibility, disrupting how people think, championing the issues and motivating colleagues? Or are you going to try and change policy itself. More importantly, are you going to go native? Or stick to the ideas that put you there?   Because my original mandate was to bring focus and leadership I suppose I have tried to concentrate on those things that would make that happen.

8) Some of the real show-stoppers have not been resources. In actual fact the real difficulty is often overcoming the mutual suspicion that exists among colleagues. It amazes me how little we trust one another in the world of public involvement, how much more we could achieve if we accepted our differences and joined forces.  Our behaviours are often far behind what we like to say.

9) There’s is much good that tsars can do by being a stickybeak.  If only we had had a Data Tsar for instance, I wonder whether we would be where we are now on care.data?  Opening up the discussion is what tsars can give most to the policy-making process.  Appearing where you are not expected also has value even if people look at you like Banquo’s ghost, muttering ‘I thought he was dead.’  In the case of some tsars they would be right.

10)  We are making the most elementary mistakes in Government about our relationship with citizens.  Care.data is an exemplar.  But I have been to public meetings this week about changes in how local research is set up where there has simply been no engagement, no communication, no growing of our relationship with people.  They know not where we are or where we are going.  No wonder they are beginning to feel there might be better things to do.

There is much work to be done.

For the time being, I am still standing.

Note:  Only Tim Kelsey has loads of dosh and people….