Some reflections on 17 years as a NHS Intensive Interaction Project Leader

This week sees the first anniversary of my retirement from my full-time role working as the Intensive Interaction Project Leader for the Leeds & York Partnership NHS Trust. Over the last year I have now had a bit of time to reflect on what I think went well over my 17 years in that post – and also what I think didn’t go quite so well during that time; or at least not nearly well enough for my liking.

So, let’s start with my thoughts on the good stuff that happened:

· Firstly, I feel that I was extremely lucky to have been given an official NHS role in helping develop and disseminate one of the most important advances in the field of learning disabilities care and education for a generation – that is not a gift given to many. 

· Also, I cannot think of any other role that would have come close to matching the many deeply personal, and personally formative interactions and experiences that I had over the 17 years in the post. 

· Working through Intensive Interaction I had the genuine pleasure (and I believe also at times the real honour) to meet and interact with so many different and fascinating people. During my time in post, I worked with and worked to support, some of the most interesting, most dynamic, most positive, most challenging, and most intellectually and/or emotionally perceptive and influential people I could ever have imagined – it still boggles my mind when I try to think of all the people fascinating people I have met (in so many different places) over the years. 

· I really enjoyed the various challenges that some of my NHS Intensive Interaction roles have brought my way e.g. working to support paid carers and families develop their Intensive Interaction practices, developing and organising training and conferences and a whole range of different Intensive Interaction events, writing and editing books, papers and the Intensive Interaction newsletter, doing some really interesting research, helping facilitate the local Regional Support Group, working into some good, and some less than good (okay, at times some truly awful) services … and many other things besides. 

· I was able to see first-hand the truly wonderful (and at times truly astounding) changes that Intensive Interaction can bring to so many people’s lives; irrespective of their age, diagnoses or condition (and all the other things or labels that we professionals all too often load on to some of the people we set out to help). The people I managed to help through Intensive Interaction were often our most vulnerable, misunderstood, stigmatised, and socially isolated fellow citizens, and their families and/or carers. It is my profound belief that no other approach can do what Intensive Interaction can do, for so many people, so often, and through such easily achievable and humane means. 

· Also, from a personal perspective, I have made many close friends who I hope will continue as close friends well into the future – Intensive Interaction people make great friends: how could they possibly not!

Now for some of the less than good reflections: 

Deep down, towards the end of my time with the NHS, I increasingly had the feeling that we (well, me really – I was responsible for it) didn’t do nearly well enough in continuing the process of getting Intensive Interaction “out there”. We (well, me again) didn’t get Intensive Interaction to stick well enough, nor at a high enough quality, across all the care or day services or with every carer or family member we supported. I feel that, over the final 3 years especially, we in the NHS (so okay, that’s me again!) lost some of our previously developed Intensive Interaction focus and momentum by getting distracted by:

  • An excessive degree of unhelpful and often conflicting managerial control (at multiple levels) due to Intensive Interaction being seen to somehow (although not always easily) fit into so many teams or service areas.
  • Increasing pressures to monetise the Intensive Interaction service in a vain and counter-productive attempt to balance out the budgetary cuts then being made elsewhere across Learning Disability services.
  • Expecting Intensive Interaction to fit into the standard ‘referral – assessment – treatment – discharge’ model of clinical care provision delivered to individual ‘cases’ through ‘episodes of care’ (although it can sometimes have elements of that) rather than it being seen as a change in the culture of care at a service or family level.
  • Expecting unruly people like me to follow tightly prescribed ‘clinical pathways’ that ultimately seemed to constrain the provision of our Intensive Interaction services, rather than enable them (and our NHS ‘Intensive Interaction Pathway’ was actually written by me – so, sorry about that!).

Now, obviously Intensive Interaction should more or less sell itself (of course it should; just look at what it is and what it can do!), but I feel that we (i.e. me again) didn’t always get our Intensive Interaction messaging out there in the right way, to the right people (the steadily declining numbers of people booking onto our training and conferences told its own story). Our Intensive Interaction communications styles and formats had I think become a bit dated, and were also perhaps too professionally or academically focused, and not sufficiently accessible or family-friendly. 

Also, I think we/I got a bit stuck with offering the same models of training, communications, and events, etc, and I think some of my thinking behind these had over the years become a bit stale. Perhaps, no, undoubtedly new ways and new perspectives would have benefited our overall NHS messaging; but I am confident that will come in the future, with the new generation of Intensive Interaction people getting more and more involved.

So, do these issues of ‘less than good’ stuff make me sad about the past 17 years of NHS work; well, no, generally they don’t – the balance is so much in favour of the good. Also, I look at all the current people who are now out there promoting, training, and generally supporting the dissemination and development of Intensive Interaction (and I am still, but not with the NHS), and I feel that they are people of such high quality and commitment that the Intensive Interaction future looks very well secured.

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