I wrote this blog as CEO of Primary Care International in May 2021, as we emerged from the throes of pandemic lockdowns. If the past months since have taught us anything, it’s that we are living in volatile times where nothing can be taken for granted. This blog takes a look at how to embrace uncertainty by focusing on your guiding star and looking beyond your own organisation as you develop strategic plans.
You’re writing a new business plan, what now, in the middle of all this? I had to agree, last autumn seemed a strange time for long-term strategising. We were, after all, knee-deep in short-term planning cycles and operating in contingency mode. Two years ago, I was reflecting on PCI’s fifth birthday and our journey as a social enterprise tackling health workforce challenges around the world during that time. One year ago, I was peering into the unknown as a global pandemic loomed into view, wondering how we and many other organisations, would survive. Today, I can simply say with certainty that nothing is certain.
We lived through a rollercoaster year when my team really pulled out all the stops (and then some), as we pivoted and went through a significant digital transformation of our work, resulting in the creation of a unique blended learning offer. Emerging from a steep learning curve with a sense of cautious optimism, we then learnt that our largest and most significant project for the coming year was being cancelled due to a slashing of the British overseas aid budget and the devastating cuts being made by FCDO across the sector. It felt like we were playing a board game and had been sent back to square one – only this time with devastating human impacts on the people set to benefit from the project. Perhaps there are lessons to be learnt, finally, about the intrinsic flaws in international aid architecture and the need for a fundamental rethink of the very concept, but this piece is not about that.
The point is that we somehow managed to take some time out during a period of considerable uncertainty to focus on what our core purpose was. The uncertainty around us made us think bigger; we didn’t know what the immediate future had in store for us as an organisation in terms of the size of the team, in terms of the types of projects we’d be engaged in, or in terms of budget. This uncertainty made us think outside of ourselves, to look beyond our own organisational footprint, and in fact, to be more ambitious.
Our goals became focused not only on scaling what we know we do well, but influencing others to take it further. We have seen first-hand the transformative impact of high-quality, well- functioning primary healthcare systems around the world but as a small social enterprise our role has to be about testing, generating evidence, and catalysing that large-scale change, not delivering it all by ourselves. So our new business plan focuses decisively on the areas where PCI can add most value. We aim to reach 25,000 healthcare workers by 2025 and have committed to: 1) Strengthen primary healthcare capacity by delivering practical health workforce solutions through strategic partnerships with organisations working at scale; 2) Generate evidence of the value (and viability) of decentralising the prevention and management of chronic diseases to primary healthcare through field testing innovative models of care; 3) Create sustained impact through investing in local leadership to strengthen health systems and facilitate learning exchange.
Cutting across this we are focused on digital transformation, partnerships, diversity and inclusion, and advocacy. We continue to develop and grow an increasingly diverse, multi-disciplinary and globally co-located network of passionate, talented people serving on our Board, within our Associate network, and across our Advisory groups. And we are building innovative, multi-directional learning opportunities into our new PCI Academy so that people with lived experience of health systems around the world can take their proper place around the table of ‘experts’. I’m incredibly excited that one of our most long-standing partners, the UNHCR, will be one of the first organisations to sign up cohorts of healthcare workers to this Academy, creating space for peer learning and knowledge exchange, and ultimately getting quality healthcare to refugees living in fragile settings across several African countries.
We were able to surface these areas of strategic focus – and focus our energies into the corresponding flurry of activity needed to start delivering on it – only because we were really clear on our guiding star: getting quality primary healthcare to all.
The uncertainty is not over. The pandemic continues to rage around the world. Pre-existing health inequities are deepening. The disruptions to healthcare, and corresponding impacts on peoples’ wider health and well- being is yet to be fully revealed. Cuts to the UK aid budget will mean ever greater competition for dwindling resources. And we have barely scratched the surface of what climate migration-related health impacts lie in wait. Despite all of this, I am optimistic.
Having a clear guiding star gives us purpose as an organisation, as a team, and as individuals. It may feel (a bit too often) like a struggle that never ends. But it is a struggle that I am proud to be a part of.