Recently I have had the privilege of closing a Leadership Programme with a group of Senior Leaders at NHS Cheshire Clinical Commissioning Group on the Compassionate & Inclusive Leadership in Cheshire Programme (CLiC). As part of their final presentation to the Executive Team the group were tasked with providing feedback about what they had learned on the Programme and how this had impacted on them. As part of that they produced a 2-minute video that highlighted the events of last year and the roles that staff had fulfilled as part of the pandemic effort.
Although the piece was only 2 minutes long it was incredibly moving to see the reality of what was faced on a daily and hourly basis by CCG staff. The piles of PPE that arrived and had to be distributed to local community and primary care services; Shifting resources around the system at pace to ensure staff were safe at work and could work remotely and more recently working 24/7 to set up and run the vaccination programme through local centres and community healthcare providers. All of this done with care and compassion and smiling faces.
There has been a phrase used throughout the pandemic which says “Not all heroes wear capes” referring to the frontline staff who have toiled and suffered to ensure people get the treatment they need to deal with the impact of the virus. For this the nation owes them a great debt and personally for me all NHS staff are heroes. However, this is my tribute to the other people in the NHS who support the frontline – the back room boys and girls who have been doing their thing to support the covid effort.
In leadership terms the covid pandemic brought a unique and unifying aspect to the work of the NHS – a national common goal that mobilised millions of staff to work together. Talking to colleagues in many CCGs – the camaraderie and dedication that was brought to the table was second to none and I have listened to impassioned Directors who have talked about their inspirational teams who went above and beyond the day job because they cared and are still doing so even as the effort is now focussing more on business as usual.
Having heard first-hand from such a dedicated and hardworking team that have quietly got on with the job it just felt right to shine a spotlight on them in recognition of what an amazing job they do. When you go for your covid vaccination to a community centre or GP Practice just remember who played a leading role in getting the supplies there for you and your family – that was the work of CCGs and their teams working collaboratively with others.
So what of heroic leadership? Here is one definition: Heroic leadership is the pinnacle of leadership, conducted by a transformed and enlightened leader who seeks to transform and enlighten others. The NHS has not weathered the pandemic through the heroic efforts of one transformational leader (in spite of the politicians vying for that position) but through everyone stepping up to be a leader every day in everything they do. So whilst I applauded the frontline staff every Thursday and they will always have my admiration for what they do; in my book not all heroes wear white coats and I want to pay tribute to all those staff who work in CCGs and all of the support services to the frontline.
Today marks a milestone for all of us – a year to the day when we entered a national lockdown as a result of what was then becoming a global pandemic of Covid-19. It is a day we need to take to remember the lives lost, those we hold dear, lifelong partners, parents, sons, daughters, friends. It is also a day of reflection for the NHS, to consider what a huge impact the pandemic has had on our national treasure. For without the NHS and its ability to care for us in our time of need the impact on us and ours would have been far worse. I feel truly grateful for all those amazing people who turn up every day to ensure that we all get access to healthcare free at the point of need. Not just the frontline but everyone who supports that effort.
I have spoken before about my passion for the work that I do which is as a result of my joining the NHS many moons ago. Today is for me another day of reflection – it is 40 years today since I joined the NHS workforce as a Clerical Officer at the then North West Regional Health Authority – Gateway House next to Piccadilly Station – known as the ‘Lazy S’ due to the shape of the building, but also a tongue in cheek poke at the productivity levels emanating from it.
This morning I woke and recalled the first day like it was (forgive the cliché) yesterday. I remember getting on the bus from home in Oldham and getting into central Manchester to join the metropolis that would be my place of work for the next 6 years. The anticipation of what was to come – my first proper job. In those days smoking was allowed in the office and I remember how in one corner of the office the curtains at the windows had turned yellow as a result of their proximity to a couple of chain smokers. I can feel the nervousness of my first phone call to arrange a meeting for one of the senior managers in the team and not knowing how to conduct a ‘business’ conversation.
Little did I know then that the NHS would provide me with so much that has shaped my life:
- A career with unlimited opportunities
- A university education to gain a master’s degree
- Friendships that have lasted 40 years
- A sense of purpose and a job with meaning that I was doing important work
- Treasured memories of fun times
- The chance to shape healthcare through personal influence as a senior leader for my local community
It is a legacy I will always be proud of and thankful for, despite the challenging times and stress through countless reorganisations, modernisations and changes of government that shifted the focus. The thing that always lingers in the memory banks is the people I have met along the way – the good hearts, the ‘Steady Eddies’ the mentors and critical friends, the aspirational leaders I looked up to, and the dedicated professionals of all clinical and non-clinical persuasions. My acknowledgement list would be far too long to list here.
Whilst the work that I do now is at arms-length through business partnership, leadership development and coaching, it feels at times I am able to give back to the people and the service that gave me so much in my formative years – a full circle after 40 years. To reflect on one’s own life experiences and the lessons we can learn from this practice is how good leaders operate. How we got through this last year was down to that leadership at play in every corner of our NHS and our local communities. We have to learn more lessons through an open process to find out what we can do better next time – and there will be a next time. Let’s take a leaf out of Martin Luther King Jr’s book who said “We need leaders not in love with money but in love with justice. Not in love with publicity but in love with humanity.” Those are the leaders I see in the NHS every day.
So where have I got to in 40 years? Well, I feel like a round peg in a round hole – I fit, I still belong to the NHS body and soul and wouldn’t have it any other way.
“I have worked with Mark a number of times over the last decade. It has been easy to develop a relationship with Mark, he makes you feel relaxed and is extremely good at listening, it feels like he knows you as a person, and remembers information from previous sessions. During my time with Mark he has used a number of diagnostic tools to aid discussion, as well as prompting questions before the session, and items to follow up on afterwards. I always look forward to meeting with Mark as it gives me an opportunity to step-out, reflect and gain alternative perspectives on life. During my coaching time with Mark my career has developed from a middle manager to board level across three different NHS Trusts in a variety of posts. My work with Mark has broadly focussed on three different areas; interacting with others, career choices and personal resilience. In all areas working with Mark has helped develop my perspective, thinking and action. It has developed my appreciation for other points of view and therefore my interactions with them, I have developed in my career to executive positions in the NHS and I am a more content, confident and relaxed professional. Thanks”
Healthskills were commissioned in early 2020 to support the four CCGs in the Black Country and West Birmingham as they form a single collaborative commissioning organisation. Mark, Dawn and the team are currently providing executive team development, supporting staff with Managing Change and Interview workshops, and shaping the organisational development strategy for the next two years. We are thoroughly enjoying working with such skilled and energised leaders and being part of a long-term collaboration to make an impact on reducing health inequalities.
Healthskills has been supporting you and your teams for many years now, and in these incredibly challenging and difficult times when everyone is anxious and time-strapped, it is even more critical to treat each other with compassion and kindness. Here in a few words, is how Healthskills can help you, your teams and your staff right now:
- First, an obvious point to say, that we have waived cancellation charges for any scheduled Healthskills interventions that have had to be postponed during this crisis;
- If you or your team need a 30-minute coaching conversation to provide practical support about how to manage your resilience, your teams, or simply some headspace to think during this crisis, then please let me know. You can contact me on 07771 655382 or . These sessions will be free of charge, and my Healthskills colleagues and I have all committed to provide at least one day a week for this, for however long is necessary;
- Facilitated ‘Team Check-ins’ for leadership teams can be incredibly powerful when you are under such pressure currently. These can be virtual, for up to 8 people, and can provide thinking space to focus on what’s working, what could be better and provide a solutions focus for ways forward;
- One-to-one coaching sessions for up to 90 minutes on Skype, Zoom or MS Teams (for example) are formidable vehicles for personal reflection on behaviours and actions during change, and the Healthskills Coaching team is on standby to support you;
- We have cancelled all face to face workshops until further notice and are able to provide alternative online / virtual solutions to support you immediately. An example is our 90 minute Personal Resilience workshop for up to 8 participants online, where you can understand what resilience is, how to become more personally resilient and how to support colleagues to be more resilient;
- All of the comprehensive Healthskills suite of workshops, action learning set meetings, staff engagement sessions and diagnostic tools are available virtually so that despite the enormous pressures on your staff currently, where development and support is critical, we can offer a range of solutions;
Finally, if you don’t see the learning, training or development answer to your issues above, then please get in touch with me. Each client has unique challenges as a result of this crisis and we are working with you all to find different virtual ways to support you.
With best wishes to stay well and positive
Managing Director, Healthskills
Healthskills is delighted to congratulate leaders at Chelsea and Westminster NHS FT for their latest Care Quality Commission (CQC) ratings, which show that the Trust is well-led, and offers safe, caring, responsive and effective services. For Well-Led, the CQC rated the Trust as ‘Outstanding’. Inspectors highlighted that the Trust is an organisation with a clear vision for what it wants to achieve, which has been developed with staff, patients, and key groups representing the local community. The Trust has been commended for having a leading role in the development and improvement of services across North West London. Inspectors found there was a ‘no blame’ culture and mistakes were regarded as opportunities for learning and improvement.
Healthskills has been collaborating ChelWest since 2016, with our co-designed and facilitated multi-professional ‘Established Leaders’ development programme, supporting over 150 senior clinical and non-clinical leaders, to develop consistent leadership behaviours, aligned to Trust strategic priorities and with a quality improvement project focus.
Working with health and care organisations across the country, over the last couple of years my Healthskills colleagues and I have experienced a welcome enthusiasm and commitment to embrace a more collaborative way of working. This is in contrast to the often competitive environment that leaders have found themselves between organisations, however inadvertently, and which occasionally has hindered achieving goals, prevented successful service redesign and encouraged silo working.
Whether you are Clinical Director in the new Primary Care Networks, trying to operate as a collaborative leader across your ‘place’ or borough, or indeed leading an emerging Integrated Care System, ditching a tribal mentality and embracing shared goals and common purposes with others can be challenging. Where do you start if you need to have what you might think will be ‘difficult conversations’ and develop a more trusting, productive relationship with system partners? Here are five steps that we have found incredibly useful over the years to help to get you started:
Step 1: Prepare by thinking through the situation
- How have you ended up in this situation?
- What has happened? What is happening now?
- What have you each contributed to the problem?
Step 2: Check your purposes
It is important to take time to consider what your real motives are for having this conversation:
- Is it to coerce or punish someone?
- Are you trying to educate or protect?
- Do you genuinely want to move from antagonism to mutual benefit?
Step 3: Start with congruence
Try to identify and share areas of common ground, similarity of views, values, behaviour and crucially outcomes – this will create a platform for dialogue.
What could be your common purposes and congruent goals?
Step 4: Explore the situation and key issues
The following points may help:
- Emphasise the value of each contribution
- Actively listen to understand their perspective on what has happened previously and what impact this has had on behaviours
- Try to unravel how the two (or more) of you got to this place
- Adopt a flexible position, and be open to new information
Step 5: Problem solving and agreement to action
- Try to find solutions that meet each side’s most important concerns and interests – relationships that always go one way rarely last
- Contract what each of you will do differently, and identify what the positive consequences will be
- Agree what the negative consequences are of not doing this
- Clarify what you will each do now and how you will review progress
Moving from adversarial working relationships to those based on trust and mutual respect takes time and confidence, but even starting out with these five steps can help you progress surprisingly quickly.
For more information about how our Leadership Coaching can help you and your teams click here.
On 1st July, almost 1,300 Primary Care Networks (PCNs) become live across England, each with a newly-appointed Clinical Director (CD) in post. PCNs are local networks made up of teams including GPs, pharmacists, district nurses, physiotherapists, paramedics and physician associates, with the aim to offer more proactive, personalised, coordinated and joined-up health and social care for patients. Typical PCNs serve communities of around 30,000 – 50,000 people; this population is small enough to provide the personal care that is valued by patients and GPs, but large enough to have an impact through practices and others collaborating, sharing services and resources.
The new Clinical Directors will have significant responsibilities in their part-time roles. Organising practices into PCNs is a vital part of the aims of the NHS Long Term Plan to move more care out of hospital and into the community, and placing a greater focus on preventative care. What skills and strategies will CDs need to deliver these outcomes and transform the patient experience? How about the following:
- The ability to seek common purpose and agree a shared vision – skills to describe a compelling vision of the future, that appeals to practice partners and staff?
- Leadership skills to encourage and empower others, and to lead and manage teams?
- Confidence to challenge assumptions and perceptions and resolve potential conflicts?
- Understand and practice a population health focus?
- Develop innovative plans collectively – to deliver better outcomes for staff and patients?
- To be an active and collaborative partner in your local health and care network?
What do others think? If you are a new Clinical Director in post, how confident and capable do you feel about taking on these challenges? How will you get your support?
As leaders in a rapidly shifting environment, understanding change and supporting others through change is often a huge part of the work that we do. Elizabeth-Kubler Ross’ research on grief offers a view of the impact of change that has now been adopted as a true representation of the stages we observe when we undergo any change say in a business or a life setting.
I often work with clients in 1:1 coaching sessions to help them understand how this impact of change is affecting the work that they do and their response to issues or situations in their lives. In my experience as a coach and a facilitator, the discussions I have had with groups and individuals highlight some important themes:
- The shape of the curve is very different for each individual – some people breeze through without sinking into a low mood.
- For others with a life changing event this may be much more pronounced and for a longer period.
- What we have observed/heard in organisations where changes occur in rapid succession there is a multiplying effect of layers of change which means that people are still in the early stages of one change when another lands and their ability to cope can diminish with every change that occurs
In response to this we often prepare people to be more resilient and look for coping techniques in the face of such an onslaught – Resist Resist Resist! But this got me thinking – What if we just accepted what is…?
I recently came upon a lovely lady in the Coffee shop at a Trust I was working in who wheeled her drip into the café and sat down next to me while her husband was at the counter. My curiosity piqued I asked her (if she was prepared to tell me) what the drip was for. The upshot was that she was in the terminal stages of cancer and this was a palliative intervention. As I sat and listened to this lady who calmly told me of her journey and the impact this life changing experience was having on those around her one word came to mind. Acceptance.
She had clearly been through the stages of the change curve and had arrived at acceptance. Her physical presence was something I have not forgotten – she was the picture of peace and serenity. As she told me about her husband of 40 years and that he was not coping very well with the position they found themselves in, it truly brought home to me how differently we all cope with change.
However it also made me realise that when we accept what is we stop worrying about it. Whatever the issue is it ceases to be a mind occupier or a source of stress. So for me this is asking a question of myself when a change occurs:
What if I just accept this?
My reflection on this approach is that it is a gentle reminder that not every change is worth fretting over and where you see that in others you work with is it a question to help them gain perspective? Is every change a fight you want to fight? Maybe we all need to be a bit kinder with ourselves and just accept what is.