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It could be you

I’ve had a mixed week. Yesterday I was in Leeds with people who mainly work in the local NHS, voluntary sector and local authorities and share an interest in helping vulnerable people. The conference was called #puttingPeoplefirst. It was enlightening and uplifting. I observed a groundswell of support for a different way of being at work, where people bring their whole and unique selves to bear on issues that matter, where failure is seen as an opportunity for learning rather than a weakness to be vilified,  and where treating patients/clients/service users with deep and real compassion is underpinned by working with love and compassion with one another.

Sounds a bit wooly and Buddhist for you? Then listen up. There is an increasing body of evidence that staff, from cleaners to chief executives, who are encouraged to operate with integrity and openness provide better, safer, kinder care. And this stuff isn’t new. Thank you @jackielynton for reminding us of our old friend Donabedian, who wrote wisely about improving quality before anyone else had thought of it, and said that it started with love.

If you don’t already follow @johnwalsh88 on Twitter or read his Yes To Life blog, and you like the sound of the conference, I’d encourage you to do so. I cannot thank John enough for inviting me. Or to the other organisers and speakers and to everyone there who was so honest and kind, including when they challenged one another.

Meanwhile, in another part of the forest,  a senior public servant has selflessly stepped down from a job they openly loved despite having done absolutely nothing whatsoever wrong, and indeed a considerable amount right, in order to meet the political ends of people who appear simply to be throwing their weight about. And is being vilified online for it. What does that say to the thousands this person leads? Are they at similar expedient risk?

And in yet another part of the forest (I do like that saying, please tell me if I overuse it) senior people who should know better have been talking about “Never Events” as if by giving something a threatening – sounding name, it will stop it from happening. Actually, what it does is make staff very, very scared. And scared people are less creative and more likely to cover bad things up and to go off sick with stress. Or worse, come to work when they aren’t psychologically fit enough to care for themselves, never mind others.

Here’s a precis of what I said at the conference about authentic leadership:

  1. Bad things happen. Good leaders look after their people at such times. We live in a blame culture so this is very, very hard.
  2. The more rules and procedures you impose, the less creative and compassionate your people will become. Resisting the external demands to introduce even more is also very hard.
  3. We performance manage and inspect individual organisations at the expense of the good of the collective system, and the patients who struggle across the bits of the system. Moving to a more collective approach is a goal we could all agree on. But what about accountability, comes the cry. Or, who would we blame when things go wrong?
  4. There is a leader in all of us, whether we are a patient or family member, work on reception or sit at the board room table. Work hard, if needs be against the grain, to be defined by what you do best, not by what scares you most.
  5. Bring all of you to what you do. It took me far too long to learn that being all of me, including the bits I was less proud of, even ashamed of, made me a more authentic leader. Don’t try to hide your imperfections like I did. It’s an added burden when things are hard enough already.
  6. Many people are privately saying that everything now isn’t right, and some things intended to improve care are actually conspiring to make it less compassionate and safe. If you agree, find the courage to speak truth to power, which is what I am trying to do in this blog.

If you are in a leadership role and you see a colleague who is having a tough time, please don’t metaphorically cross to the other side of the road as though they had some toxic disease you might catch. And please don’t believe the shit you read online or even join in the anonymous bear – baiting that passes for acceptable comment these days. Instead, offer them your genuine support.

Because you never know, one day, it could be you.

 

What goes on at conference doesn’t stay at conference

This week, NHS folk (patients, policy makers, clinicians, managers) gather in Liverpool for the NHS Confederation Conference. I’ve been to quite a few in my time. Here are my tips for getting the most from this annual NHS jamboree.

  1. Treat the event like a great art gallery or music festival. Don’t try to see and do everything. Be choosy, and give the things you choose your undivided attention.
  2. Travel with an open mind. Be prepared to learn new things and to unlearn old ones. If you only seek out sessions or speakers that you think will confirm your views, you will waste your time and the money of whoever has paid for you to go.
  3. Some people need no encouragement to network. But if you aren’t confident about bounding up to Simon Stevens or Jeremy Hunt with an outstretched paw, don’t worry. Practice by saying hullo to people who look like you feel – perhaps a bit lost or lonely. And remember what Dale Carnegie said: You can make more friends in two months by becoming interested in other people than you can in two years trying to get other people interested in you.
  4. When meeting new people, try to be neither boastful, facetious or enigmatic. If they ask you what you do, tell them. Self deprecation is good, but only if you mean it.
  5. Dress for comfort AND style. These are not mutually exclusive. And ladies, remember that hobbling about in heels that may be causing you permanent disability is not a good look.
  6. Don’t be a killjoy. If you get invited, go to the conference dinner. This is where you will get to mingle with very senior people once the pudding has been served. I’m expecting some serious selfie action from NHS management trainee chums.
  7. Burn the midnight oil if you must. But never forget you are at work. Even if someone makes you an offer you feel you cannot refuse, say No. What goes on at conference does NOT stay at conference.
  8. Take breaks. Go for a walk. Have a rest in your room. Do shopping or emails or visit Tate Liverpool or watch triathletes training in the dock. Drink coffee. But stay focussed on why you are there. The NHS is in desperate need of radical change. We are relying on people like you to work out the two or three things that will make the most difference, and then to deliver them. So you need to be in good shape.
  9. Be kind. You may see folk who you know are having a hard time. Please don’t avoid them. Some of us older hands worry that, despite all the talk about compassion, the NHS has become less compassionate, with considerable focus on inspection, compliance and performance but insufficient attention to recovery, development and improvement. And we have jettisoned most of the architecture that helped senior people to step aside with dignity when circumstances required this. The best you can do is say hullo to people working in very tough places, and listen if they seem angry or frightened. You never know, one day, this could be you.
  10. Bring back stories. I remember one year Roy Lilley started his session with the sound of an unanswered phone ringing while he did a voiceover about being a worried relative. He went on to demonstrate an inadequate vacuum cleaner, dropped it off the front of the stage, introduced us to a new bagless vacuum cleaner, and brought on then little-known James Dyson to chat about quality. He ended with a duet with his brother on keyboards. It was fabulous. This year I highly recommend Alison Cameron at 9.30 on Friday morning. I will be watching online as she reminds confetence why we all do what we do.

You can prepare by following some great NHS people on Twitter. I’ve already mentioned @allyc375. Here’s a few more: @WhoseShoes, @NHSConfed_RobW, @NHSE_Danny, @ChrisCEOHopson, @Saffron_Policy, @HPIAndyCowper, @Crouchendtiger7, @HSJEditor, @SamanthaJNHS, @antonytiernan, @anna_babic, @DrBruceKeogh, @JaneMCummings, @helenbevan, @jackielynton, @DrUmeshPrabhu, @JamesTitcombe, @NHS_Dean, @KarenLynas2012, @yvonnecoghill1, @2020Health, @Damian_Roland, @BCHBoss, @nickyruneckles, @paulfarmermind, @KMiddletonCSP. Of course there are many more wonderful NHS folk on Twitter, but the ones on this list are definitely at the conference this year. Please seek them out and say hi, and send best wishes from me. And expect a warm welcome back.

I recommend that you follow the conference chair @tweeter_anita. I hope she will mention her stunning new book Sophia, the biography of a forgotten Indian Princess who became a suffragette. It has reminded me that keeping quiet and toeing the line never got anything important done. And causes me to wonder how it can be that in 2015, with NHS staff being 70% women and 20% BME, Anita was left to interview 6 white men who are, collectively, in charge of NHS commissioning, public health, regulation and training. I’m not criticising the incumbents, just the system that perpetuates this shocking lack of diversity at the top. All the more reason to dig deep and support the statue Mary Seacole, which will commemorate not only Mary, but all women and BME people who have dedicated their lives to caring for the sick and wounded.

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Please support the Mary Seacole statue appeal http://wp.me/P4ZnZz-3Y

So listen hard, make some noise, have fun and be kind. I hope you have a wonderful conference.

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With thanks to @MarkAxcell for the lovely poster.

 

Please take care, Twitter can be cruel

I love Twitter. But it can be a cruel place. Personal attacks and even threats of death are not uncommon. Sue Perkins and Jack Monroe are the latest high profile quitters following unrelated horridness – in Sue’s case, she was attacked for being (wrongly) tipped as Jeremy Clarkson’s replacement on Top Gear. Jack’s was about supporting the Greens on the election. Death threats for this? There are no words.

I’m nowhere near their league, but I’ve had my share of online nastiness, and it continues. It can be overwhelming when you are under an onslaught from many directions. And unless you reply and risk even worse, other more measured folk won’t know what’s happening, because the vile stuff won’t appear in their time line.

I am of the “Whatever we wear and wherever we go, Yes means Yes and No means No” generation. I don’t see why bullies should frighten us away from places that belong to us all. But I’m also concerned for my own wellbeing and that of others.

It is good that Twitter are cracking down on abuse – better late than never. Meanwhile, here are my tips for staying emotionally safe and still getting the best from Twitter.

  1. Be yourself but think really carefully about how much you share. Social media is still a relatively new medium. Some are already regretting earlier openness. I’m thinking particularly of people like me who experience mental illness from time to time. Talking with others who have similar experiences really helps, because with diseases of the mind, unchecked irrational thoughts about ourselves can snowball and be really bad for us. But sharing also makes us vulnerable. Only a handful of people have accused me of psychological weakness, attention seeking or of using my depression as an excuse for past failings. Even fewer have defaced my image, called me vile names, and traduced my appearance, intelligence, morals, motivations and career. I have forgiven but I cannot forget their words. On a bad day, I imagine that others may feel the same way about me. On a really bad day, I may even agree with some of this shit. So please, take care.
  2. Be wary of individual tweeters who follow few people themselves. They may say interesting stuff, but they are unlikely to be interested in an online conversation with you. Maybe you don’t mind just reading their views? It’s a good way to start, especially if you are shy. But most of us are on social media because we want to exchange thoughts, share experiences and ideas.
  3. Don’t just follow those you know you will agree with. It might feel cosy to be in a cocoon of like – minded folk, but it won’t stimulate or enlighten. If it weren’t for Twitter, we wouldn’t know the odious extent of the views of, say, Katie Hopkins on people seeking asylum. What better spur to get the previously disaffected to vote than the thought of people like Hopkins (who always vote, by the way – they know their rights) getting more of a say than us non neo-Nazis? We need to know these things.
  4. Take the plunge and join in conversations when you haven’t got a view or are still making up your mind. Some people think that being open – minded, even undecided, is feeble or wishy-washy. I disagree. Just be sure that when you in one of these discussions,  everyone is treated with politeness, including you. Be prepared to walk away if that doesn’t happen.
  5. Join in with conversations that are happening at the time you are actually on Twitter. Prepare yourself so you don’t feel too hurt if people whose views you admire don’t respond. Just move on and chat to someone else. Don’t assume people are being rude; they might be but that really isn’t your problem. Easier said than done when you desperately want a reply, I know!
  6. Try not to get involved in those angry ding-dongs where an increasing number of @names get added, until in the end there is no space to say anything. If you get copied in, these are best ignored, in my experience.
  7. Don’t be heavy – handed with the Block button. Some people collect blocks like trophies, and will proudly list you as a person who lacks empathy along with others you may prefer not to be associated with. And you won’t know about this if you have blocked them. Save blocking for porn sites, annoying bots and people who are genuinely harassing you. And for the latter, do also report them. Twitter are rightly upping their game in dealing with online harassment. If you are being repeatedly harassed by someone, you may also need to check if they have other profiles. In my experience, these are relatively easy to spot. And do also report them to the police. They definitely do take action when serious threats are made.
  8. My thoughts here are aimed at people like me who are able to tweet as individuals. The freedom we enjoy compared to those in public positions cannot be underestimated. I’ve been in one of those jobs, and written about use of Twitter from that perspective here. It is great if such people can share something personal of themselves, but it is a big ask, given what can happen and the impacts. Which leads me to my final point.
  9. Don’t rush to judgement of others. No-one knows what it’s like to sit where they are sitting, other than they themselves. Be kind, always. Never, ever make remarks like James May did recently about those who made death threats towards Sue Perkins. He only made a bad situation worse. If you can’t be kind, walk politely but firmly away.

I’ve blogged in the past about forgiveness. If you haven’t seen it and are interested, here it is.

I’m still practising by the way.