Cats, power and building barriers in the NHS

well my cats territory now well & truly invaded and 5 year plan suggests move to patient power will personal budgets & self care not just black cat power !!!


In the last year or so we have talked a lot about NHS culture in the media, blog posts and in the Francis inquiry. How the culture is wrong, how we need to change culture. I think we use “it’s the culture” as an excuse to keep doing what we have always done and so we get the same results. Saying it’s the culture is also a way to quieten down those who might challenge the status quo.It all then becomes about keeping going and survival. Some NHS managers and leaders act like my cat when another cat enters her territory.

In the garden today I can see my cat on the fence in a “Mexican standoff “with a black cat. Hissing and howling and just sitting, balanced on a fence refusing to shift. My tabby just digs in and exerts her power on the status quo. I’m not shifting…

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Fear Diversity and Cricket Bats

Randy Lewis in No Greatness without Goodness said:

“I know fear first hand. Fear of failure. Fear of looking bad or appearing weak. Fear of losing respect or position. Fear has kept me quiet in the past when I should have spoken up. It has kept me still when I should have acted.”

That quote resonates with me and my journey from the security of the public sector payroll through redundancy to a limited company. The Knowledge also you only grow a business if you grow yourself and it only comes if I make it so and keep making it so. Some days I just feel fear.

Some days are great, and I don’t feel fear then instead only hope for the future. I already have got some great contracts public and private. I have work for November and December and some income, but it’s not enough to give me or the family security into 2015, not yet. But I know deep down strategy and coaching are the things I am good at and my customers love what I do. So, I know I need to stick with the knitting.

Yesterday was a great day as I worked with David on our strategy for growing @Norfolkbats. What a fab guy and a fab company and boy do we have a great product, market segment opportunities and a vision to grow and to be the best in breed. We spent time analysing this together along with our values and priorities. All important in strategy and business development. We spent a lot of time also talking about doing business well and who we can take along with us. How in growing the company we will need to grow ourselves too. Taking on new challenges and letting go of some stuff. I left feeling invigorated.

I know from my coaching practise all leaders feel the fear and at times the inadequacy. We call it the imposer syndrome. All businesses worry about growth, sustainability and managing change and complexity. All leaders and all our corporations have good and bad days. But whatever our role or our business setting GREAT and GOOD are not incompatible.

People talk to me now I’m on the outside, they always did actually, but I can share those stories easier now. I hear too many leaders not being GOOD, too many services failing and many boards not diverse with too many backs being covered. Those leaders feel the fear too don’t they? but we can and must be GOOD in the face of challenges, however great. We should seek after the GOOD in business. We should dream the dreams of greatness done well.

I have recently finished Randy’s book and it is brilliant, astonishing and inspiring, He is Senior Vice President of Walgreens. Real business turning 1 cent on each dollar, now that’s a tough place. A place many of us would say you just need to focus on performance and productivity not the frilly add on like diversity. BUT he tells a story from his heart of how he and his team make his organisation both profitable and good to work for. Not just good for the Harvard educated and the best in breed but for people with profound disabilities too. So with Norfolk bats and BLEND, like Kevin Costner once said “we will build it and they will come”.

sick of group think and set backs in progressing equality in the NHS

This weekend I have read my way through a challenging and important report for the NHS by Roger  Kline.

“The snowy white peaks of the NHS: a survey of discrimination in governance and leadership and the potential impact on patient care in London and England.” Middlesex University.

If leaves me troubled at the situation we find ourselves in, with data going the wrong way on numbers of Black and minority ethnic staff (BME) and women leaders in the NHS. It not just the NHS either. Statistics tell us in the top teams of the Whitehall civil servants, those who chair national committees and MPs in Parliament numbers of black and ethnic minority staff and women are reducing not increasing. This is at the same time as our country becomes more diverse and dynamic.

How long will Theresa May hold on as the token women in cabinet I wonder? She may just need those kitten heels to stamp on those trying to push her out of her cabinet room chair. How long can Sally Davies, Chief Medical Officer Keep putting up with “being the only woman in the room.” Yes, there has been outcry in the news and reinforced actively via social media.  That’s important and talk amongst current leaders including NHS Employers and the NHS Leadership Academy about needing to do something urgently is happening.

But, talk quietly and off the record to those who lead board development and undertake executive coaching in the NHS and they will tell you the sad facts.  Women who apply for CEO roles are taking 4 times longer than men to get their first post and for the rest of the board appointments look at the colour pictures on websites. 80% of the time you will guess the ethnicity and its mostly white, middle aged and male. We need action and its urgent now and Rogers work puts a loud hailer to the problem.

This isn’t just about numbers and complying with the Equality Act. Though being lawful is the first step and an important one. This is much more about the sort of NHS we are growing and developing. Can this NHS that we have been so proud of for 66 years survive the future if it does not reflect the population it serves?

How will we be truly patient centred and help people from different communities manage their own long term conditions? Where will we begin to help patients stay independent into old age and work with the capacity and capability of their families and communities to support them? That’s before we turn attention to how we maintain the morale of the staff we employ. If we do not have diverse leadership teams then we do not have people who have walked in their shoes and understand their challenges.

One of the most striking things ever said to me more than 8 years ago was a plea from a psychologist when I left a role as a provider director. She said:

“Amanda keep working full time in senior roles and keep progressing upwards in your career. Because when a mum works full time with small children at a senior level and talks about it then we all believe we could do it too.”

This is one of the problems I suspect our BME staff face, lucky to make it to an 8 grade post then they look up at the white peaks populated by tiny numbers of BME staff and many more men than women and don’t believe it could be them.

Beyond rending our garments what can we do? Well I think it has to start with all of us who are leaders and who are coaches in the NHS. As we are there at the top of the mountain and the BME staff are not. We have to make this as important as financial balance and quality of care. Monitor and CQC need to challenge us and themselves to do that too. As successful private sector companies have realised for a while now board diversity does breed success.

But, do we sit quietly in dark corners and think yes we need to do more, but surely the best people are the most talented and ambitious and they apply and secure promotions. Maybe men and white people are just better – we would not dare say that in 21st century multi-cultural Britain would we? We know it’s just not true, more than 50% medical school students are women and numbers of BME doctors continue to increase. Ability deficits are not the issue here, its opportunity and the unconscious bias or group think of the status quo leaders at the top – all of us.

My teenage son, still on his 3 weeks Easter break attends a state boarding school that holds International school status with the British Council. He therefore lives and learns with many black and Asian children (around 30% of the boarding students are Black or Asian and in rural Norfolk!) I asked my son to describe what he knew about the careers his friends wanted and he reeled off lawyer, architect and lots wanted to be doctors. It’s a hard working, high performing school. I then asked him about all the staff in the NHS and asked what does he think is going on if the leaders are not more mixed he said ITS NOT ABOUT THE LACK OF ABILITY MUM.

I’m proud my son lives, learns and grows up within a diverse community as I hope he will be someone comfortable to work and progress alongside other ambitious people of all backgrounds.

But back to the NHS, as Trust Boards finalise their corporate plans and objectives I suggest you take a look at the NHS EMPLOYERS website and their 10 top tips for diversity;

There is lots more great advice via the NHS Employers website on equality and diversity we just need to decide to act on it as leaders and ask for the help to make a difference.

Finally, in 1966 a White Irish Catholic US Senator went to South Africa, the first white US politician to do so during apartheid. While in South Africa he challenged the status quo, right there in South Africa, in the height of apartheid while Nelson Mandela was locked up on Robin Island. He didn’t see it as the responsibility of the BME community to address this, he did something himself as a privileged white leader.

He directly challenged thinking on apartheid and the organisation of life in South Africa by saying in a speech:

“But suppose God is Black, what if we go to heaven, and we, all our lives, have treated the Negro as inferior, and God is there, and we look up and he is not white? What then is our response?”

And of course the irony this Easter is that God is black, white, Asian, male, female, fit, disabled straight, gay, old and young. Because He made us all in his image and guess what, the NHS is that diverse too.

I urge us as leaders to do what we can to change this situation. Challenge ourselves, challenge our teams, and challenge our organisations to let others in, even if that means no place is left for us on the not so snowy peak.

passion reason and courage an old blog but still relevant

My first blog independent of public sector employment so I cannot underestimate the significance of this moment for me . I have been on the payroll for 28 years until last week and thought I would stay until pension. But, like many the constant restructure and reorganisations got me this time. I didn’t want to leave, I enjoyed my job and had more to do in my career and so I pleaded to stay.

Why plead, I had done enough years so the kids wont starve. I guess I didn’t feel done yet and didn’t want to be forced out. So I went through a lot of personal pain because I  struggled to accept this situation. I’m known by many for my dispassionate logic and reason, but I’m also marked by my passion and courage (some say bloody mindedness!)

It was the passion to support people with mental health problems that brought me in as a student nurse at 19 and that has never left me. As my career progressed great bosses,mentors,coaches and colleagues saw the courage and the passion to make a difference and inspired me to try harder, go further, reach out to more people. So, I moved up the ladder, worked across more areas, more responsibility followed, I acquired more skills and more opportunity.

Pretty darn good for a girl from a broken home, homeless at 17 with a factory working trade unionist for a father and mother who cleaned offices. I didn’t come from the right family or have the networks for an intern ship or the privilege of the right school or the right university for the first job. But the public sector gave me so many great people and they ALL believed in me. So to all of you who lead, pay attention to the young ones, be the one who sees and believes in their potential. Look for talent everywhere and don’t discount anyone.

My thanks go to the Housing Director in Greenwich Council who put me on a diploma in management studies, the Operations Director at the Maudsley who recommended me for an MBA, the Professor of Psychiatry who chose me to co author a book with him, the PCT CEO who sent me on a Kings Fund Directors course, the NHS SHA CEO who added me to the NHS Top Leaders list, a previous Director General who modelled public sector values to me, the retired CEO who picked me to join his exec team and my current coach.  You have all done more than you will ever realise as you helped get me there.

So now I thank all of those who have believed in me and stood with me these last 6 months in this personal storm. My church, work colleagues, patient leaders, neighbours. You all remained confident when I really doubted myself, some of you listened, some of you coached, some advised, some challenged, others shared your networks and skill sets. All of you helped me to eventually see this as an opportunity and a release.

My husband (a natural Eeyore) has been bouncing about telling me the future is bright and he knew I would be fine. For a while I wished he would be his usual Eeyore but my sincere and greatest thanks go to him MY BEST COACH.  He also chose the company name and more of that in the next blog.

So what next, well for the next few months to my twitter friends I’m still here and will continue to give my opinions and views on health and social care. I am doing an executive coaching masters so reading and writing (lots of).  I have a few people to coach so starting next week I will seek to give them the time and space to become the best leaders they can be. And tomorrow is the first of four sessions learning French Patisserie, so I’m doing ok.

All this talk about patients – just run the NHS

Keep ignoring patients and you miss something of the divine and I guarantee you will miss the opportunity to truly transform the NHS. My experience is real change happens when you engage the patients, the advocates, the families. The job of a leader is transformational not transactional – you have administrators for that process stuff. Unfortunately, as business management has over run the NHS, too many administrators get told they are leaders. Some can be, but many cannot. I’m not bashing NHS leadership per se, I was one. Given my way I would still be one but I am bashing how we apply leadership.

I have been feeling down the last few weeks and so a blog was something I just couldn’t get around to. Hubby kept saying write it down, post it, tell it, but it would not come in any coherent format. Knowing it would probably be morose or a rant and not really touch what I felt I needed to say.

But, I have been keeping up with twitter and a number of people have influenced me of late @Sarasiobhan and seeking redress for Connors death of course @eden_charles @thornton_dt and today I read @JonNHSNorwich latest blog. Amongst other things last week he spent a day with the integrated learning disability team in Norwich. The integrated team I set up 10 years ago. As I thought of the teams across the county I thought of our patient leaders who helped me make change happen. I moved mentally from wanting to rant at the CEO who restructured me out of the NHS and shoved me off the career escalator and realised instead I had done some great stuff. Helped in no small part by some great people.

So, I want to focus on why really involving and listening to patients and their families is core business and not just for your patient empowerment team. This isn’t a history tour as it’s as relevant now as it was then.

Back in 2002 I found myself leading the closure of a long stay institution when many before had tried and failed. I was reminded of this a few months ago when I was honoured to be asked to give the eulogy at a funeral. Having been made redundant I was in Norfolk and available of course.

Joan had a learning disability, she had a large number of children, some of whom had been of interest to social services. She was in wheelchair, obese, had a number of long term conditions and was in her 50/60s when we met in 2002. We had nothing in common except our energy. She was loud, proactive and angry about the delays and mess of this supposed hospital closure programme. I admired her fighting talk and I tried to connect humanity to humanity.

She was a customer and a spokesperson for so many of our patients and families and if I was to pull off this huge change in the NHS then I needed to understand, persuade and take with me many people.

Joan was with People First advocating for people who wanted to move out of Plumstead Hospital. Joan was on the interview panel when I applied in 2002 for the post of Director of Learning Disability. She told me years later that although I did a good interview I got the job because I wore a red jacket!!! And she described the other candidates as trapped in dreary suits saying dreary things.

When we set up the Partnership Board she co-chaired it and was there advocating for better lives and independence for people with disabilities, telling the CEO of the Health Authority to stop talking rubbish and what we should follow was “the law of the bleeding obvious!” She helped me close Plumstead by making sure it was well planned. Managers would tell me all was going well and we were listening to and planning good moves for the patients. Off she’d whizz around the hospital in her wheelchair to hear direct from patients and come back and tell me my managers needed to buck up their ideas!

We would not have closed Plumstead or have the Community Services we have without her. She also helped me be better at the jobs I did after I left Norfolk through the lessons I learnt from Joan. I learnt that:

The NHS is accountable to the public, communities and patients that it serves.

I learnt that this is best tested by engaging directly with those who use our services and their families. I have tried to apply this in all my roles since and it has led to some great transformational changes and some success. But, as once famously said:

“There is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its success than to take the lead in the introduction of a new order of things. ”

So, I have come up against many who think even at very senior levels the job is to not to engage directly with patients, not try and change things, not ruffle feathers just be a good administrator. I’ve had colleagues rage at me for putting meetings with patient leaders in their diary and letting patients come to the HQ. Those people struggle with me and boy despite my smiles I really struggle with them. And this time they and my engagement with them were my undoing. The CEO who head hunted me was gone and the new CEO was appointed to retract the organisation, to sort the money and to bring stability. And of course that future didn’t include me. I didn’t fit the mould any more and the board was going to model the new strategy going forward.

I was dumb enough (my own undoing) to speak up for a strategy of engagement with patients, the community and partner organisations. A blended strategy of health and social care working together. I asked where in business there was a successful example of retraction? I think retraction says hunker down, don’t innovate, don’t expand, we will just slow down and wait till the storm is over. My experience tells me it is completely without ambition or hope and arrogantly assumes that all we do now works.

I am angry, but my track record shows I’m not interested in change for change sake I am interested in being a good guardian of the public purse. The money needs to be spent on liberating the patient and getting good value for the tax payer in doing that. The moral of the story here is if you do what I did you will have a great ride for a number of years working for great leaders who value your contribution. But, eventually they might kick you out if the power shifts to a conservative and containment strategy. But, I would not have done it differently as I have been proud of many achievements including the integrated teams and the long stay institution I closed in Norfolk. The good stuff is lasting even if I am no longer a part of it.

So, to Boards my message is engage directly with the patients and the families and you have a chance of assuring yourselves that you run a good health service. In doing this you will have to wrestle with the noise, the disquiet, the anger, the energy though. You might also, like me find solutions to the problems of the NHS direct from the customers (the patients and their families). You will sure as damn sleep well at night knowing you were part of making it much better.

I am beginning to attract work and have some work with the NHS Confederation, TLAP and the NHS Leadership Academy. It’s not enough to keep the wolf from the door so I am also using my business development skills supporting a cricket bat maker –

@norfolkbats Yesterday we heard that we have an order for the German women’s cricket team so I am off to Berlin in August delivering handmade bats!!! I have not been to Germany since I took the Mayor of Bedford there setting up the unitary council in December 2008 – guess I won’t see snow this time!

It’s a life, a good life beyond the NHS. But I miss it, the NHS was part of my life of work for 28 years. I miss the direct contact with patients, their families and staff and being part of making a difference there.
The honest truth is I feel bereft as a big part of my life and work is missing now and blog readers know I never felt happy being asked to walk away.

Living recovery where the boss is no leader

This latest blog will share some of my experience of supporting and facilitating the development of patient leadership in mental health through the South Essex Recovery College. It is an important story to be told about amazing people doing some great work. The patient leaders happen to have used secondary mental health services themselves but that’s not the story. It’s a more generic story about recovery, courage, hope and overcoming the dumb, stupid, uninterested and those who stand in the way of needed change. Yes I’m afraid my experience even at the top was that some of the senior people in the NHS and Local Government think they need to be in charge of recovery themselves and patients need professionals all the time.

I will provide a small part of the narrative here BUT it’s NOT MY STORY. It’s their story that I share with their permission as they develop their work. If I claim anything here it is that I saw a great group of people who wanted to change a bit of their world. I was keen to travel with them and open some doors hosting them for a while. I had a chance to do all of that and of course upset some power by supporting the idea that patients should lead this themselves without highly graded NHS project managers to supervise them. My reflections are tinged with a sense of sadness that I couldn’t stay to be part of the recovery college further development.

My bit of the story starts a few years ago when I joined my last Trust Board and I was approached by one of our Trust patient governors, a researcher at the University, one of our psychiatrists and a senior social worker. Quite a dynamic quartet of strong advocates for change! They plied me with tea and biscuits and pleaded for me to take an interest in their work on recovery. They expressed frustration that although they had been part of a national programme of work which had birthed many Recovery Colleges their work had not progressed very well. I listened, I offered to host one meeting of the steering group and discuss it with my CEO.

A Recovery College comes out of the concept of recovering your health but not necessarily completely to a previous state. Though many with mental health problems do recover completely others don’t so the focus is to recover your life and your control. No longer a victim but someone who is reflective, who has the ability to plan and build a life beyond illness. Someone who is not settling for the stigma or discrimination of accepting less.

So off we went and I began to facilitate as we held meetings which lots and lots of patients attended as did front line staff. We asked at each meeting for a PLEDGE. Asking people to think about what skills they can bring to the setting up of the college? Suggesting you can offer yourself even if it’s just making the tea and we will sign you up as a trust volunteer. We had tea makers, policy writers, web designers, graphic designers. People told their recovery stories and these were inspiring moving and challenging. This gave us a list of 40 or more volunteers and the trust volunteer office were fabulous getting people cleared to volunteer and trained. All we had spent at that stage was money on tea and biscuits and expense to attend meetings. The energy and agency in the room was amazing as I hosted these events.

Soon the leaders in the group emerged and they quickly co facilitated events with me. My role switched to mentoring in the background and opening doors by facilitating links with trust departments. So I got communications, volunteering, the CEO and his office, governance and operations on board very quickly. We spoke to those in power inside and outside the organisation and with a number of great local user led organisations to get support, minimise challenge and ensure we were not derailed, a few times we came close.

We set up a good old project structure as here I have a few technical skills. I chaired the project board and reported to Executive Team colleagues and Trust Board. Our recovery meets became the BIG recovery meets as so many people were now involved. We got the University to support us and we bid successfully for some service development/research funds. Because we deliver the ARUs post graduate priorities of research to improve health and well being, innovative education and user led.

So we developed our PID project initiation document, sent key patient leaders and staff off to St Georges to be trained at their Recovery College and got on with recruiting and thinking about course locations and design. And just before I left the trust in February we recruited the project lead on an NHS agenda for change contract (no small feat). Somebody with excellent project and technical skills for the job, welcomed and supported by people with lived experience because he is also a person with lived experience of mental illness himself. And in June they run their first course called BE YOU.

I’m so pleased and proud beyond words to have travelled with them for a while as I gained so much and learnt so much because here the boss is no leader the patient is and it’s as it should be.

So I will end with further thoughts on recovery, the Equality Act and mental health discrimination. This follows the media reporting around Megan Cox and Emirate Airlines decision to withdraw their job offer to her. I don’t know Megan’s medical history, I like most of you know her story as it is presented by her in the media. But, I do know if Emirates were based in our country and subject to the Equality Act then they would need as an employer to prove they have not discriminated against Megan. In the Act there are 4 ways she could have been discriminated against here with her mental health history. Is it direct discrimination stopping her employment? (Because she had a mental illness). Is it discrimination by association as she is well now but had an illness? Or is it perception discrimination worried about the risks someone with mental illness might pose on a flight? Or could it be indirect discrimination because someone else in Emirates air crew has had mental health problems and the organisation has not got the systems and support in place to deal effectively with staff with this condition.I know for a fact based on averages 1 in 4 of Emirates air crew will be today or have in the past suffered mental illness. Are they being supported and treated? Or are they hiding it for fear of a potentially discriminatory employer? Would I rather fly Emirates or fly with Megan if that’s the case? I’m with Megan here and I hope her career takes off with a much better employer.

Meanwhile perhaps the UK based airlines could think about up signing up as an organisation to
As finally said so brilliantly by Margaret Wheatley in 2010 and paraphrased here:
“Leadership rests on the illusion that someone can be in control. …. we need to abandon our reliance on the leader as hero and invite in the leader as host…….these leaders as hosts are candid…..they don’t know what to do…..its sheer foolishness to rely only on themselves for answers. But, they also know they can trust in other people’s creativity and commitment to get the work done. They know that other people, no matter where they are in the organisational hierarchy, can be motivated, diligent and creative as the leader, given the right invitation.”
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Challenging Ourselves to THINK, LISTEN, ACT & most of all let THEM OTHERS in

Some more ramblings from an Ex NHS Board lead on Equality and Diversity
It’s a few weeks since I last blogged on the theme of diversity and I thought it was timely given it is NHS Equality Diversity and Human Rights Week to discuss the issues again.
My initial blog was prompted by Rogers Kline’s report:
“The snowy white peaks of the NHS: a survey of discrimination in governance and leadership and the potential impact on patient care in London and England.” Middlesex University.
The report left me troubled at the situation we find ourselves in, with data going the wrong way on numbers of Black and minority ethnic staff (BME) and women leaders in the NHS. It not just the NHS either. Statistics tell us in the top teams of the Whitehall civil servants, those who chair national committees and MPs in Parliament numbers of black and ethnic minority staff and women are reducing not increasing. This is all happening at the same time as our country becomes more diverse and dynamic.
I am really pleased that Rogers report has had air time at senior levels in the NHS, in national media and has been taken seriously by the NHS Leadership Academy. Meanwhile Clive Efford MP spoke to the BBC about the FA and Mr Scudamore’s attitude to women:
“They either mean it when they talk about discrimination or they do not.”
This is a really important challenge for all of us, as the things we talk about as leaders get focused on. The things leaders focus on in big organisations usually get delivered on by their staff or in terms of culture get modelled by them. So, we need to now move beyond the talking about it.
In this blog for the leaders of the NHS I think more about the challenges we face in the lack of diversity in top teams and suggest it needs us to THINK, LISTEN, ACT & most of all let THEM OTHERS in.
As, if you talk quietly and off the record to those who lead board development and undertake executive coaching in the NHS they will tell you the sad facts. Women who apply for CEO roles are taking 4 times longer than men to get their first post and for the rest of the board appointments look at the pictures on websites. 80% of the time you will guess the ethnicity and its mostly white, middle aged and male. We need action and its urgent now and Rogers work puts a loud hailer to the problem.
This issue is fundamentally about the sort of NHS we are growing and developing. Can this NHS that we have been so proud of for 66 years survive the future if it does not reflect the population it serves?
A number of you will know the story of the man walking on the beach. In the distance another man is throwing things into the sea, as he draws nearer he sees the man is surrounded by thousands of star fish gasping their last breath. He asks the man what he is doing as the man throws another back in.
“I’m saving one at a time,” says the man.
This reminds me that no challenge is ever too big for organisations and their leaders if we start with one starfish at a time. It’s about a mind-set, a culture, a willingness to act and to change.
THINK, leaders when you are in your Board meeting or Executive team could you take some time to review Roger Kline’s report and consider the challenges in your own organisation. Look at your own stats your HR team will have a mine of info on workforce demographics and you are likely to have info on patient data elsewhere. Look at who goes on leadership courses, who is and isn’t getting coaching, mentoring or getting promoted.
Reflect for a while on when you staff look up who do they see? Do they believe it could be them? Do they see people like them sitting around the table? People with the skills and talent they possess being valued and celebrated.
But, when you think about these issues don’t beat yourselves up, start to imagine what little things you might do to better understand the blocks, barriers and the organisational behaviours that limit diversity. Use an appreciative enquiry approach and think of your starfish.
I have been thinking on this issue a bit since my last blog. And, over the weekend I finally got around to watching Mandela – Long Walk to Freedom. As I watched it I was struck by the very tangibly different way that Mandela acted from prison to his earlier life. When from prison he responded to the apartheid government newer thinking and that tentative reaching out to him. I thought for the first time about the governing leaders and how they needed to initiate the change, letting him in. They had begun to THINK and in small ways admit they needed to change.
What did Mandela do? Well he went and met them and spent lots of time listening to them and their concerns. So, trusts boards I bet your stats will not be very reassuring on diversity in your top teams. Don’t kid yourselves its better than it is, and it’s ok to say we need to do much more. You might be starting from a weak place but it’s a place. All you now need to do is begin to LISTEN to your staff.
If you don’t have one already then I suggest you get yourself a coach as you will be challenged. You will need to take time to work through what you hear. Some of it will be uncomfortable and difficult to resolve easily.
Then go listen some more find your body of staff, talk individually and in forums about equality and diversity. As in the crowd will be women who have been identified as potential leaders, the black and minority ethnic staff, the gay, the straight, the disabled, those with faith, those without, the carers of children and elderly relatives and the older and younger workforce themselves. Go find them and seek to listen to the issues from your workforce perspective.
I can guarantee that if you are genuine and authentic in your inquiry you will find out what this place is like to work in? The good, the bad and the ugly. You will discover what the organisation does that helps staff from diverse backgrounds get on and what hinders. You will also get suggestions from the front line of how you might make it better. That’s gold dust as we know unhappy staff equate to poorer care outcomes. So this is never just about the Equality Act .It is the core of what we need to do and its mainstream.
Then it’s time to ACT. That might mean more thinking, more listening, going back with more questions. That is all ACTION and all is valid. It probably will involve feedback to your board on what you found. You will not fix this quickly and it requires a leadership investment. Like with starfish the most powerful action can be a small thing that really tells your organisation you have listened, heard and are trying to be a better leader. Be honest about what you do not know, what makes you uncomfortable and do ask for help. Your staff want dialogue and to be listened to and they will value that.
My experience is you will need support so looking to NHS Employers is a good place to start. They provide regular briefings on equality and diversity, run events and they are very high profile on twitter. I found their support invaluable when I was leading this agenda.
Some suggestions for further on going work. You might commit to meet regularly with one of your BME staff to check progress on the issues. What about shadowing a senior working mum or older member of your workforce who has to organise their fathers care and support for his dementia before they come to work in the mornings? All of this will begin the slow and difficult journey of LETTING THEM OTHERS IN.
What struck me about Mandela was the way he sought to let the others in, he changed his mind-set on the challenges. They were not an easy group to trust or for him to meet with. I suspect without being let in and letting them in he could not have built the trust to then put his perspective and his people’s perspective over. And we would have probably never have seen the end of apartheid.
I urge us as leaders to do what we can to change this situation. Challenge ourselves, challenge our teams, and challenge our organisations to let others in.
As “It always seems impossible until it is done.” Nelson Mandela.
I hope you all have a productive week and give some time to creating a fairer more inclusive place for your staff, your patients and their families.