Authentic Leadership, culture of compassion, Leadership, staff engagement

Staff engagement – a matter of life and death?

Most of us spend more time at work than we do with our friends and families.  Ensuring that the workplace is somewhere you can bring your whole self to work is incredibly important for our wellbeing.

In the 2015 NHS staff survey nearly 40% of staff reported feeling unwell due to work-related stress.  This suggests that staff are not able to bring their best to work and deliver high quality patient care.  In fact, in the same survey 41 % of staff would not recommend their trust as a place to work and 31% did not feel they would recommend their organisation to a friend or relative as a place to receive treatment.

These are stark figures, particularly when staff wellbeing in the NHS is proven to have an impact on patient mortality rates and patient care.  The Royal College of Physicians published at report in October 2015 stressing the need to improve work and wellbeing for NHS staff to keep patients safe.  Proving that in the NHS happy staff really is a matter of life and death!

I’m passionate about the need to create organisations that enable people to flourish.  I am not particularly keen on the phrase ‘staff engagement’ as I think it’s more about building organisations that people are proud to work at and can bring all of themselves to work.

On Monday 30 January 2017 at 10am I’m presenting a free live webinar on the topic of engaging staff in change.  I’ll be talking a bit about how we’ve been working hard to really make Guy’s and St Thomas’ an organisation that staff are proud to work for and recommend to their friends and family to receive treatment.

As a taster I’ve made a short video talking about some of the approaches we have taken over the past ten years, starting with our values and behaviours in 2006.

If you’re passionate about bringing more love into the workplace, have any questions or your own approaches to share then on the webinar, you can still register here.  It would be great to see you.

About the author

Sarah Morgan is the Director of Organisational Development for Guy’s and St Thomas’ NHS Foundation Trust and the lead for staff engagement and leadership for the Trust.

Sarah’s eight part blog series on ‘How to get more love into the Workplace’ was nominated for a UK Blog Award – healthcare in 2016

 

 

 

 

 

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Authentic Leadership, culture of compassion, Leadership, Motivation, NHS Leadership, Organisational development, Resilience, wellbeing

2017 – My year of Focus

I was asked at the beginning of the year what my word for 2017 is and I decided it is ‘Focus’.

Just before Christmas I found myself in a complete state of overwhelm and was working inefficiently, flitting from task to task; meeting to meeting and trying to juggle too many variables at the same time.

Over the break I took time out to reflect and think about what I wanted to do differently in 2017 and came to the conclusion that less is more and I needed to re-prioritise.

I realised that in order to stay resilient I need to be more discerning and disciplined with my time, to not give it away too easily and spend more time on the things that energise me and make me happy in life including my spiritual and physical wellbeing. Most importantly I need to prioritise my time with my friends and family and ensure that I’m not taking them for granted.

I have decided to prioritise to five key things to focus on, which are:

1. The creation of a diary management system to prioritise both my work and social to have a much better use of time. This includes saying no more often and builds in protected time to think; write and research to ensure we stay ahead of the curve in leadership; OD and new models of care. This will ensure I can dedicate the right amount of time to the three major programmes that I am currently leading. I’ve designed a colour coding system so I know what is a must-do and what I can delegate or drop if necessary.

2. Limiting my social activities to only having one to two nights a week when I’m going on to an event after work. Prioritising things that I’m really passionate about. I became a Fellow of the Royal Society of Arts in November last year and am keen to connect with their Reinventing Work network as is connects with my passion of creating more love in the workplace – the theme of my 2016 blogging year.

3. Leaving work on time to go to the gym and making time to get enough exercise. Particularly reconnecting with the activities I love such as yoga; climbing and recently I’ve gone back to High-Intensity Interval Training (HIIT) . Even after a few short weeks it’s making a real difference to how I’m feeling.

4. Improving my sleep as before Christmas I was only getting 5 hours a night and I was finding it was affecting my decision-making and judgement. I’m experimenting with making sure that I’m winding down and in bed for between 10pm and 11pm to make sure I’m getting enough sleep aiming for between 7 and 8 hours a night to try and maintain my ability to stay focussed

5. Writing To Do lists is something that I have to really discipline myself to do. I’ve been lucky enough to have been able to rely on my memory for keeping me on top of my workload for my working career. However I noticed that as I became more overwhelmed, coupled with getting less sleep I found that I was starting to forget to do things until the last minute, which is very out of character. I find writing a To Do list quite cathartic and am using magic white board paper on the wall to write things down as well as using a To Do List book and a daily ‘plan of attack’ to make sure I prioritise every day. I find the discipline hard but rewarding when I do it.

I’m hoping that by putting in place these simple changes I’ll stay resilient; passionate; achieve more in my working day and have a greater sense of wellbeing. I’m starting to see the shoots of improvement and I’m encouraged to stick with it for now.

I hope you’ll stay focussed with me in 2017!

 

About the author

Sarah Morgan is the Director of Organisational Development for Guy’s and St Thomas’ NHS Foundation Trust

Sarah’s blog was nominated in 2016 for a UK Blog Award – healthcare

Sarah is passionate about getting more love into the workplace which was the theme of her 2016 blog series and nominated for the UK Blog Award

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Authentic Leadership, Diversity, Inclusion, Leadership, NHS Leadership

One conversation at a time – How to get more love into the workplace – part 7

We all dream of days at work that uplift, inspire and fill us with good feelings; however the reality is that they don’t come along as often as we would like. On 13th July, we had a day just like that, with 130 staff from all parts of our organisation, discussing how we create an organisation that is ‘fit to house the human spirit’. It created a positive energy and vibe that lasted throughout the day.

At Guy’s and St Thomas’ we have the highest staff engagement scores in the country, but we still have some dark spots. We’re focussing on shining a light on these key areas, one of which is improving staff feeling a sense of inclusion in the organisation. We have been running a series of Staff Engagement Inspiration Masterclasses, starting with Professor Michael West in May, and most recently we invited Eden Charles PhD to talk to staff about inclusion.

The amount of enthusiasm for the session was unprecedented. We had 100 places but were packed to the rafters with 130 staff wanting to take part. Eden delivered a key note speech and through the use of ZOUD – zone of uncomfortable debate – really got everyone to think about how we all have the ability to exclude others and to precipitate micro inequalities without even realising it. Leading on from Eden’s inspiring speech our Chief Nurse led a series of discussions both in thinking pairs and at a table level, to help participants to really engage with thinking about what they value about their own characteristics and how they might also lead them to accidentally exclude others both in the workplace and outside. This engendered a real energy and engagement of the participants really wanting to engage in thinking about how they could really start to understand others better.

In thinking about diversity overall, thought diversity emerged as a key topic; a conclusion of the Masterclass was that inclusion and understanding of others takes place “one conversation at a time.”

After only 2.5 hours of talking about inclusion, the atmosphere had changed and the energy carried out of the room with the participants. Some challenging points were raised such as ‘what will be different’ and the response is clear; “embracing diversity and being inclusive is everybody’s business”.

Having authentic conversations can often feel quite daunting; especially in the workplace. There are often cultural norms guiding what is considered appropriate and what is a taboo area, and if you are brave and do challenge the status quo it can often feel psychologically unsafe. This means that the culture prevails as people protect themselves by not challenging the norms, and those that feel differently will often leave as they do not feel comfortable or understood within the organisation. This leads to the unsafe practice of groupthink and can lead to poor decision-making and a stunting of the potential of an organisation to progress.

Moving to a place where diversity of thought is not only accepted but positively embraced is the way forward for the NHS and the wider public sector. We are living in a very uncertain and ambiguous time and therefore having a linear approach, based on the thinking that has always prevailed at the top of organisations, will not enable us to navigate the complexity of our new environment. We need a new way of thinking and being that will engender new, evolving conversations and inspire new approaches to enable us to re-invent our workplaces.

Back to the Masterclass; you could argue 130 staff out of our 15,000 is not many, however this is only the first step on the journey for us – a small step but an important one nonetheless. We want to start a completely different conversation in the organisation that encourages diversity and enables our leaders to create enabling environments that supports all our staff to bring their best to work every day. This will help us to continue to deliver high quality healthcare to the in excess of 2 million patients who access our services every year. We will do this one conversation at a time.

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Left to right: Sarah Morgan, Director of Organisational Development; Eden Charles PhD, People Opportunities Ltd; Yadveer Kaur, Staff Engagement Manager; Amanda Pritchard, Chief Executive; Dame Eileen Sills, Chief Nurse at Guy’s and St Thomas’ NHS Trust at the Inclusion Staff Engagement Masterclass held on 13 July 2016

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 Participants of the GSTT Inclusion Staff Engagement Masterclass 13 July 2016

 About the author

Sarah Morgan is the Director of Organisational Development for Guy’s and St Thomas’ NHS Foundation Trust and passionate about changing the world of work

 

 

 

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Authentic Leadership, culture of compassion, Leadership, NHS Leadership, Organisational development

Move away from fear – how to get more love in the workplace – part 6

Earlier this week research showed that there are high levels of perceived bullying in the NHS workplace.  According to the research by NHS Employers 20% of NHS staff report that they have been bullied by other staff and 29.9% indicated that they had some element of psychological distress. Managers and supervisors were perceived to be the most common source (51%).

This is quite a shocking statistic and one that begs the question ‘why?’. What drives, seemingly normal people, who work in a compassionate profession and are probably lovely outside of work, to behave in a bullying manner in the workplace?

My guess is that it is based in fear.

Fear of missing the target; fear of the ramifications of spending too much money; fear of losing job/ reputation/ career that you’ve spend decades building; fear of rocking the boat or speaking up. What fuels these fears?

Fear is toxic; it creates a unconscious psychological response in our amygdala or ‘reptile brain’ which is fight; flight; freeze. This is helpful when a sabre toothed tiger is bearing down on you but has no place in today’s healthcare environment except in extreme circumstances. We are starting to see some of the unintended consequences such as a recent CQC report awarding a requires improvement rating citing ‘learned helplessness’ as one of the cultural indicators created by the senior leadership team.

So, how can we support our leaders to move away from fear and start to create the right conditions for staff to be able to operate to their full potential?

As we know culture is the shadow of the leadership and if the shadow that is being cast is one of fear; perceived lack of ability to control or influence; driving for results no matter what the cost and an inability to listen to ideas or thoughts that differ from the cultural norms; then the conditions that are being created for staff to work in are oppressive; toxic and limiting.

Having grip and telling staff what to do can work for a short period of time, particularly in a crisis. However, over a longer period will lead to reduced results and a culture of escalation to the organisation as paralysis will seep in and staff will start to fear making the wrong decision and therefore will make no decisions.

To move away from fear takes a huge amount of courage and the ability to trust in others. Although the current regulatory environment means that there needs to be an Accountable Officer so it is clear where the buck stops, this does not mean that this person has to do everything; quite the opposite.

The key to that opposite approach is enabling the Executive Team to feel it is safe to let go. A recent interesting article by the Harvard Business Review (1) on exactly this, highlighted the rules of ‘self organisation’ the main element of which is communicating intent. This is a very different approach to delegation. One which establishes a set of principles and a clear framework from within which all staff are able to take decisions.

Many of the organisations featured in Fredric La Loux’s inspiring ‘Reinventing Organizations’ (2) have in common a clearly set out vision and principles and enable their staff to make decisions based within the simple framework that they have established. All of the organisations have established approaches to dealing with performance issues and with those people who do not make decisions according to the agreed doctrine, quickly and simply. This clear and simple approach appears to be yielding amazing results the world over.

It is often argued that this is much easier in organisations such as Google and Amazon and in healthcare organisations such as Buurtzorg in the Netherlands (3) as they are all start up companies and had the opportunity to set things up right from the beginning.

So how easy is it to introduce this new way of working into a well established; heavily regulated environment such as the NHS where everything that is paid attention to, measured and rewarded is the opposite? Well the answer is that it is not easy – but rarely is anything worth having easy to achieve. If it was we would have done it already!

Collaboration is the key. Today’s healthcare environment is too complex to rely upon the leadership approaches that worked for complicated problems. Complicated problems can be solved through processes and linear solutions. Complex problems are worsened if this thinking is applied as there are too many factors and variables and therefore a more emergent approach is necessary.

The fear many leaders will have to face is that their ‘tried and tested’ methodologies that worked for yesterday’s problems no longer work and they have no more tools in their toolkit to rely upon. This can often be the root of fear that drives the ‘tell’ culture and often leaders struggle to understand why these methods, previously so successful don’t work in today’s technology driven, disrupted environment. They interpret the lack of results as due to the way the staff are implementing their instructions rather than it being the wrong approach and so give further, more detailed instructions.  Thus creating a vicious circle of decline.

The simple truth is we need a new toolkit and manual for ‘letting go’. Bringing together clinicians and giving them the tools and techniques to enable them to improve how they deliver care and trusting them to come up with the answers, is the first stage to truly transforming the culture in the NHS.

We need leaders that can:

  • lead from behind, rather than in front
  • pose questions rather than offers solutions as they recognise wicked problems require emergent solutions
  • truly collaborate with the workforce and inspire them with purpose and commitment.

These are the leaders that will create the right conditions to replace the fear currently being felt in the NHS workplace with love and compassion, both for staff and patients.

(1)   How Leaders Can Let Go Without Losing Control; Mark Bonchek; Harvard Business Review; 2 June 2016

(2)  La Loux F; Reinventing organizations; A guide to creating organizations inspired by the next generation of human consciousness; 2014

(3) Community nursing organisation in the Netherlands based on the principles of self managed teams which achieves high levels of patient satisfaction, improved clinical outcomes and reduced cost. Featured in La Loux’s book as referenced above

About the author

Sarah Morgan is the Director of Organisational Development for Guy’s and St Thomas’ NHS Foundation Trust and passionate about creating happy workplaces

 

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Authentic Leadership, culture of compassion, Leadership

How to get more love into the workplace – Part One

In my last blog post I shared my new years resolution for 2016, which is to get more love into the workplace.  This is part one of my approach.

I’m posting this from a snowy Colorado mountain on Martin Luther King Day; which seems very apt as MLK once said, “I have decided to stick with love. Hate is too great a burden to bear.”

MLK was a truly authentic leader who spoke out for what he believed in and empowered people to think and act in a different way.

It’s been a tricky start to 2016. With industrial action from junior doctors and the continued struggle with waiting times and financials; it’s starting to feel as though the old methods just aren’t working for us anymore and a new approach is needed.

It seems to me what is needed is a new leadership approach that moves away from traditional pace-setting, command and control styles that have dominated the NHS for at least the past decade, to a more authentic leadership style – MLK style. One that supports staff with the right tools and techniques to make the changes needed on a day-to-day basis, without the bureaucracy of committees that are – in some cases – far removed from the frontline.

The NHS has a good track record of supporting staff with training in tools and techniques, but what has always been lacking is a systematic way of improving the services and solving problems as they happen. Many healthcare organisations have trained up hundreds of their staff in various quality improvement techniques, though few have managed to leverage the benefits. What has been missing is the infrastructure and governance that allows decisions to be taken quickly, at the frontline, at the time it’s needed.

In the past, managers such as myself were trained to be ‘heroic leaders;’ i.e. it was their job to solve the problems (otherwise what are they doing?); however the time for this has now passed – if it ever really was the right approach – and it’s time to really think differently about how we support our staff.

In my view, there are three steps that leaders could take to become more authentic and to enable more effective decisions to be taken as close to the patients as possible:

Step One admit you don’t know all the answers and place the decision making in the hands of those who do; especially those at the frontline. That is a very big ask in this world of accountability and takes bravery; however it has been proven to yield effective results in healthcare systems elsewhere in the world.

Step Two give the staff the tools and techniques to make the necessary change. Supporting clinical staff by training them in quality improvement techniques; using data effectively and understanding how to manage change has the potential to make more of a difference in two months than a year’s worth of committee meetings.

Step Three take the governance to them. Don’t expect clinicians to navigate the intricacies of the corporate governance that many of us spend our days steeped in. Work with intention and develop a systematic approach that allows decisions to be taken quickly and easily. If needed, schemes of delegation can be drawn up to keep everyone safe. Knowing that the intention behind the decision is to ‘make things better’ for patients and staff whilst supporting clinicians to understand the constraints will unleash their creativity. As the saying goes ‘innovation loves constraint’. A really successful example of this is the Virginia Mason test: ‘What can you do with half the money, half the staff, half the space?’ This has supported them to radically change how they deliver healthcare at the same time as increasing quality and reducing cost – the holy grail.

In my view, these three steps will go a long way to bring about a more authentic leadership approach which will lead to a better engaged and enabled workforce and overall more love and wellbeing into the workplace. The question is, can we do it quickly enough to make the difference? In reality, do we have a choice?

I’ll leave you with the words of Mark Twain; “There isn’t time, so brief is life, for bickerings, apologies, heartburnings, callings to account. There is only time for loving, and but an instant, so to speak, for that.”

About the author

Sarah Morgan is the Director of Organisational Development for Guy’s and St Thomas’ NHS Foundation Trust

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