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

culture of compassion, Leadership, wellbeing

Put your energy in the right place – how to get more love in the workplace – part 5

I had a revelation this week; one of those Aha! moments that come along very infrequently but when they do they make a significant difference. It was about energy and the need to put your energy in the right place to increase your work productivity and sense of well-being.

It emerged during a coaching session when I was thinking about how to more effectively lead the programme that I am currently directing. What became clear was that as the programme is in the start-up stage and does not have a full team in place, my energy has been spent in the mechanics of the programme, administrating and being ‘in the weeds’ of the day to day rather than strategising and thinking through the policy implications.

My preference is for global (strategic) thinking, which is right brain dominant and leads to a focus on the future state; the big picture and people with this preference thrive on experimenting and spend time ‘thinking’ rather than ‘doing.’ This means that when I put my energy into detail; reactive activities and short term tasks, it results in a drain in my energy.

I had convinced myself that I was getting to the end of the week exhausted and lacklustre due to the fact I had been spending all of my time on intellectually challenging activities; however when I really thought about it and closely examined how I spend my time during the week it became clear that the majority of my time is spent in meetings and working on the mechanics of setting up the programme leaving only a small amount of time left for thinking and working on strategy and policy development.

This has started me thinking about energy and how to use it more wisely to be more productive in the workplace by focusing it in the right places. A further look into some tools and techniques for how to do this best revealed a really informative Harvard Business Review article about ‘how to manage your energy not your time.’ The article identifies that energy is defined in physics as the capacity to work, and comes from four main wellsprings in human beings: the body, emotions, mind, and spirit. It suggests that it is possible to systematically expand and regularly renew energy through specific rituals, which are described as behaviours that are intentionally practiced and intentionally practices so as to become unconscious thinking.

This article summed it up for me: “To access the energy of the human spirit, people need to clarify priorities and establish accompanying rituals in three categories: doing what they do best and enjoy most at work; consciously allocating time and energy to the areas of their lives—work, family, health, service to others—they deem most important; and living their core values in their daily behaviors.” Take their test to see if you are heading for an energy crisis and for top tips on how to prevent it.

My revelation has made me think more widely about the fact that, despite having the highest staff engagement scores in the country, my organisation is in the worst 20% of Trusts scoring that staff are working long hours and we are noticing that for the first time stress due to workload is on the rise. Finding the approaches that are going to make the difference in busy, healthcare environments is very difficult. Working on helping staff to manage their energy may be the completely different approach we might need to consider.

Over the next few months I’m going to be trying out some of the new techniques coupled with applying the learning from Covey’s 7 Habits of Highly Effective People (more on this in a future blog) to see if I can change my energy balance; be more productive and fulfilled and hopefully make more quality time for my team and colleagues.

Resources used:

Identify the difference between strategic and global thinking

Test whether you have a strategic or a linear thinking preference

 Full article from Schwartz and McCarthy; 2007; Manage your energy not your time; Harvard Business Review

Covey; Stephen R; The 7 Habits of Highly Effective People; Rosetta; 1989 

About the author

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

Leadership, Millenial Generation, Organisational development, Staff development

All present and correct?

In today’s increasingly fast paced; always connected, always ‘on’ world, it feels as though there are never enough hours in the day to get done what needs to get done. Time feels like it slips through the fingers like sand but suffers from the polarity of being both fiercely protected and recklessly squandered. A way of making the most of the time we have; our precious 168 hours a week; is to improve our work/life balance, but is that as easy as it sounds?

Work/ life balance is something we all talk about, but achieving the perfect balance appears to be the Holy Grail. The Millennial generation (those born between 1980 and 1995) are particularly protective over their work/life balance and as the Deloitte Millennial Survey (2014) highlighted, by 2020 75% of the global workforce will be millennial, and so understanding what they are looking for in the workplace is increasingly important.

An international study published in the Harvard Business Review report from February 2015 ( demonstrated that the term work/life balance means different things in different parts of the world. Many interpret it as work/me time. Interestingly, except for Central/ Eastern Europe, in every other region, over half the respondents said they would give up a well-paid and prestigious job to get better work/life balance.


Source: Harvard Business Review, What Millennials Want From Work Charted Across the World; February 2015

Broadly speaking, most Millennials across the world cited spending time with family and to grow and learn new things as the most important to them, if they could prioritise in life.


Source: Harvard Business Review, What Millennials Want From Work Charted Across the World; February 2015


This is great in theory, and companies such as Google and Apple are famous for having mastered it, however many organisations still have a prevailing culture of presenteeism i.e. I have to be able to physically see you to know you are working. Frederic Laloux’s fabulous book Reinventing Organizations tries to tackle this very issue, citing the companies around the world that have moved to self-management; putting the power in the hands of the staff rather than the management. He describes these types of organisation as being evolutionally teal, the characteristics of which appear to be looking after the spiritual well-being as well as the emotional and financial well-being of their workforce.  In reality, these organisations are the exception rather than the rule, so the real challenge is how to move away from a culture of presenteeism to one that values effective outputs.

This demands a different kind of leader; one that is comfortable with a more collective or distributed type of leadership; who moves the power to where the skills, energy and motivation lie and creates the right conditions for innovation to flourish (West and Dawson 2014; Kings Fund).

Enabling staff to have more flexible and agile working practices is crucial to ensuring the recruitment and retention of the best talent. Unusually for an NHS organisation, over half of our staff are under the age of 40 (54% against the NHS average of 41%) and so understanding what is important to different generations, particularly millennials, is an important part of our workforce strategy. We are about to undertake some research looking at what is meaningful to the different generations and different professional groups in our organisation, so that we are better able to tailor our training and development; workforce policies and support different working practices. Moving our managers away from a prevailing culture of presenteeism to one where they are comfortable in treating staff as individuals; interpreting policy and managing staff on the basis of the quality and timeliness of their outputs will require investment in supporting our managers to think differently and will require our leaders to change the ‘ask’ in the organisation.

This feels like the right direction of travel and should enable a different type of workforce to emerge to ensure that we remain one of the best employers in the NHS and are growing a workforce that has the work/life balance they both want and deserve.

About the author

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


Leadership, Organisational development, patient centred care, Staff development

OD in the NHS III – visiting OD of the past, present and future

As a social animal I’ve always been a ‘joiner’, wanting to have a sense of belonging and a community to call my own. I’ve not had that feeling in the NHS since I was on the graduate scheme in the early 2000s; that is until today at the third DoOD ‘OD in the NHS’ conference.

The 200 delegates, representing 150 organisations found their way to the centre of London to share, learn, connect and grow. Building on the inspirational conference held in Bristol back in March, this was the ‘coming of age’ and a maturation of the OD community from its inception in February 2013.

After an hour of coffee and networking, the conference opened with plenary session led by the two stars of DoOD Paul Taylor and Karen Dumaine. In typical Paul and Karen style, they started the session by terrifying themselves (and us) by launching with not one but two ignite presentations. I was new to this concept (5 mins, 20 slides and 15 seconds per slide) but I absolutely loved it! It set the tone and energy for the rest of the day as Paul rattled through the story of DoOD – 1 million minutes told in 5 and Karen tantalised us with agenda for the day – a trip through an OD of the past, present and yet to come. The promise was the rare luxury of a safe place to stay sharp. So far, so energised.

Taking a steer from Peter Drucker’s premise that “the best way to predict the future is to create it” an eminent panel of speakers projected themselves to 15 July 2020 to have a rich debate Newsnight style, on how it feels to have achieved the goals of the Five Year Forward View (5YFV). Listening to the panel who spanned acute and mental health providers, Monitor, NHS Employers and the NHS Leadership Academy it was clear that the future is in our hands and OD has a huge part to play in supporting ways of working that bring ‘joy’ back into the workplace. ‘OD is the alchemy of great performance’ coined by Danny Mortimer Chief Executive of NHS Employers (home of DoOD) really resonated and his words ringing in my ears as we moved into our ‘thinking differently workshops’.

Stimulated from the panel discussion I headed into Mike Chitty and Kash Horoon’s session on Systems Thinking. I’ve been wrestling with concept of systems thinking and systems leadership so I’d been looking forward to this session. Kash told us the story of DevoManc and then we examined what this means for systems thinking (apparently different to systems leadership) in a wider discussion. My take away was that in essence in order to be a systems thinker you have to accept that we are in a complex and adaptive system which is unknowable and ask questions to reveal what the change should be. We need to resist the urge to analyse and become reductionist in order to try and solve problems. This made me question whether or not the NHS is ready for this and if not, what would need to be in place for it to become ready? It piqued my interest and I took away more questions than answers, so more musings required.

My mind blown and my tummy empty signalled it was time for lunch. I took the opportunity for some reflection before heading into the session straight after lunch with Practive on the power of changing our language and structuring our dialogue to bring about much more effective conversations.

Based on David Kantor’s Four Player model which examines the roles of Mover; Follower; Opposer and Bystander and how to take a positive position in each one to engender an effective dialogue. Kantor found that ‘when a team is capable of communicative competency, there is an exponential leap to effectiveness. By becoming more competent, the team accelerates it ability to define new outcomes.’ This took me back to the morning session of future-basing for the NHS and the fact that the key to success is not using the same thought processes and methods to define the new world as we have done the old.   Enabling the system to design the new world is a pivotal role for the NHS OD community.

This will require significant culture change, so my next session was perfectly timed. Having attended Stefan Cantore’s session at the last OD conference I was really looking forward to his session on Culture Change using the Theory of U as a change enabler. Stefan took us through a set of provocative questions delivered through a journaling technique that revealed thoughts I did not even realise I had.   I found this incredibly useful to frame a live issue that is on my mind at the moment and coupled with a few minutes of mindfulness, I came away from that session with more clarity than several weeks of thinking in a busy work schedule had managed to generate.

Saving the best until last (and believe me the bar was set high throughout the day) the final session with John Scherer and Amy Barnes took us through the history of OD and how the practice has developed through today and beyond, ‘in order to create the future you must respect the past’. This session gave us practical tools and techniques for how to use action research to really get to the heart of issues and co-create solutions with our clients. My favourite quote was John Scherer who said, ‘it takes courage and heart to be a really good OD consultant’. This was a high energy session where we explored how to formulate quantitative questions using a Likert scale approach and how to have really effective one to one interviews imbibing the ‘Vegas principle’, which is exactly what you think it is!

At the end John challenged us to think about ending every meeting by asking 2 Likert scale based questions:

  1. On a scale of 1 to 5, how interesting or useful was the content/ process of our meeting?
  2. How could we make it better for next time?

I’ll be trying that one out on my team.

I finished the day richer than I started. There were questions whirring through my mind with a hunger to find out more about the things I heard; the networking led to a conversation about the opportunity of a buddying relationship with another teaching hospital and to top it all off I won the prize draw – the book ‘A Field Guide to Organisation Development; Taking Theory into Practice’. A fantastic end to a fantastic day.

The OD community have definitely come of age and I feel honoured and privileged to be part of the movement, with two membership badges to pledge my allegiance.


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About the author

Sarah Morgan is the Director of Organisational Development t Guy’s and St Thomas’ NHS Foundation Trust

Blog first published as guest blog on NHS Employers website on 21 July 2015

Leadership, Organisational development, Staff development

Increase your creativity & productivity – reclaim your lunch break!

I decided to reclaim my lunch break today. It was completely unplanned as I, probably like the majority of you dear readers, spend most of my lunchtimes fork in one hand, mouse in the other, glued to my computer screen.

I’d reluctantly left an interesting conference early with the view of attacking my To Do list with gusto and on my way back to the office I popped into a well know purveyor of ‘good natural food’ for some lunchtime sustenance. The girl behind the counter asked me if I was going to eat lunch in the park and as I heard myself utter the words , ‘no sadly I’m going back to my windowless office to eat it’ I caught myself and thought “WHY????.” Right there and then I resolved to eat said lunch al fresco.

I’m luckier than most as, although a rare occurrence, lunch al fresco for me is either by the Thames at London Bridge (home of the windowless office) or opposite the Houses of Parliament on Westminster Bridge (upmarket hotdesking).

The minute I sat down to admire the view and ponder this afternoon’s tasks ahead, my creative juices started flowing and this blog popped into my head. Stylist magazine started a Reclaim Your Lunch Break campaign in January 2015, backed by Deputy Prime Minister Nick Clegg. This was on the back of a recent study that said by not taking our lunch break we work an additional 19 days per year! Shocking really and if you’re interested in finding out more go to

If the working for free isn’t enough of an incentive to unchain you from your desk, there is a growing body of evidence that suggests that our brains are not designed to work solidly for eight or more hours a day and that breaks make us more productive and creative. In fact, brief and rare mental breaks actually keep you more focussed, not less according to an article in Cognition in 2011 from Alejandro Lleras, a psychology professor from the University of Illinois

Still not convinced? Well my own mini experiment meant that my 20 minutes of fresh air and vitamin D by the river not only created this blog but also cleared my head for the mammoth task of tackling that To Do list this afternoon.

We have 13,500 staff in my organisation and as the Director of Organisational Development, how to improve the working lives of our staff; keep them psychologically resilient as well as physically healthy and motivate them so that they continue to provide excellent patient care is constantly on my mind.

As Spring turns to Summer I’m thinking of starting a Reclaim Your Lunch Break revolution of our own. What with that and our Associate Director of Equality and Human Rights promotion of walking meetings it feels like we could be on the cusp of releasing an amazing level of creativity and innovation in workforce that mean fantastic things happen.

Oh and if you’re wondering I managed to whizz through my To Do list and even managed to leave work on time for a change. I’m converted.

Join the lunch break revolution!

reclaim your lunchbreak

Me earlier today enjoying my lunch break on Queen’s Walk by the Thames with Tower Bridge and the Tower of London in the background

Leadership, Organisational development, Staff development

DoOD conference Putting OD Theory into Practice – Creating the right conditions for possibility

It was a sunny March morning when over 100 delegates descended on @Bristol science museum for the DoOD conference ‘Putting OD theory into practice.’

We all had different levels of expectations and different intentions for the day, but our collective spirit was aligned – we wanted to learn more about how to use OD tools and techniques to support real and meaningful change in the NHS.

The day started with Stefan Cantore asking us which came first, the chicken or the egg – very apt for a science museum setting. He challenged us all to recognise that however we choose to answer that question we are bringing our own life beliefs, experiences, observations, academic theory etc to bear on the answer – social constructionism in action. Stefan levied at us, that we are our own experimenters, researchers and practitioners in our own life, which was a real revelation and one that Mark Doughty, a patient leader, reminded us of later in the day.

Stefan went on to ask, how can we start to be generative in our conversations in a way that help us to prepare for and therefore shape our tomorrow? This was a great provocation to start the day; it definitely woke me up and made that 5.30am start worthwhile from the get go.

I went on to Stefan’s next session on Appreciative Inquiry (AI) – Seeing Beauty and Saying Beautifully (the title from a John Piper book). This session explored the 5 principles of AI and what it actually means. Discussing this concept sitting outside, overlooking Bristol, in the sunshine (as Karen Dumain from the DoOD team tweeted Doing OD with Vitamin D) led to a very powerful conversation with a colleague from Worcestershire Health and Care NHS Trust about how we develop courage in our organisations – Courage to speak and courage to hear. My first of many networking opportunities of the day.

Next session was Cliff Oswick from Cass Business School on practical change within traditional structures. His provocation of ‘how do you get bottom-up, networked, emerged change (social movement style) within top down, hierarchically organised structures (traditional organisations). You can’t really get more traditional and hierarchical than the NHS so this led to a really constructive conversation about how to create the right conditions for possibility. I once saw a job advert for my perfect job – Director of Possibilities – it sounded like something from the Harry Potter Ministry of Magic and I love the idea of it. The art of the possible is truly vast in the NHS and if we can harness our staff to really make the possible happen, the NHS could be unstoppable.

Lunch was a time of reflection. I have a ‘little book of ideas’ that I take everywhere and over lunch me and my new little DoOD sat out in the sun and pondered ‘how do you create disruption and create the conditions that enable staff to innovate?’ One to take back to my Director colleagues and OD team.

After lunch, in a complete about turn from the usual after lunch slump slot, Maxine Craig got us sitting up and thinking about Dialogic as a new approach to OD. She whammed us with the fact that 70% of transformation programmes fail (a well documented fact) but we keep repeating the same mistakes. So how do we change our approach to change? The provocation that you ‘cannot plan transformation like a project’ – wow! It’s all about sense-making early on and gaining commitment rather than compliance around changing the narrative of an organisation. if you want to read more. I was fascinated and am really keen to learn more so will be reading the white paper from NHSIQ ‘the new era of thinking and practicing in change and transformation: a call for action for leaders in health and care (Firman and Bevan 2014).

The final two plenary sessions were superb and kept most people from slinking off early to get their trains. Firstly, the lived experience of Mark Doughty who has recently been appointed as a patient leader for the King’s Fund describing how he reframed his mindset and became a disrupter for the NHS. This was a really powerful version of the Radio 4 listening project and a great conversation.

Then a great idea, Paul ran a session which created time to think based on Nancy Klein. This was a great way to really reflect on the day and not just run away and all the good thinking to be lost. This created a lot of energy and enthusiasm at the end of the day.

Overall, a thought provoking and inspiring day and I emailed my OD team from the train on the way back to London to share with them how inspired I was and to enthuse about the day, which they sadly couldn’t join me for. Thank you to the DoOD Team for putting on such a great day and can’t wait for the July gathering.


Does money really make the world go around or are we motivated in a different way?

It is a hugely challenging time for the NHS.  The funding gap is estimated to be £2bn and with pay making up 70% of the costs in the NHS, substantially increasingly salaries in order to incentivise staff is not a viable option.   So how do we motivate staff to release that discretionary effort that we need to improve patient care without financial incentives and rewards?

But for to those that work in the NHS is it really about the money?

In 1964 Hertzberg revealed his motivation and hygiene theory, he hypothesed that money was hygiene factor i.e. people need to be paid a fair wage for the job they do and they appreciate a pay rise or a bonus but it doesn’t last.  It isn’t a motivator.  Fast forward to 2005 and research conducted for the Federal Research Bank of Boston by Dan Ariely et al from MIT demonstrated that financially linked reward actually reduced performance, which is completely counter intuitive  So if money doesn’t motivate or improve performance then this could actually be good news for the NHS but how is it achievable?

Daniel Pink, Al Gore’s ex speech writer, has written a fantastic book called Drive (2009), which is definitely worth a read, as he describes how to release the intrinsic motivation within people.  He cites three factors:

  • Autonomy – control over your own destiny, how you work and the ability to make decisions
  • Mastery – the ability to become extremely proficient at something
  • Purpose – doing something you believe in, that drives you and speaks to your values

People work in the public sector, and particularly the NHS, for a variety of reasons, however the majority of staff really believe in the NHS, its core values and what it achieves.  They feel their purpose links to the wider purpose of the NHS and they have the potential to love what they do.

Healthcare is a complex field and therefore it has very bright and very skilled people who work in it making life and death decisions to help millions of people every day.  It is also a fast moving sector as technological advancements mean that the clinicians and managers are constantly changing and adapting how they work.  Mastery and being an excellent clinician or manager in this complex environment brings with it a huge sense of pride and supporting staff within the NHS to be the best they can be will improve patient care and outcomes beyond compare.

Being valued and trusted as an employee demonstrated by having control over your own work environment and autonomy cannot be underestimated.  The predominant ‘pace setting’ leadership style (Goleman 2000) that has dominated the NHS over the last ten years as a by-product of the target culture, has meant that the autonomy of many staff has been challenged and a learned helpless prevails.

It seems to me that we may be missing a huge opportunity and one that would really benefit the NHS as a whole by considering how we support staff to develop autonomy, mastery and purpose. We need to help staff to unleash their intrinsic motivation so that they feel empowered in their day to day work and as a direct result improve patient care.

For Daniel Pink’s TED talk