Leadership Listens 5 – The importance of compassion and inclusion

Paul O’Neill Hello and welcome to leadership listens, curated podcasts for leaders in health and care. My name is Paul O’Neill, head of strategy, research and development at the NHS Leadership Academy, part of the People Directorate of NHS England and Improvement. This mini-series of podcasts as part of Leadership Listens, is a series all about compassionate leadership, but it’s a collection of conversations between Professor Michael West and a leader of the health and care sector. This recording is a conversation between Michael and Dr. Habib Naqvi, director of the Race and Health Observatory, and focuses on the area of the importance of compassion and inclusion.  

Michael West Welcome everybody. My name is Michael West, and I’m really delighted to be joined by Dr Habib Naqvi, a very old friend of mine and a wonderful inspiration for me in the work that I do in the National Health Service. Habib, a really warm welcome to you.  

Dr Habib Naqvi Thank you so much Michael it was an absolute delight and honour to be talking with you today.  

Michael West So a little bit about you first Habib, you have a background in public health and health care policy and strategy development. And I know you’ve played leading roles nationally in seeking to create a more inclusive and compassionate and diverse health service. You’re now director of the NHS Race and Health Observatory. Can you just say a little bit about what that role involves?  

Dr Habib Naqvi Yes, absolutely. I’ve been fortunate enough to be leading the NHS Race and Health Observatory, an organisation that looks to identify and help tackle some of the systemic health inequalities that we have within the country. We are fortunate, Michael, to have a fantastic health care service that is perhaps the most visible expression of a social contract between people. But to be proud of our health care services, not to be blind to some of its imperfections and we see within our health care service some of those imperfections that play out in some of the ethnic health inequalities that we have in society. So our goal of a remit within the NHS Race and Health Observatory is to help to tackle some of those longstanding health inequalities that we have.  

Michael West And what sorts of work is the Race and Health Observatory currently doing, just to give us a sense of its activity and the likely impact.  

Dr Habib Naqvi So at a very practical level. We are looking at themes such as maternal health and of course, the very sad statistic that we have today, which is that black mothers are up to four to five times more likely to die during pregnancy, childbirth or soon after Asian mothers being up to two to three times more likely. Of course, we’ve got all the issues around mental health and access to talking therapies for all different, diverse communities. We have issues as we are going through the pandemic at the moment, a world that’s becoming very much digitalised. But to ensure that actually those new innovations help to reduce rather than increase health inequalities for our diverse communities. And then, of course, we have a work stream, which is a very exciting one, I believe, which is looking at some of the common solutions to some of the common challenges that we have around ethnic health inequalities globally so that we can learn from other societies, other countries and apply some of that replicable good practice and learning within our own society as well. So it’s a whole kind of breadth of work that we are focusing on at the moment.  

Michael West So those are really shocking statistics in relation to maternal health, Habib. And it does seem to me that it’s really important that we understand the issues of diversity and inclusion are not simply moral issues. Of course, they’re huge moral issues, but they’re really huge health issues. And I suppose what I’ve been struck by as well is research in social psychology on belonging and the importance of belonging in human behaviour, we’re more likely to die from the effects of loneliness or as likely to die from the effects of loneliness as we are from the effects of smoking or of obesity. We also know that, you know, if children are excluded from their friendship groups in the playground, then that has an impact on inflammation of the central nervous system with health consequences. And I suppose it’s the kind of the knowledge that you’ve been very involved in developing and how when we scale that up, we see that for people who experience discrimination and exclusion over the lifespan, there’s a biological weathering effect could you say a bit about that?  

Dr Habib Naqvi Yes, absolutely. I mean, I think the first thing to keep in mind is the fact that when we look at different types of discrimination and I focus on racial discrimination, as an example. We know that racial discrimination and racism, you know, these are global concepts, system wide issues. And of course, they require a system wide response if we are to have sustained and meaningful positive outcomes from any of the interventions that we put in place. And that’s why, yes, of course, health care system has a role to play in focusing on this agenda, but it’s not, and it cannot be the only enabler. For equity. And that’s why we need to join up with all aspects of society in order to get those better outcomes for people for their well-being in a very equitable way.  

Michael West And so my understanding from the research of people like Dr Williams at Harvard is that when people experience discrimination over the life span, black people, for example, that the impact on their health is cumulative, resulting in a greater incidence of disease and also early mortality. And I guess that was really powerfully and tragically demonstrated in the pandemic. And you, in the Race and Health Observatory would have been monitoring the indicators of that.  

Dr Habib Naqvi Yes, absolutely, Michael. And it’s the weathering effect, the drip, drip cumulative impact of discrimination and racism and its direct relationship with health outcomes and experiences of health care is absolutely critical for us to focus on. And there is a lot more research in this area, perhaps in the United States, but a growing body of evidence now beginning here within the UK itself. And when we look at the context of COVID 19, we know that this has played and continues to play a huge role. And I have to say, Michael, I’ve been working in the field of equality, diversity, health inequalities for over 20 years now. And when the pandemic started, I knew that issues around equality and inclusion would take the backburner. But I have to say I was very surprised as to how quickly these issues were almost thrown out of the window and not paid full attention to until it actually dawned on leaders that these issues are absolutely critical in order for us to navigate the challenges of the pandemic when it comes to issues such as trust, confidence, the take up of services throughout the pandemic, and we are still seeing that today.  

Michael West So I’ve been really struck by some of the data and the pandemic internationally and discrimination. So data for Hispanic people in Chicago being ten times more likely to contract the virus and many times more likely to tragically die as a result of infection than white people in Chicago. And data from Brazil on differences between black people and white people there, particularly striking data from the NHS of the  disproportionate impact of the pandemic. As you said on people from minority ethnic groups, people with disabilities, people from lower socioeconomic groups, but within the health service, how there was a disproportionate impact on health service staff with a hugely greater number of deaths of people from minority ethnic groups, members of staff and also infection rates. And some of the data on whether people were involved in frontline care of COVID patients, whether they had access to PPE equipment. And you must have seen some of the data that has emerged from that. Can you tell us just a little bit about what you’ve learnt from that?  

Dr Habib Naqvi Absolutely. And we put the statistics on behind every statistic is a human being and we need to keep that in mind and so know we cannot escape a very sad reality of the disproportionate impact that COVID 19 has had and continues to have on our staff within the health and care sector and particularly our ethnic minority staff. But what we can do, Michael, is to learn lessons from the different waves of the pandemic and be on the front foot in order to tackle some of these issues as we go through the recovery phase of this current pandemic. And, of course, be on the front foot in terms of any potential pandemics that may emerge in the future. And there’s a huge amount of learning to take with regards to what we can do differently and how we can be a lot more proactive in being at the basic level, inclusive and compassionate in our approaches to health care.  

Michael West So I believe that as a consequence of all, we’ve learnt about the impact of discrimination and exclusion and the importance of belonging and connection. It’s really clearly such a profound health issue in our society, and it’s a profound cause of inequalities. And it seems to me fundamental that in every training programme, in every educational institution, every programme that’s involved in training, health care professionals must be teaching them about the health consequences of discrimination and of whatever the opposite of inclusion is exclusion. And that should also be part of the. Training of leaders. But there’s another dimension to this as well, which you’ve hinted at. And obviously, you’ve had a huge amount of influence on thinking about inequalities and discrimination in the health service. I neglected to mention at the beginning in my introduction that you were awarded an MBA in 2019 in the Queen’s Birthday Honours for  

your services to equality and diversity in the NHS. And as you say, you’ve been deeply embedded in this for 20 years now. And I think what’s also not really well understood in this domain is the importance of diversity for good performance in health services.  

Dr Habib Naqvi Absolutely. And that’s absolutely critical when we know of the benefits of inclusion and diversity, not just in terms of the diverse thinking, but also in terms of representation at senior levels of organisations. Because it’s that diversity, Michael, that leads to the more inclusive, the more equitable outcomes that we want for our workforce and for our patients and communities and where that is not in place. We know what the outcomes are. And of course, the NHS and the health care system is not alone across different parts of the workforce and society to have a long standing challenge of increasing its representation at senior levels within its workplaces and for there to be absolute levels of inclusion and diverse thinking in the decisions that are made around board tables and in the boardroom. And that is absolutely critical if we are to have a health care system that is fully equipped to meet the diverse needs of our diverse communities. And it makes me think actually, Michael, of some of the work that we are doing within the NHS Race and Health Observatory. I can’t just give you one example. We’re working on a programme of work that is carrying out an independent review of something called the AFGAR score. Now the AFGAR score is assessment that’s used within maternal health to determine whether or not a baby is healthy minutes after its birth. And as part of its criteria, the app score asks whether or not the baby is pink in colour. Now the AFGAR Score, has been around for exactly 70 years, so it was established and rolled out in 1952. Not only is it still used across all maternity units in the UK, but it’s also used internationally as well. And as you can imagine, having a criteria around the colour of skin, basing it on the pinkness of the colour of the skin may well have been the right thing to do in 1952, but it’s not the right thing to do. It’s not the right thing to focus on in 2022. And so some of our policies or processes, assessments, medical devices etc have not kept up to speed with the diversity of our communities. And that’s why we need that level of diverse thinking, diverse representation. And if we are in the business of tackling health inequalities, which we are, then we need that diverse representation at all levels within organisations.  

Michael West That’s just an astonishing example and is for me, an indicator of just how lacking in diverse leadership and diverse awareness our leadership and our organisations have been and that that should have endured for all of that time is extraordinary. And for me and the work I’ve been doing over the last, I suppose, 30 odd years finding that we come up with again and again is how important diversity is. So you know about our research, looking at the performance of Trusts and where frontline staff are representative of their community care quality in those organisations is much better. And in fact, financial performance is much better, too. But also, I started looking at team working in health care back in the 1980s and every study we’ve done, we’ve included a measure of diversity to look at the relationship between diversity and outcomes. And we find consistently that diverse teams, particularly when they have clear shared objectives and they meet regularly, are much more productive and much more innovative than more homogenous teams, if you like. So that’s true whether we look at primary health care teams, community mental health teams, executive teams, breast cancer care teams, and it mirrors the research around the world of how diversity and teams and organisations is a benefit, and it makes sense because you know where you have diversity people from different professional backgrounds, different cultural backgrounds, different life experiences, you have a greater wealth of knowledge and skills and abilities to draw on. And I always think, you know, diversity is the nature of our universe. As a species, we’re diverse. Biodiversity is diverse, our planet is diverse, the universe is diverse and we have to embrace diversity. And again, I think that everyone who’s a leader in health care should have an understanding of the research evidence on the benefits of diversity for performance. So the big challenge, I think for many people is they kind of get a bit paralysed about all of this and think, Oh, well, what can I do? How can I make a difference? I guess what seems important to me is to explore. First of all, what compassion means in this context. Some why it’s important.  

Dr Habib Naqvi I think compassion Michael is absolutely critical because it enables us to understand not only ourselves, but others better. And I guess in the context of health and care, the more we understand others, the more we want to relieve their suffering. So it defines us as human beings. As you say, it promotes meaningful connections meaningful interactions. It facilitates problem solving and it helps to improve health and well-being. But it pushes us to address inequality, discrimination and the struggles of others. Others that may not look like us. And in my view. Those that are not compassionate are those that do not have the ability to see things from someone else’s perspective and are unable to sympathise, empathise with their emotions. And as we move through this awful pandemic now more than ever, it’s important for leaders to demonstrate compassion. Leaders must embody the quality of having positive intentions and a real concern for the well-being of others. Michael, you talked earlier about health care workers on the front line of facemasks and deployment, etc. All of those issues are really important. Our senior leaders must embody having the real concern for our most vulnerable within our workplace and within our society. Compassion is leadership that creates stronger connections between people of different backgrounds, improves collaboration, and it raises and enhances levels of trust and confidence, something that we know have been important concepts throughout the pandemic.  

Michael West So when I talk about compassion, I talk about four behaviours attending, understanding, empathising and helping and reflecting on what you’re saying. I mean, for me. You know, part of being with other people and diverse others is being present with them is having the self-awareness to be present in the moment to give my attention to let go of all of this thinking about what’s coming next and what’s this, but just to be present with each other. And we know that compassionate presence leads to a blurring of the boundaries between self and other. So one of the problems we see is this othering of people who are somehow different from us. I mean, I feel continually astonished and appalled and sometimes quite depressed about how we treat each other, you know, on the  

basis of things like the hue of our skin. I mean, it’s just kind of it’s utterly bizarre when you step back from it and it feels just so, I don’t know, obscene.  

And we somehow have to rise above all of this and see that we are we’re one where one, we’re interconnected. We’re interconnected with all of biodiversity, with the whole planet. And so compassion is about an inclusion of the same thing. Actually, they’re both about belonging. They’re both about the sense of being present with the other feeling interconnected, seeking to understand, to learn from to benefit from the richness of another person. And as you say then to empathise to mirror with them. I mean, we’re hardwired to mirror each other’s feelings and emotions. And I’ve been struck by the research that shows that when we seek to empathise with others from different backgrounds, then we’re much less likely to be unconsciously discriminatory and biased and then always asking the question, Do you know, how can we help? And I guess that’s a kind of key question in a way that people need to address. How can I as a leader? How can I, as somebody working in health services, help to change this discriminatory environment so it becomes more inclusive and compassionate and positively diverse where we value difference, whether it’s differences of skin colour, cultural background, professional background, gender, age and I guess what would be wonderful is to hear your words of wisdom about what can we do to change all of this?  

Dr Habib Naqvi So I think, Michael, this, as you say, boils down to belonging issues around inclusion, compassion, but also, you know, with that inclusive leadership and inclusive leadership is something that we can all embody in our day to day lives. And that’s about not just making sure that we have diverse thinking and that diverse thinking is heard. But ensuring that that diverse thinking is respected. And applied in a meaningful and consistent way. And that’s absolutely critical, it’s absolutely critical for the success of individuals, of teams of organisations of systems, inclusive leaders support and bring out individual potential. In others, they sponsor and support others through their challenges and to overcome hurdles. They enhance the collective power of teams, and you’ve done a huge amount, as you say, Michael, around team working. But when it comes to organisations and this is, I think, critical for the health care system, particularly when it comes to organisations and systems. Inclusive leadership supports an organisation’s ability to adopt innovation and growth, and we know from other parts of the labour market, other companies, global companies. Where they have that inclusive leadership, where they have the compassion, where they have diversity of thought at all levels, then they are more likely to be innovative, more likely to grow and more likely to be successful. So, you know, there are a huge amount of benefits for us just on a daily basis. Be more inclusive, be more self-reflective about the levels of our inclusion.  

Michael West So that’s really, I think, profoundly helpful. And it marries with what we think about compassion that being compassionate is about being present with the other, but it’s also about being present with myself. So being self aware in the moment, here I am having a conversation with somebody who is from a very different background from me. They’ve maybe come from a quite different country, like maybe Nigeria, and here I am, having a conversation with them. Am I self-aware enough to be aware of what my reactions are and to be open, to be present, to be here and now? And you use the words open to another’s thinking and that’s about hearing and listening. And the most important skill of leadership, I think all the research tells us is listening is hearing deeply and then the importance of seeking to understand the other’s perspective, not imposing some understanding, but through dialogue arriving at shared understanding. And that, sometimes, is difficult because we have different perspectives. But that’s what in a sense, being inclusive is being prepared to have differences of perspective and exploring those. So we come to a more comprehensive, helpful shared understanding. And then that ability to empathise, I always say to people, you know, think about what would it be like to be a black person going into work the day after one of those bombings that happened in London? What would you experience as you go to, let’s say you go to work on the bus when you arrive in work, so putting ourselves in the other’s position so that we more deeply understand. And then asking how we can help. And I do think that, you know, given the challenges we face in healthcare at the minute, both because of the pandemic and the challenges we faced anyway, we need all of our resources. We need all the creativity and the innovativeness we can muster. And that comes from embracing diversity. That the challenges we face as a species dealing with climate change, dealing with pandemics, dealing with weapons of mass destruction require us to work together across boundaries. So I think what you say is really profoundly important for us and I guess there are various practical things that leaders can do as well. One is, I think, as you say, inclusive leadership is about attending, understanding, empathising and helping not just equally, but creating an equity in that so that we are helping to improve so that there is an equity of experience. And what are some of the practical things that leaders can do? I know you’ve been involved in schemes like reverse mentoring and so on. Can you say a bit about that and about some other practical methods that we can all use for changing the culture of our organisations and societies? 

 Dr Habib Naqvi Yes, absolutely. Michael, I think that I think the first point to highlight I think I would start with is the fact that when we look at the NHS with 1.4 million people working within it. The NHS is a microcosm of wider society. What happens in the wider world, and you touched upon things like terrorist attacks, Black Lives Matter and all the other things have happened over time, Brexit, etc. Those views, those issues are bound to come into the workplace. And so. The culture of wider societies in effect reflected within our larger organisations, and we need to keep that in mind when we think about, you know, what can we do in terms of cultural change within an organisation? Your specific question, therefore, links to that, I believe. Firstly, we need allies, we need people that can help and support us along that journey, and we need to be supporting those allies on their own journeys and the sudden reversal. Reciprocal mentoring is perhaps one example of that. If it’s done properly in the right way. Reverse mentoring is generally when a person in a more senior role is mentored by somebody who’s usually in a junior role, from a different background to that particular leader. So firstly, we need people to practice compassion and inclusivity as we said Michael. I believe with an open mind and an honest heart, and that is absolutely critical in any kind of mentoring, reverse mentoring relationship.  

Michael West You had a reverse mentoring relationship with Sir Simon Stevens, who was then head of NHS England. How did that go?  

Dr Habib Naqvi I was fortunate enough to have a reverse mentoring relationship with Simon and that kind of relationship still continues, which I’m very honoured and fortunate to have. I think Simon, without getting into the details of the reverse mentoring, is a different kind of leader to any other leader that I’ve known. If you just look at his approach to race equality and his approach to inclusion, he came into his role as chief executive of the NHS by talking about racial equality and the importance of inclusion, and he left his role as chief executive of the NHS by setting up the NHS Race and Health Observatory. And between those two milestones was absolutely pivotal in highlighting the issues and doing something about issues around racial discrimination. But we need people to be genuine and to implement these values, just as Simon has done, because we want people to not just focus on this agenda because they have to, but because they want to. And that is absolutely critical when we look at the issues around inclusion, the strategies around diversity and compassion and those concepts, self-awareness, the awareness of others in that reciprocal relationship is absolutely critical. Listening to others in a way that I believe does two things firstly, increases your own understanding of others’ perspectives and secondly leads you to implement in a practical way what you have heard. Now those are the fundamental principles of good mentoring and good reciprocal mentoring and practical impact that actually changes the way you think and the way you do things on a day-to-day basis.  

Michael West So I think, you know, we’ve had The workforce race equality standard and you played a key role in developing that and then directing the workforce race equality standard. And there was a sense, I think, and there has been of late that sometimes people are very good at putting in place organisational policies and procedures, and it doesn’t lead to any change that somehow the change we need has to be also in people’s day to day experiences in their work teams and that that’s the responsibility of every single person in health services. And it’s not just about, you know, a select group of allies or a select group of leaders that somehow everyone who works in the NHS. I mean, we can take this to wider society. But everyone who works in the NHS has a responsibility for creating an inclusive culture, and that means that everybody has to work harder with everyone that they see as somehow other work harder in the sense of being more present, seeking to understand listening more deeply, being empathic and asking how to help so that it’s not just some passive process that we think, Oh, I hope things get better over time, that each of us, every interaction by every one of us, every day, it seems to me, is an opportunity to create a more inclusive culture in terms of how compassionate we are. And that’s what I draw from what you’re saying.  

Dr Habib Naqvi Yeah, I would absolutely agree with that. We know that in the NHS, changing some of the operational procedures, whether that’s has to do with recruitment or whether that’s to do with disciplinary processes or whether that’s to do with continued professional development opportunities, etc. Those will kind of have a limited impact, but we also know that changing those processes and those metrics does not necessarily mean that the culture of an organisation also changes in a positive way. And that’s the kind of the picture I think that we’re getting from programmes such as workforce race equality standard. And so therefore, we need to focus as much on culture and issues around compassion and inclusivity as we do in terms of the operational processes that we use on a day-to-day basis within our workplaces. But learning from others, as you say, Michael, and learning from ourselves is absolutely critical. You know, making the changes you need to make on a day-to-day basis to improve. Because for me, you know, there’s no end point to this being compassionate. being inclusive is a journey of continuous learning and exploration. And so there is no endpoint. We need to be on that journey, but we need to be respectful also of where people are at different points on that journey.  

Michael West So I kind of have five questions that I think every organisation should ask itself.  

Are equality and inclusion, vision and values, a robust part of the leadership strategy for your organisation.  

Do all leaders and leadership groups have agreed goals around developing positively diverse and inclusive leadership?  

Do all leaders, model inclusion for all team members, patient service users and all they interact with, I think we should be measuring compassionate and inclusive leadership at every level.  

Are all leaders involved in QI projects in relation to equality and equity and inclusion, and  do all leaders demonstrate compassionate and inclusive behaviour in their teams and in their relationships with other teams and departments? So, you know, I think those are kind of questions that get to. Are we incorporating this into the DNA of our organisations and our leadership? One of the key questions you and I have discussed over many years and we come back to it again and again is where are the good examples of where this is already beginning to happen, that we can learn from that give people hope and inspiration?  

Dr Habib Naqvi So I think there are good examples around not just within the health care sector, but beyond as well. And these are examples where if you think about teams, teams that value diverse voices have a level of clarity in terms of their goals and direction of travel that have some of those objectives that you mentioned, Michael, and not just have these objectives, but have a level of feedback on how well individuals are doing on those objectives are kind of examples of good practice, common purpose, common goal. Common goals that are articulated consistently and as a leader of a team myself, that’s something that I try to check with myself on a regular basis. But also taking regular time out and having those strong team values that are agreed upon in the NHS Race and Health Observatory. One of the first things we did within the team and with our board was to establish our own values. And we came to five values that we hold very close to everything that we do within the observatory. Those are the values of independence, objectivity, integrity, collaboration and effectiveness. But we are absolutely committed to those values as an organisation and as a team. So having a common purpose is absolutely critical for the success of any kind of intervention or any programme or any team or any organisation that you need. The other thing that I think it’s important here, Michael, is not to have a level of concrete structured hierarchy within teams or within leadership. A leader should not dominate, but should instead support and facilitate the development of others. Give others opportunities to grow and to flourish within the workplace. Give them opportunities to develop, to create fair and just cultures within the team or within the organisation. And in order to do that, you have to be self-reflective. You have to acknowledge that actually as a leader, you are not the finished product. You always have to learn and you always need to and want to do better for yourself.  

Michael West So in terms of what we can do within organisations to achieve change, one of the concepts that I’ve heard a lot about is Allyship. Can you say a bit about what that means in theory and in practice?  

Dr Habib Naqvi I think, Michael, allyship is absolutely critical as we move towards building a more inclusive, fair and just society, not just organisation, but society as a whole. We knew that doing more of the same will no longer suffice. And this should not be a reset moment for us as we come out, for example, through the pandemic, but a complete refresh moment for us. And what we need are people to practice compassion. We need people to practice inclusivity. We need genuine concern for each other. And as we mentioned, that allyship is absolutely critical listening to others in a way that increases your own understanding and other’s understanding of difference leads to better outcomes for everyone and including on the on the metrics and the measures that you’ve done a lot of work on yourself, Michael, in terms of staff engagement when it comes to organisations better outcomes for the people that we’re serving better, kind of, organisational efficiency at the same time. So allyship has so many benefits, but it has to be carried out, as I said before, with an open mind and an honest heart.   

Michael West Our friends Safina Nadeem who has done a lot of work in developing greater inclusion and equity, and across the health service talks about five important elements in allyship she talks about listen with fascination to perspectives different from yours. And be open to learning about the barriers that people face. And I’m one of those that I always reflect on is, you know, we know that people from minority ethnic groups, for example, are often not given challenging projects. And so they’re prevented invisibly, almost certainly from developing new skills. So part of recognising those barriers is ensuring that everybody, particularly people who’ve been held back, have opportunity to take on challenging projects with support, of course. The third is owning your privilege and using it to make the change you want to see, knowing that you have a privilege and then helping to make change and amplifying the voice of underrepresented groups at every opportunity with their permission. And that might mean challenging inappropriate behaviours, for example, in meetings little subtle acts of discrimination. Because when somebody from like a majority group like me, a white male speaks up when somebody says something that is discriminatory, it’s more powerful than sometimes those from those groups that are discriminated against. And the last one, she says, is about creating safe spaces for people to share their lived experiences. And so those, I think, are useful pointers to allyship as well.  

Dr Habib Naqvi I think that’s absolutely right, Michael. And, I always say that this agenda when we talk about race or any other protected characteristic. Yeah, it should not be the burden for those that are most affected by it. Everyone has a role and everybody must have a role to close down the gap between the promise of our ideals and the reality of our time and the reality of our time is the levels of stratification in outcomes of access and experience that we see day in, day out. So the concepts of respect, civility, compassion between people, understanding and acknowledging the issues and struggles of others is absolutely critical and educating ourselves around discrimination and its impact is critical to that. It does remind me of a quote from J.R.R. Tolkien, which goes something on the lines of “all we have to decide is what to do with the time that is given to us”. And I personally believe that those individuals that spend their time on making sure that we have a more fair, just and compassionate world are spending their time wisely. 

Michael West And benefiting from that time as well in terms of their own well-being and their own sense of meaning and purpose. We feel hugely passionately about this issue, and I think most people want to help create a better society. So what’s maybe the one or two things that those listening to this podcast could go and do that will make a difference?  

Dr Habib Naqvi I think the first of the most critical thing to do is to self reflect about ourselves, look at where we are on the journey of inclusion and compassion, identify what is it that we can do to move forward on this journey because this is critical not just for ourselves, but essentially and very importantly, for others. So making sure that we can actually understand where we are is a very good first step in order to shift that dial of inequality that we see in society and to ensure that our own moral compass is pointing in the right direction.  

Michael West So values, that principle is, I think, really important. You know what we value means what’s important to us and the NHS was created with, I think, two founding values compassion and inclusion. It was created with the commitment to provide high quality free care for everyone who needs it, regardless of their skin colour, their age, their gender professional background, what class? It was set up as a compassionate and inclusive system. And in a way, I think the NHS must be a model for the rest of society. I always think, you know, if the 1.3, 1.4 million who work in the NHS come into work every day and encounter increasingly compassionate and inclusive cultures, then they take that back out into their families and their communities. And if all the people who use NHS services, I think it’s something like a million people every 36 hours. If they encounter compassionate, inclusive cultures, then they too take that back out into their families and their communities. And it’s clear to me you’ve done an enormous amount over your career of changing cultures across the whole of the NHS, and I think you’ve had a huge impact also therefore in raising awareness and changing the culture of our society. And it’s been a huge privilege to work with you over the years and just a delight to have this conversation with you this morning. So a huge thank you Habib.   

Dr Habib Naqvi Thank you so much, Michael, it was an absolute pleasure as it always is to speak with yourself. 

Paul O’Neill I hope you enjoyed this conversation. Please look out for others in this mini-series and subscribe to the Leadership Lessons collection for more content like this.