Leadership Insights 1 – What does great leadership in the NHS look like to you?

Speaker 1 – Jeremy [00:00:05] Welcome to Leadership Insights. This podcast features interviews with people across the NHS and highlights their useful insights, reflections and practical techniques designed for current and potential leaders. My name is Jeremy Kourdi. I write about leadership and I work with leaders and managers. And in today’s episode we ask What does great leadership in the National Health Service look like to you? We also delve into one of the biggest challenges for leaders anywhere, especially relevant today. Techniques for succeeding in times of difficulty, challenge and change. Joining our discussion today are three leaders. Dr. Chloe Selwood is deputy head of Emergency Preparedness, Resilience and Response. Chloe works for NHS England in London. Laura O’Neill is Deputy Director of Nursing with the Isle of Wight NHS Trust. And we’ll hear first from Giles Thorpe, who is the chief nurse with East Suffolk and North Essex NHS Foundation Trust. As you listen to our speakers, it’s worth asking one vital question “what are the areas where my leadership could improve?” It’s lovely speaking with you today, Giles. Thank you for your time and I’m really keen to understand your view on what great leadership looks like, what great leaders in the NHS and social care need to do.

Speaker 2 – Giles [00:01:31] Sure. So what? So it’s an interesting question. What does great leadership look like to me? So I think there are a couple of things for me, which is which symbolise great leadership. And the first I think is compassion. So to be compassionate in your leadership is is a skill. And I think the last two years have shown the importance of that now more than ever before, to recognise the challenge and to lead with confidence, to provide a framework where your team, your colleagues feel psychologically safe, has been so incredibly important. And to be able to have humane conversations in times of crisis and to be that calm in the storm for me is the epitome of what great leadership looks like. So it’s to set the scene, create the environment, give the space to allow people to be the very best that they can be, sometimes in incredibly difficult circumstances.

Speaker 1 – Jeremy [00:02:41] I’m mindful that NHS and social care is really undergoing a lot of change at the moment and that’s set to continue. Can I ask Laura, what does what does great leadership look like to you? What do great leaders need need to do to succeed?

Speaker 3 – Laura [00:02:59] I think for me, great leadership really works. It’s compassionate and it’s inclusive. I think within the last couple of years and going back before the pandemic, it certainly needs to, when I say really great leadership, I say it’s agile and I’m someone who has a good sense of humour as well. And yeah, I think that always helps when you’ve got someone that can bring that to the table. It makes light of situations. I think it’s difficult, it’s a difficult ask, but it’s not impossible. And in high pressure healthcare environments, I’ve been really fortunate to witness the theory into practice for both. So before, during doing Anderson and prior, I’ve seen where lack of compassion from leadership drive down staff morale, misaligned to what people want to do when they come in to the NHS to care for people. Really. I think great leadership for that focuses on compassion and also has the attributes of consistency and third takes responsibility and also holds to account because nobody really likes nobody not being held to account for know actions as well and rolling up your sleeves, being there with people. But to have all of that, I think you really need to deeply understand human because. So that’s from IQ. So EQ. So your emotional intelligence and CQ. So being curious and being really interested in individuals, take the time to invest with that sort of servant leadership outlook. Some of the great attributes, so not just what it looked like, but the attributes, that I’ve seen drive and improve and psychological safe a culture always get better patient outcomes. Where people have joy in work, where they laugh, patients are also happier. We know from evidence, so let’s look at the research, and they [patients] get better quicker as well. Staff always want to bring their whole selves to work, so I think so it’s enabling that and great leadership for me enables that congruence of hearts and minds bringing the collective together to thrive.

Speaker 1 – Jeremy [00:05:29] I love the way that both Giles and Laura highlight compassion as an essential leadership attribute, something that’s vital both for patients and colleagues, and is an indispensable part of who we are and how we work within the National Health Service. In different ways, they also touched on the need to create a positive and inclusive environment somewhere that people can feel secure and bring their home self to work, their authentic self perhaps, leading to better patient outcomes. Our next conversation is with Chloe Selwood, who builds on these points and highlights the need for openness, the need again to be yourself and above all, to put patients first no matter what. Chloe’s answering the question “What does great leadership look like to you? What do great leaders in the NHS do?”

Speaker 4 – Chloe [00:06:18] I’ve been exposed to a lot of first hand wonderful leaders over the past couple of years and I’ve seen them work under really high pressure. I’ve seen them work in public forums and private forums and I think for me what’s always stood out is how they’ve maintained their humanity and their sense of self and who they are. They stay true to themselves and their character. They’ve always kept the services or the patient at the forefront of their thinking, even when it’s something perhaps quite abstract that was being discussed. And whilst they may have gone in with a really clear ‘this is what I’m aiming for’, they’ve listened to others and when necessary, adapted or met a mutual kind of centre point around things. So it’s a whole breadth of skills. I particularly like and admire those that can maintain, that kind of, I’m not going to say optimistic, I don’t think optimism is necessarily a good trait, but that realism and just appreciate that sometimes things are bad, and they’re going to continue to be bad for a while, but we will get through it, we don’t know when yet. And being able to give what essentially is really quite a hard message, quite a negative message, but being able to give it in such a way that people don’t end up incredibly depressed about it, or hopeless, but feel that there is something to aim for, that there is hope, there’s a light at the end of the tunnel at some point. And I guess that comes back to communication that we talked about a moment ago as well, their skills and in that communication.

Speaker 1 – Jeremy [00:07:46] Yes, that’s a great that great insights that and I guess having within you self-awareness of knowledge of who you are and what your strengths are and a kind of complete understanding, commitment, guiding light on the patient. Having those two things in here then makes it easier to support others, you know, do the job more effectively. But it starts it starts from within, isn’t it, really?

Speaker 4 – Chloe [00:08:16] Absolutely. Absolutely. And I think some of that self-awareness is when they know they don’t know the answer and they are completely comfortable in themselves to ask others for help. And as a senior leader to do that, something which perhaps could be perceived as a weakness is actually a real strength to say, ‘no, I don’t know the answer, I need more time to find it’ or ‘I don’t know the answer but this person does,’ I think, is a real strength.

Speaker 1 – Jeremy [00:08:45] Our guests also have useful insights about the challenge of succeeding during times of challenge and change, most obviously during the pandemic. Here’s Chloe Sellwood again, followed by Laura Neal.

Speaker 4 – Chloe [00:08:58] I think that it’s, I’m not going to phrase this very well, so  stick with me on this. I think that it’s alongside all of everything that we’ve done over the past two years. There have been some amazingly wonderful, pieces, bits, tiny, tiny gestures that we’ve still managed to progress and even in the face of all of that was coming towards us and not just in health care, but across social care, across society, people have held onto to themselves and onto what they believe in and what they want to do and have delivered that so well. And I think if we can do if we can do tiny pieces of wonderfulness in the face of a pandemic, if we can somehow tap into whatever that is and do it when we’re not in a pandemic, just imagine what we could do, what we could achieve this. That’s the real bits of wonderful ness out there. And it’s how do we keep that going?

Speaker 1 – Jeremy [00:09:52] That’s really encouraging. And to your earlier comment, that’s not optimistic. That is so constructive. Actually, I see that as positive. I see that as actually quite practical. So what have I done in the last year that I can do, that I can take forward? What have I learnt? So I think that’s a kind of encouragement to everybody to reflect on that. The other thought that occurs to me is that it’s kind of easy to lead and do well when the sun is shining and things are fairly routine when it’s a tough time that that’s when we were tested isn’t it. That’s when we’ve we really do need to bring our whole selves forward.

Speaker 4 – Chloe [00:10:28] Absolutely. Absolutely. And I guess a kind of a practical example of that of achievements that we’ve done in the face of such adversity is the implementation of so many digital interventions to support patient care, not just in kind of using this sort of technology for consultations, but the way we’ve been able to support patients to stay in their homes and be in their own environments and so forth. I remember conversations, I was tangentially around, before the pandemic started and people were saying, Well, it’s going to take six years to do that. We need to do this, that and the other. And actually, when people put their mind to some of these things, we can achieve stuff for real positive purposes so quickly.

Speaker 1 – Jeremy [00:11:07] What are the top three tools or techniques that have helped you through through difficult times or periods of change? And what would you recommend to help others?

Speaker 3 – Laura [00:11:17] I think the first one would be the moral compass. I developed this in the actual learning sets and group, and that was to keep me central, central in what I do always. And that is patient, team, organisation and self. So if I am centered in all of those, that that keeps me positive and resilient. And to do that and to align to my purpose, I need to, when I’m looking after myself, I have to exercise. So I’ve got to keep mentally resilient and to keep patients for me, close. So I need to go and talk to patients. I need to be able to talk to staff as well on the front line. I can’t be so removed. These things will really help me. These are techniques that help me. And I know I love knowing what matters to patients and that keeps me grounded from the floor to board. Again, I want to know what’s happening with staff. So what matters to the staff? And the only way you do that is by getting out of your office and going to talking to patients and staff. I also meditate. I’m really got to plan my time, to free up to innovate so I can be creative. I have a creative side that for me, you know, if I want to remain positive I’ve got to keep to all of the sorts of spiritual aspects that makes me whole. And the other ones would be behaviours. So the first one for me was moral compass, but the second one would be behaviours. And one of the tools and techniques that learnt on the NHS Leadership Academy programme was something called BOF. BOF is the acronym for Behaviours, the Outcome of it and the failings of it, and then Feedback and how that affects all of us. So we’re going to be dealing with people who are compassionate fatigued. You know, we’re not quite who they would be ordinarily. And so this helps me understand, you know, what are the behaviours, keep me centered, take a step back, what the behaviours that are affecting others, what could be the outcome of that behaviour, feedback for you and others to learn on that, on what you would agree to do in the future? And then the third one for me would be continue to do your three-sixty reviews, you know, and to have that facilitated support it, the NHS leadership support doesn’t just stop when you finish your course, continue it. It’s been great for my continuous developments and confidence as a leader to keep holding that metaphorical mirror up to myself, to keep me humble and grounded.

Speaker 1 – Jeremy [00:14:13] There are several themes and priorities that recurred throughout our conversations about what makes great leadership. I was really impressed and struck by the way that Giles, Chloe and Laura were remarkably consistent in their insights. Some of the themes they highlighted include keeping a personal focus on patients, as well as the team, listening, questioning and understanding others, but also looking after yourself, being open and curious and recognising how your behaviour is affecting the people around you and understanding when people, yourself included, work at their best. And then there was a really big emphasis, I thought, on trust, empathy and compassion, all of which are clearly essential. So while great NHS leaders have these qualities, they also have a clear focus on patients. This matters, because it means that they can provide both support and challenge the support to the patients and the colleagues around them, and the challenge to either call out poor behaviour or simply to look for better ways of delivering for patients. Great NHS leaders work well individually, but they understand that teamwork, collaboration and inclusion are all essential for the NHS to deliver. The last word goes to Giles for responding to the question. If you had one or two key challenges or priorities for colleagues in the NHS to consider, what would they be?

Speaker 2 – Giles [00:15:44] I think there are two priorities for me and I think this goes back to my earlier conversation around the golden thread. So for me, I would put forward the priority of now more than ever, how do we truly hear the voice of our patients as partners in our plans to really progress the paradigm shifts that we’ve already seen? We’re coming out of a command and control environment, and rightly so, because of what we’ve had to deal with. We had done such great work in starting that journey of really believing in patient partnership, co-production, co-design. Because we know the lived experience gives us the power to truly understand where we need to focus our energies. So I guess for me, that’s one of what one of the biggest priorities for me that I really think we need to be thinking about. And within that is something as important, probably the most important to me, is how do we hear the voice of the marginalised? Which is massively important. We know that the NHS constitution is quite clear upon the health care being delivered regardless of any protected characteristic. But how do we actively become the advocate for the marginalised and the silenced in our communities, which is very difficult for us to address? And that for me I think is it is a huge priority now as we look at the health inequalities agenda. And for me, the second priority is, of course, our workforce. I’m picking up that point in terms of people are tired, they have their heads down. And to be controversial, it was great when the country were clapping. That time has gone. There is a level of expectation, and rightly so, for us to be delivering the services that we need to deliver to provide the care that so many people want. So how do we motivate our workforce again to step up again and to answer the next challenge? But to do that with grace, with humility and with compassion. That for me is a huge priority because our greatest asset is our workforce. We can do nothing without the people who 24 hours a day, seven days a week, 365 days a year, to the detriment of their own friends and their own family, step into our organisations, provide care, provide support and humble me every single day with what they do. So for me, my question, my priority, my query is how do we collectively come together as leaders to make sure that we create an environment so that we hold our workforce to be the best that they can be?

Speaker 1 – Jeremy [00:18:35] Focus on patients, people and the future. A great way to finish today’s episode. My name is Jeremy Kourdi, and I’ll see you next time for more leadership insights.