Leadership Listens 2 – Compassionate leadership and quality improvement and delivery of high-quality services

Paul O’Niell: 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. It’s a collection of conversations between professor Michael West and a leader for the health and care sector. This recording is a conversation between Michael and Annie Laverty, Chief Experience Officer and Kate Thompson, Deputy Director of HR and OD at Northumbria Healthcare, NHS Foundation Trust. The conversation focuses on the role compassionate leadership plays in quality improvement and delivery of high-quality services, as well as its importance across teams and organisations.

Michael West: Welcome everybody. My name is Michael West. I’m Senior Visiting Fellow at the King’s Fund and Professor of Organisational Psychology at Lancaster University. I’m really delighted today to be joined by Annie Laverty, Chief Experience Officer at Northumbria Healthcare Foundation Trust and Kate Thompson, who is Deputy Director of HR and OD at the same Trust. Warm, welcome to both of you. 

Annie Laverty: Good morning, everyone. Really lovely to be here. 

Kate Thompson: Morning – same here. Thank you, Michael. 

Michael West: So, just to say a bit about you both; Annie, you’re Chief Experience Officer. There’s a phrase to roll around the mouth and think about. At the Trust, you’ve led on one of the most comprehensive patient experience programmes. So, the Chief Experience Officer’s partly about patient experience. It’s one of the most comprehensive programs in the NHS and it’s based, I guess, on the Trust shaping its strategy by listening to the feedback from thousands of patients and then acting on that. I know a few years ago, you expanded the role to make staff experience equally important so that not just patient experience but people experience, generally, shaping the strategy of the Trust. You’re a Generation Q Fellow (people probably won’t know what that is). You graduated in 2012 from an 18-month health foundation leadership scheme, focused on developing skilled leaders for quality improvement in healthcare. And I know you direct Rubis QI, an NHS consultancy, which supports other NHS organisations, social care, third sector organisations to develop quality improvement. So that’s hugely important for the topic we’re focusing on today: quality improvement and innovation. Kate, Deputy Director of HR and OD at the Trust – I know that you also bring huge experience of innovation. You’ve been 17 years at the Trust, so you’ve seen the development of this amazing organisation over that time and the extraordinary things it’s accomplished and you’re a mother of three children, so you’re also flying the flag for working parents. It’s just a delight to have you both here.

I guess for me, the starting point is, it might seem rather obvious, but really to ask you the question of why are quality improvement and innovation important? Why don’t we just get on and do the job the way we’ve always done it?

Annie Laverty: I think, Michael, it comes from a deep connection to the work that we do. I’ve worked in the NHS for 30 years, (more than 30 years actually) and had the privilege of having worked with extraordinary colleagues in that time. My love of the NHS and what the NHS represents, in terms of access for all to meaningful and high quality safe and compassionate healthcare, is something that is at my core. I think if, like me and other colleagues, you care deeply about that purpose, then that involves recognising that from a position of humility, if you like, and authenticity, that it can be better. If we really listen to people, to our communities, to patients and families, we will hear lots of times when we get that absolutely right. But we will also learn where we fail to meet people’s expectations. So, quality and improvement and innovation, I believe, is a fundamental part of our ability to keep striving to be better, to never be satisfied with the status quo and to recognise that the world around us changes, so the needs of the people around us changes and the workforce needs change. We have to adapt and grow. So, it’s an exciting part of our roles. I would feel very sad if my role didn’t involve a fundamental part of how we think about getting better, changing things for the future and responding to the needs of the people who use us. 

Michael West: I was having a conversation with Don Berwick a couple of years ago now in the King’s Fund. (Don Berwick, as you know, was the, I suppose, founder of the Institute for Healthcare Improvement in the U.S. and he was also Barack Obama’s advisor on healthcare during part of that presidency). I remember him saying, “if quality is not improving, then it’s going backwards”. And I think that’s a really profound comment. It’s that, it’s an illusion to think that things will stay as they are. And in fact, the more I’ve thought about it, the more it chimes with what we understand about the universe, (the concept of entropy), that if we don’t work continually at things, there’s a gradual decline into disorder. So, if we’re not continually seeking to improve the quality of care, then it’s getting worse with real consequences in terms of patient outcomes. I’ll just pick up on a couple of things that Annie said, just firstly to say that it’s a real privilege to be a leader in an organisation that is so innovative – I think that’s reflected in a lot of the staff experience data that we receive. 

Kate Thompson: For me, the point Annie made around moving with our workforce. So, we’re getting there now where there’s a generational shift and now staff are wanting different things. They’re wanting to work in places that are innovative, they want to work in places that have a real, huge corporate social responsibility. We have that responsibility to widen participation for our local community. And the way we do that is looking at innovative ideas and how we can bring those people into our organisation. Innovation, for me, excites people and it keeps people going and it’s a key focus for me for engagement in people’s roles. I think as you mentioned there, Michael, that you can end up going backwards if you’re not excited about what the future holds. And so always keeping that in people’s sights, for me, is really important. 

Michael West: What you say, Kate, reminds me that the arc of human history is an arc of innovation. We are the species that has constantly developed new understandings. We’ve gone from being relatively simple animals to discovering the code of our own genetic makeup, to exploring the outer reaches of the universe – and we’ve done that through innovating. I guess I started looking at innovation in healthcare back in the 1980s. And what I came to understand was that creative ideas are a consequence of human interactions between people but particularly the implementation of change, of applying creative ideas in practice, (innovation,) is dependent on teams working together. That in a way, almost, the measure of a team’s effectiveness is the level of innovation. If a team with diverse knowledge and skills and abilities and experiences is working well together, then innovation will be the consequence, inevitably. And if they’re not working effectively, they’re more like stagnant ponds than sparkling fountains as it were. The question that that begged then was, how do we get such effective teamworking? 

Kate Thompson: Just to pick up on your point with regards to diversity and teamworking: at Northumbria, we have developed comprehensively a number of staff networks and an example of that really good teamwork and innovation is that our autism mental health and enable networks have contributed hugely to our wellness action plans. We’ve listened to them, they’ve had some fantastic, innovative ideas. We’ve implemented them as an organisation. So, it’s really good relationships with those people that have the ideas and us listening to the right people. So, we’re not making decisions in isolation and not making decisions about things that we don’t really have the knowledge about. We’re asking the right people. I think that’s really important. 

Michael West: Yeah. And the research that I’ve seen on innovation across sectors is that the most innovative organisations, companies and the private sector/ the public sector, are those that are hearing the voices of the people who use the services and the products that they develop.

Annie Laverty: I think undoubtedly, one of the reasons that are probably stayed with Northumbria for three decades is that I’ve had the privilege of being part of some quite extraordinary teams. I think some of the things that those teams would have shared are a number of features that really enable teams to thrive, to innovate and continuously improve. So thinking about those things, I think the first for me is, if we aren’t working in an environment where it’s safe to say what needs to be better, then our ability to improve will always be limited. We need to feel psychologically safe. I got my current role by writing to my Chief Executive and my Medical Director to say, what are we really doing about person-centeredness in the organisation? Innovation by itself is going to involve falling over, it’s going to involve making mistakes or having to rethink our original assumptions. But if we’re part of a safe and supportive team, then we’re not scared to have a go and learn in the process of doing so. I think that’s fairly fundamental. I think it’s also about connecting to really having meaning and purpose behind our work and an ambition for the team that everyone can get behind. So, the clarity of the vision and goals for that team are essential. I can remember many years ago working on the stroke unit and it was a Sunday afternoon. I overheard a healthcare assistant speaking to a relative. She was conscious that the wife had been with her husband all day. He’d been through emergency care. He needed a scan to confirm his stroke. And with compassion, she turned to the wife and said, “look, you’ve had a rough day. Can I get you a cup of tea? Can I get you something to eat?” And it happened to be a Sunday and it was high-tea, so there were scones involved and cake. And I obviously looked a bit like that had been laid on, especially, and the woman was quite struck by it. She said, “oh, I’ve never been treated like this in hospital before”. And quick as a flash, the healthcare assistant said, “Madam, you’ve never been with the stroke team before”. I was following on to provide care after she’d done that, but she had so beautifully set the scene for what mattered and what we represented and that ownership of ‘this as what we stand behind as a team’ is really important. I think teams need to meet really regularly to be clear about what that goal and ambition is. And people, as well as having clarity, they also need to have cohesion, if you like. They need to understand how their role fits within the rest of the team to deliver that ambition. That spirit within a team, when you’re genuinely part of a clinical team sometimes or managerial team, where you genuinely have a sense of trust being strong, people having your back and that we’re all in it together is really critical. It links, as Kate said, to a culture that is inclusive, where we value difference and celebrate that difference and that when that difference, (and it will incur results in conflict, because we need conflict sometimes to help us keep innovating and changing) that we found good and constructive ways of dealing with that conflict, so that it’s not a lasting impact for the team. And finally I think for high performing teams, and I would say this in my role, but I think it’s absolutely critical, we’ve really got to understand impact of the work that we do so that we can share that story of our work. We measure well and measure often and openly share those results, even the stuff we’re not proud of. In fact, I would say, especially the stuff we’re not proud of, then we have an excellent foundation for improvement. 

Michael West: That’s really profoundly helpful. Both. Thank you. The themes there, I think are fundamental themes in human experience. So the theme of psychological safety is fundamental in the sense that we are only likely to take risks, to try new and improved ways of doing things when we feel safe. So, we know from the research on attachment theory over the last 50 or 60 years, that children who have strong attachment with the parent/ parents with the mother are much more likely to explore their environments, to build a sense of confidence than children who are insecurely attached. We take risks, we explore, we try new and improved ways of doing things when we feel safe; when we feel we’re not going to be punished or blamed, when it’s safe to make mistakes within certain boundaries. I think that’s the truth about human ability to develop new and improved ways of doing things. Part of the motivation for trying new ways of doing things, as you say, I think is about having a really clear purpose or vision that there’s a meaning that comes from having a real purpose. And I’m really struck by what you’ve both said about hearing constantly, the voices of patients and service users, shaping quality improvement, shaping what we need to provide for high quality care, rather than them just being supplicants, recipients of healthcare processes, if you like. The importance of the relationships that we have with each other; how we manage conflict, in creating that psychological safety. The other point, I suppose, that feels fundamental is that innovation comes from diversity. Whether it’s diversity of professional background, diversity of voices, patient service users, diversity of people from different demographic backgrounds, different cultural backgrounds, different countries, different skin colours, different genders, different ages, different sexual orientation. Diversity is fundamental to innovation. The idea of making sure that we continue to measure, because that’s the basis of quality improvement, I think is fun but as a researcher, I would say that wouldn’t I. The research I was involved with that focused on cultures of high-quality care across the country, one of the key learnings for us was the most effective organisations had executive teams and boards like Northumbria, where leaders were out there sensing problems that they didn’t know about as opposed to when they did go out there, just seeking comfort (‘tell us everything’s okay’). The other area that I want to explore with you is my sense that we need to create time and space for people to come together and to innovate, to reflect on what we’re trying to do. How are we going about it? What do we need to change? But of course, the constant question people come back with is, ‘well, how do you make time when we’re under so much pressure in our services?’ 

Kate Thompson: Absolutely, the reflection/ the time is something that many people would say, ‘we just don’t have the time’. Given the past couple of years, I think that’s more evident. What I wanted to bring in was the importance of that immediate line manager in that element and the immediate line manager, facilitating that time for reflection and holding really close in the core of that team, that relationship you’ve got with your line manager. In Northumbria, we’ve started to really measure that in our pulse surveys at a local level about ‘can we have open and honest conversations with our line managers?’ ‘Do they support us when we need them?’ ‘Do they ask us the right questions?’ For me, that is a step where we can then look at that real granular detail and say,’ who needs some help with this?’ That’s not a bad thing at all, because it’s a very difficult role being the immediate line manager, but it’s ‘how can we support you and enable you to give your team the time and the space to have those great, honest and open conversations?’ As I understand from what you’re saying, what you do is you have surveys on a regular basis, and it would be interesting to know how often you do those, where you’re getting feedback from staff about relationships with their line managers. But also, you’re reinforcing the point that it’s a managerial responsibility to ensure that people have the time and space to come together, reflect learning. Yeah, it is. And I think we also encourage our staff to take that responsibility as well and ask those questions. And I think I mentioned earlier, the staff networks allow that time for reflection in that space from a diverse range of people – that is something that the organisation promotes and gives the time to staff to do. We started off with one staff network. I think we’ve probably got about six or seven now and they’re evolving. The most recent one being ‘Family Ties’, working parents. Annie, I don’t know if you want to address how often we do our surveys. 

Annie Laverty: Yeah, we established our staff experience program in December, 2019. Originally set up pulse surveys that were themed around key things that we thought were important. So, whether that was about happiness at work, health and wellbeing, we’ve looked at belonging and inclusion. Kate had a really good influence in the last survey, just around those key relationships with managers and what we need to learn. And because we get thousands of responses with each one, that level of engagement, a key feature of the staff within Northumbria, we can really learn across the organisation at team level. I would argue that measurement without the support to improve is disrespectful. I think if you’re going to ask people what their opinions are and that’s patients and staff and communities alike, don’t do that, if you’re not following on close behind with the plan to stay close and improve and work together to make better. Releasing people for improvement is key and that’s been a feature of our program. We’ve worked with teams with using experience-based co-design to release staff. We’ve particularly looked at the recovery from COVID, learning from the armed forces and how they’ve recovered from Iraq, how they recovered from Ebola and giving teams time to reflect on a weekly basis about how we’re doing. Actually, it makes us more efficient. We can make time now for people’s wellness or we will be making time for their illness further down the line. It’s that important. And if what we’re focused on is compassionate care, then prioritising that reflection; that ability to come together in the room in a really meaningful way and honestly reflect where we are and what needs to change, that’s critical for us. 

Michael West: I think that concept of measurement without improvement is disrespectful is a very powerful observation. What I see as part of the difficulty we have in the NHS is we’ve created these complex hierarchies where we have reporting levels in double figures in organisations. The observation we have from research in organisations is the most effective organisations, regardless of size, usually have no more than three or four reporting levels but in a typical NHS Trust, we’ve got at least a dozen. What that does is somehow makes it more difficult to transmit messages up and down and side to side. It inhibits decision-making. It inhibits innovation. You’ve alluded to it a bit already, but how do we move from what many people see as a dominant ethos of command and control, hierarchical leadership? How do we move to the more collective leadership that, it feels like you’re describing, is in place in Northumbria?

Annie Laverty: I know Kate would want to say more about this, but I just wanted to pick up on the importance of the strengthening the patient voice and how important it is. As well as following up people after care, we have 700 conversations every single month with 700 people whilst they’re with us in hospital. It’s our real-time programme. We spend 20 to 30 minutes talking to those patients and learning how their care has met their expectations, if we’ve disappointed them in any way or what they’d hoped from us and whether we’ve delivered on that. We get that message back to our teams within hours of speaking to patients. So, it’s about that working week that they’re experiencing. They can see that in the round. Now, when we set that up, I don’t think we had any idea of how important that feedback would be for staff. We designed it as a way of delivering person-centred care. But actually, it was because our people needed that feedback so much about the work that they were doing, needed to be noticed for the works they were doing and that all of our staff, not just the doctors, not just the nurses, but the role of everybody contributing to that high quality, compassionate healthcare was noticed by patients and talked about in those reports. During COVID, we had to stop some of that and it was really obvious how much our staff meant. That isn’t by all intents and purposes, a governance framework/ a measurement framework that tells us how we’re doing, but actually for me, it’s about the connection to purpose in healthcare that is just so critical. If we don’t have that we can lose our way. We’ve been able to restart that again and it’s meant everything to our teams. Again, what we’ve seen is incremental rises over the last six months as teams recover. Based on that feedback and that loud voice of patients. But Kate, I know you’ll want to say something. 

Kate Thompson: Well, just firstly, to touch on the hierarchical element of the NHS. I have worked in private sectors of what you described, Michael, with that flatter structure. I think there’s a couple of things fundamental for me moving into that executive role. What we’ve demonstrated very well at Northumbria, especially during COVID times, is people want us to be accessible and they want to be able to reach us. They want to look at a team of leaders that they can think, ‘I can get there and I can be that person’. They want to hear us talk. They want to hear our ideas. They want us to ask questions and talk to them. I think we’ve led from the front in that respect, especially during COVID where it’s been extremely hard, but we are still getting out there. We’re still talking to people and having those discussions. So, almost fighting through that hierarchy and talking to people and giving them that empowerment and autonomy to say, ‘this is what the problem is. How do we deal with it?’ We’re very good at that and we’ve got some really good examples. In Northumbria, we recruit on our values. I think that probably came in now more than five years, I’d say 10 years ago. We train people to recruit and we have what we call ‘super recruiters’. So, these people receive a body in programme, they receive support and training, where we give them the autonomy and that responsibility to say, you recruit who you need in your team using our values. We have some fantastic examples of some great recruitments within the organisation. And I think that’s an example of us saying ‘have the tools, have the support to do it’ and then they feel that ‘that’s the individual that I recruited, and this is where we’ve got to with it’. It’s feeling that responsibility and that actually credit where credit’s due and the values-based recruitment, I think is a really good example of that. 

Michael West: That’s building in the values into the DNA of the organisation I’m really struck too, by what you describe about listening to staff, voices and patient voices. It’s very much compassionate action. It’s attending, being present with patients and staff. Listening. Seeking to understand what works well, what’s been really helpful, what’s been difficult, what’s not working well and the real sense of empathy and care and love for patients and for staff. Then as you say, we must have improvement, otherwise it’s disrespectful. So, having the courage to help, to make a difference. I suppose my observations of the extraordinary successes of Northumbria is that it feels as though patient and staff experience shapes the strategy. So, how are the voices of patients and staff represented in board and executive meetings? 

Annie Laverty: We open every meeting with a story from both patient and staff perspectives. I’ve really learned that stories are often told at a price by the storyteller. And again, it’s about fundamental respect. We’re asking people sometimes to revisit harm, revisit distress in the process of telling their story and that’s staff and patients alike. So, whilst we open every board meeting with a patient and staff story, it’s always linked to an arm of improvement that is existing in the organisation. I can’t separate that storytelling with the improvement that follows. They’re themed, they’re relevant. Then I can actually say to the person that has given us the time to tell the story, ‘This is what’s happening as a result of what you’ve shaped and what you’ve influenced’. Just as a clinician learning quite early on in my career about the influence that strengthening patient leadership can have in terms of directly improving your service. More than 15 years ago, we created patients as peer supporters for patients on the ward that’d been newly diagnosed with stroke, for example, and that really challenged the medical model. It goes in with the way of spending time with patients making that bridge between hospital and home, allowing for conversations that the clinical team may not have prioritised in the here and now. We trained and recruited 30 patient leaders, put them through a 30-hour programme, paid for their time. In the first 12 months, they made more than 250 visits to our wards. It was a service in its own right but one that really flipped that relationship between staff who are providing services and patients who are receiving it and recognising that when we really strengthen that partnership, we emerge with something so much more. And that was on the back of learning that we might have been very focused in a clinical service around hyper-acute care and time to scanning and all of those really important things that save lives. But actually, when we spoke to patients, they were worrying about finance, they were worrying about losing their jobs. They were worrying about the likelihood of carers. 50% of family members of people with stroke have experienced anxiety and depression within six months. So, we get a much richer picture of everything that needs to be better when we strengthen the patient voice. And then we’ve learned, we can’t do that at the expense of staff. I think we’ve done a lot of work to strengthen the patient voice. And it’s only in recent years that we’ve thought ‘we’ve got to get that balance completely right. Our staff need to know that we are as invested in them as we are in the quality of care that patients receive’. That’s why, beautifully, they sit side by side as the very foundation of our improvement work. 

Michael West: We’ve been through these COVID times and I’ve been struck by how what that context did, was to just create the circumstances where Northumbria could continue its cultural strength of responding to diversity and challenge in really profoundly, innovative ways. I think that the story about your reaction to the shortage of PPE equipment early on, I think people would love to hear about that. 

Kate Thompson: Well, very early on, in fact, just as we went into lockdown, we wanted to stay close to the mood of our staff, the emotions of our staff, and really feel that. So, we’d been working with a brilliant group of technology geniuses at Newcastle University and developed an online platform. And instead of going for pulse surveys, every three months, we were pushing out very short, brief surveys every week to our staff to understand how they felt. And one of the key fears at that time emerged around, ‘keep me safe, just keep us safe’. We were conscious as leaders in gold, PPE supply was running short and I think the inspiring story was just an organization that thought, ‘you know what, we just have to take this into our own hands. This is within our control. If we’ve got good relationships with local communities with local industry, what can we do?’ So on top of an old car show room, the beginnings of our factory began. Volunteers from the community came forward, started making equipment for us. We took guidance from industry about the quality of all of that PPE. And it just took off, really. We’ve now got factory in its own right in Seaton Delaval, it’s employed 60 staff in roles in manufacturing that are critical to the area. But really interestingly, when in the week that the factory opened and our staff became aware of it, we saw a real spike in the mood of our staff in that weekly pulse survey – a positive lift around motivation for work, with a genuine belief that the organisation was doing things, acting quickly to keep them safe. So a whole lot of needs of our staff emerged in that free text data. We got 10,000 responses in just three months and we were able to analyse that and feed it through gold command every week, feed it through our health and wellbeing responses. Some of Kate’s teams organising the way we stayed connected to people that were isolating at home, feeling disconnected, feeling lonely in that process, the health and wellbeing hubs, gift boxes at Christmas, brown paper packages tied up with strings. Sometimes it was massive things like opening a factory. Sometimes it’s tiny things like ice cream vans driving around in the summer or giving people sustainable goods that tell them to take a break and it’s just ways of saying, ‘we notice you; we know how hard you’re working and we’re in this together. We’re with you’. Really powerful stuff. 

Michael West: There’s a deeper message as well about the role of leaders is to address the most difficult issues we face. Lack of PPE equipment, problems of discharge of people from beds because we don’t have support resources in the community, financial pressures that staff face. The sense I get is that in Northumbria, what you’re doing is saying, ‘give us the most difficult challenges we face so that we can bring our attention to bear on that and find ways of solving the problem. It doesn’t mean we’ll find the right solution the first time, but we keep looking at it until we can find a way forward’.

Kate Thompson: Yes, that’s exactly right. And I was going to mention some of the initiatives that Annie talks about. What was really great was it was such a team effort. People from all the different functions across the organisation helped in that setup of the PPE factory, for example, the recruitment team, finance – that just felt really great to people that they’d had been part of something really great. Annie touched on the health and wellbeing. That has been absolutely at the forefront of our mind; the impact that COVID has had on our staff, not just at work, but personally and how we’ve been able to look after them through the resources that we’ve got but also help them to look after their family and point them in the right directions of signposting them, if it’s financial issues, if it’s bereavement guidance. I’ve mentioned it before, but really personalise those conversations and that care to staff, listening to them. One thing that really struck me through COVID: no one person is exactly the same and you can have a whole wealth of health and wellbeing resources, but it’s up to a line manager, a member of your team, a friend, a peer to say, ‘have you see this?’ and point people in the right direction for what they need and everyone’s just very different in that respect. It was so important that we personalise that care for our staff. 

Michael West: I’m really struck to see that we’re expecting to see staff survey data for 20/21 quite soon as we speak and we’re having this discussion. But from the previous year, the first year of the pandemic, when we know that the percentage of staff reporting being unwell as a result of work during the previous year was around 40%. And then that first year of the pandemic, it went up another 10% (and the point I want to make is that some people could say, ‘oh, well, we hear all of this kind of rhetoric about looking after staff’) 44% on average in NHS Trusts, in Northumbria it was 27% a year. I mean, of course it’s still too high, but Northumbria was almost half the average for other Trusts in terms of levels of staff stress. And also, the same with engagement, which we know is the key predictor of performance of Trusts and you have very high levels of staff engagement. What are the one or two or three things as a Trust you’ve done to enable that?

Kate Thompson: I could bring in here, because it’s been extremely important and it always is in Northumbria, is our really strong relationship with our staff-side representatives. During COVID, we stayed close in terms of making sure they were updated with where we’re going, consulting on initiatives, having conversations with them because then staff will go to them and have that conversation and we want the staff-side representative to feel prepared for those conversations. And we have really great relationships and I can’t stress enough how important those relationships have been during the pandemic and how they’ll be even more important going forward as we enter into recovery. Along a similar line, Northumbria have a freedom to speak up guardian, which all Trusts do. We’ve recently won an HSJ award for that process. And that again, gives staff another route to have those conversations, to open up concerns, to filter through to the people that can help them and the relationship with the speak-up guardian and the trust and the confidence that we have in each other has paid dividends in moving forward with that. 

Annie Laverty: I think it’s two things that are important for me. I talked about our way of understanding how people were feeling in the moment and I think that’s true. I think it takes courage of an organisation at a time of a pandemic to actually ask staff, how you are because there’s a natural fear, perhaps, in leaders around ‘what if we can’t help with that?’. And so, I’m really proud that the Trust was courageous enough to ask the question, because I think it was really critical in terms of keeping our staff engaged. When we looked at what staff told us, seven core needs emerged and they were: Listen to me. Care about me. Lead me. Keep me safe. Keep me connected. Keep me going. Notice me/ honour my work. And my belief is I don’t think that’s just relatable to a workforce in Northumbria and nor do I believe it’s just around the context of a pandemic. I think it is a framework for leadership that can help us in terms of engagement and improvement, if we pay attention to addressing those needs and recognising how universal they are. And then the final point that I think is really critical and it’s the strength of the exec team overall. We had a quality and innovation festival recently celebrated across the organisation and we interviewed Jim [Chief Executive]. He described his role as whatever the noise outside, it was his role to buffer and to act and respond to staff, to keep them safe from what they didn’t need to be hearing but at the same time, act with conviction around the things that he could directly influence and control. I think in the establishment of a factory with the support of so many colleagues and teams across the Trust, he modelled that strength of leadership beautifully that enabled people to feel fundamentally safe and looked after. And I think that helps massively within engagement and has contributed to some of our national results.

Michael West: It’s profoundly inspiring and you’ve shared so many insights, so much learning from all of your experience. And I’m really struck by the courage that the community that’s Northumbria Healthcare and patients and service users have shown in innovating. Here is a tough question. If you had one recommendation, practical recommendation, you would make to others working in health and social care from all of your experiences, what would that recommendation be? I cheat by not having one. Just have a go. That’s a core message from Jim. Just keep going, have a go. Make a start. Don’t wait for the perfect moment when you’re going to have the perfect resources or the perfect situation, it’s probably never going to happen. Just have a go. There’s a lovely quote from Goethe that says ” Whatever you can do or dream, you can. Begin it. Boldness has genius, power and magic in it. Begin it now”. 

Kate Thompson: I was going to add to Annie’s around have a go and don’t be afraid to have those open, honest, and difficult conversations with people because ultimately it helps them. We get to a really good place with people when they trust us, they open up to us and we engage in those conversations. That would be a recommendation from me for any immediate line managers, anyone that has the access to staff to make sure you’re having open and honest conversations. And you’re asking how they are.

Michael West: And those themes that I’ve heard throughout our conversation exemplified in what you’ve just said, Kate as well. It’s about being present with each other, listening with fascination, honouring each other through our attention, understanding the challenges we face individually/collectively. Caring, connecting through care, through love, through empathy, through nurturing and then seeing our role as helping, being altruistic, being compassionate, making a difference for the people we provide care for, the people we serve, indeed, everybody we interact with. So, all of this, I think is, underpinned by compassion. I want to say a huge thank you. It’s been the most inspiring and wonderful conversation and I wish we could go on for the rest of the day, the rest of the week, the rest of the month. Thank you both really warmly for all your contributions.

Annie Laverty: Thanks so much for including us. 

Kate Thompson: Thank you, Michael.

Paul O’Niell: I hope you enjoyed this conversation. Please look out for others in this many series and subscribe to the ‘Leadership Listens’ collection for more content like this.