"Let's not restore factory settings"
07 July 2020 -
Managers and leaders have learned huge amounts about themselves under the intense pressure of Covid-19 – especially in the health service. We speak to two NHS leaders about the lessons of speed, staff wellbeing and diversity that they’ll be taking forward
Ann Francke OBE
The NHS celebrated its 72nd birthday on 5 July, so it was very apt that my guests on my latest webinar were two health service leaders: Samantha Allen CCMI, CEO of Sussex Partnership NHS Foundation Trust – responsible for mental health care provision across east and west Sussex; and Rosalind Penny CCMI, deputy director of organisational development for the Royal Berkshire Trust, which serves more than one million people across Berkshire and south Oxfordshire.
Here are some of the key lessons they will be taking forward into the future.
Your values are the glue for your leaders
Leadership has been pivotal to helping organisations deal with the uncertainty unleashed by the pandemic. The visibility of the CEO and other senior leaders is crucial, Ros stresses. “We need credible, calm, courageous, creative leaders – and we need them to communicate.”
The glue that ties leadership and management together is the willingness to innovate and think in ways that were previously unheard of, says Ros. Despite the freedoms this offers, it’s also a test of organisational values. “If your values have been built by the people – which they have for us – that becomes an anchor in the situation.”
Double-Down on Wellbeing
The Covid-19 experience has, in the words of Sam, “been a marathon of marathons, not sprints”. People have been working on average ten or 20 hours a week more than usual. From a management perspective, that raises questions about how you make room for decompression. Both leaders agree that the health and psychological wellbeing of staff is paramount.
This issue prompted Ros to seek out advice from experts including the military about post-traumatic stress disorders. “Teams need time to talk about what they're going through,” she explains. Across the NHS, daily huddles and “compassion check-ins” allow staff to unload what they've experienced and talk about where they’re struggling. It’s equally important to talk about what’s going well, Sam says, “maintaining that sense of optimism and hope and togetherness, that we're all in this together and we will come through it.”
Both agree that the pandemic will have lasting mental health ramifications – not only the work-related stresses but also the impact of the economic downturn and the complex reactions to bereavements. “For us as an organisation, it's not going to be a case of packing this away. We've got to be in this for the long haul for our staff,” says Sam.
A digital turning point
The crisis has accelerated the use of virtual clinics. Across Sussex almost 1,000 clinicians have been working online, conducting 16,000 virtual consultations (compared with fewer than 100 in the past year). This has been a revelation. “We need to try to retain a sense of boldness that the crisis has enabled from a leadership perspective. Let's get on with it. Let's do this. Let's put some pace behind it,” Sam says.
Let’s Not Restore Factory Settings
We shouldn’t assume things will automatically revert back to the old ways, says Ros. “Our chief operating officer uses the phrase, ‘let's not restore factory settings’, and I think that's absolutely right.”
The power of a shared purpose has also led to a new mindset that favours speed and decisiveness over the NHS’s infamous bureaucracy. “There’s a willingness to innovate, and think in unheard-of ways,” says Ros. To take decisions at the lowest possible level, not the highest. There’s a freedom in that that we have to try and keep, and not make people jump through unnecessary hoops.”
She says the crisis has precipitated a desire to embrace remote and flexible working more fully, although the intricacies of managing blended teams remains a work in progress. “How do we ensure that there's parity in the way those people are seen? In order to be a very efficient organisation, we also need to look at what digital skills are required at every level.”
The disproportionate impact of the virus on those from BAME backgrounds has shone a light on the issues of diversity and inclusion across the NHS. At the same time, the Black Lives Matter movement has highlighted the prevalence of racism across society. “As leaders or managers we have a role to dismantle and address that,” says Sam. In her own organisation, the conversation has turned to how they can be actively anti-racist. “How do we have meaningful conversations about the structural issues that we've got in place? How do we improve the outcomes for all communities?”
For Ros the answer lies in more diverse representation at senior levels to better reflect not only staff communities but the patient communities the trust serves: “We need to remove some of those barriers that prevent people from coming forward for promotions or, if they are coming forward, that stop them getting into the post.”
Outstanding community response
From pop-up supermarkets to Project Wingman – which saw furloughed airline staff providing a lounge experience to hospital workers – and local businesses supplying food and donating tech to allow patients to stay in contact with families – the pandemic has highlighted just how much can be achieved through collaboration.
The overwhelming response of the business community towards supporting the NHS has laid the foundations for ongoing collaboration in the future, both leaders believe. “We should be creating more opportunities for leaders across business to come together with our healthcare partners to think about what we can do more together for our communities,” says Sam.
Early on in the crisis in Sussex they set up a team whose task was to answer the question: what are we learning from Covid? ‘We wanted rapid results, not a huge slide deck and a thesis,” says Sam.
Ros: “What we mustn't do is say, thank you very much, that's the end of it. There's a lot to do. We need to do it together.”
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