As is always the case when the blog has been published by a guest writer in my absence, let me begin by saying thanks to the author and put on my record my appreciation for stepping into the breach.
In this instance, our recently appointed new Chief Information Officer (CIO) Daniel Hallan did a great job introducing himself and talking a little bit about his role and portfolio last week, as well as sharing his views on one of the Trust’s most critical ongoing projects: the Electronic Patient Record (EPR).
His guest blog was extra timely too as we gear up to say goodbye to his predecessor Mark Johnson, who leaves the Trust on February 23. As I related during Mark’s last appearance at the Senior Leadership Group (SLG) on Tuesday, we must acknowledge his long and distinguished service not just to East Lancashire Hospitals (ELHT) but to the NHS as a whole.
I have to confess I did tease him on completing an amazing 600 years of service so diligently – but I suspect that in recent months, as he has led and wrestled with the project, it has perhaps felt that long at times!
He replied to observe, equally jovially, how he really wouldn’t miss the difficult subjects covered by SLG and, whilst clearly a joke, it reminded me that there is usually a grain of truth in all comments somewhere.
And the truth is that the operating context across the NHS continues to be very difficult and I know how hard everyone is working to deliver safe, personal and effective care, whilst often managing complex transformational improvement projects too.
We can’t and wouldn’t want to pause the latter, of course. It is these projects which will make life better in the future. But it is an indisputable fact that it adds more pressure to the here and now. I want to thank everyone who not just supports these things but often volunteers to get involved – it is appreciated and we wouldn’t be the organisation we are without you.
That colleagues do this willingly and with good grace doesn’t reduce the impact on them, though, and I am always mindful of how much people give to the Trust out of their own personal tank.
To this point and to try and track and manage this I wanted to share how, at the start of key meetings such as SLG, we have standing items to focus and raise any issues of patient safety that are causing concern and also, as demand and pressure has increased, the safety of staff too.
It’s clear that these two items are inextricably linked. How we make sure colleagues are physically protected and psychologically supported is critical to our performance in all areas. If we get it right people are best equipped and able to weather the challenges and be resilient in their health and well-being, enabling the team to support patients and their families effectively in turn.
The flip side is that when we don’t manage this well we might see indicators such as sickness absence increase although, more often in my experience, it can also lead to underlying issues around values and behaviours in the workplace.
This week I have chatted more than once with various groups about the opportunity for this to creep in, what it looks like, how we spot it quickly, diagnose the issues and help resolve appropriately.
Some tangible examples that colleagues shared – and I agree – that result in a negative impact on others are actually less evolved from burn out or frayed tempers and are actually deeply ingrained in NHS cultural practices, which have passed generation to generation for years but, really, need to be eradicated.
This includes one of my own particular ‘pet hates’ where we refer to colleagues by their banding in their role. For example, someone might be described as ‘the band six’ or ‘the band two’ rather than by name.
This is so deeply rooted in our custom and practice that colleagues themselves will often introduce and refer to themselves in this way and this is linked to and was highlighted in the campaign encouraging people to open any interaction with ‘hello, my name is…’ instead.
Seems so simple doesn’t it, but it just isn’t the case every time, even now.
That we need to remind some of the most caring and compassionate human beings you’ll ever meet to do this as they discuss intimate personal information or carry out physical examinations is amazing, but testament to the power of the way people will conform to established cultural norms.
The trick is to recognise it and challenge yourself and others to break out and support change to occur.
Linked to this we can also be guilty of grouping people together by the colour of their uniform, by team, ward or division, location or even profession – anything that allows us to generalise for our own convenience – as in ‘oh, those junior doctors’ or ‘that’s Burnley for you’.
Whilst it might seem minor to some or an issue that wouldn’t really bother others, this type of behaviour can lead to people feeling undervalued and, at worst, isolated and bullied. It can lead to people being stereo typed rather than seen as an individual and poor behaviours excused without intervention. It also allows us to make excuses and let things pass us by when we probably shouldn’t.
Alongside this, I want to offer some balance, of course, and highlight how ELHT also prides itself on delivering shared vision and values that unite us in our aims, approach and culture each and every day too. We have active staff networks and a thriving equality and inclusion programme among many other things, which I have talked about at length before.
I have shared many stories of our positive and proactive approach and, in addition, I do walk around, pop in and visit people all over the Trust regularly and can confirm it is certainly the ELHT spirit that I see and hear on the whole.
But we are a Trust which builds continuous improvement into everything and, on our journey to becoming an outstanding organisation, we need to be brave and open to the idea that not everything is perfect. It’s important that when colleagues and patients do experience or observe something different and speak out and share it, we are open to their alternative account, listen and act.
And so, in coming weeks and months, I intend to explore more of this with others and be overtly open to the idea that while there is positive and ‘good’, there is also stuff that needs to be better too. I’m very interested to know how people really feel and take on feedback and suggestions about what we can do to improve.
As part of this we’ll triangulate data such as the 2022 national NHS Staff Survey return, due to be published in the next few months, and other colleague engagement tools and interactions.
I’m keen to test if the picture provided is fair and accurate or whether we’re missing something we should know and ultimately address. Please, if you have something to say, to add or to share, let me or anyone you think appropriate within your own team know.
If you want to document your experience as a colleague or a patient there are many formal and informal routes and options to help and support you. You can find out more here.
I’ll keep you posted as we progress through this and will, of course, continue to share great examples of activity being delivered right across the Trust. As ever, please feel free to drop me a line or catch me when I’m out and about.
Take care,
Martin