I was recently involved in an interaction which troubled me. Sometime after the implementation of a change which a senior colleague found difficult, I bumped into him. The greeting was a little awkward and he commented, “that is an unusual dress for a chief executive.” I was quite taken aback and at a loss for words. It isn’t often that I feel this way. I am a confident person in a senior position in the NHS. This really got to me and has led to a lot of reflection since.
Over the past two years I have been increasingly aware of how we in the NHS interact with one another. I’ve had conversations, made my own observations and I’ve paid particular attention to information about behaviour among professionals or colleagues. Sometimes this has been distressing and occasionally appalling. It may or may not be a coincidence that there have been some recent high profile reports about unacceptable behaviour in the NHS. These have been about bullying, discrimination and intimidation.
I must stress that there have also been some wonderful examples of kindness, support and caring for one another. It is important to celebrate and hold on to these stories. So, why these extremes? How can we work towards having much less of one and more of the other? It is without question that how we all behave has a direct impact on the quality of care that people receive.
Therefore I have been examining my own behaviour and the impact it has on others, both directly and indirectly. I will start by saying that there have been and there will be times when my behaviour will be lacking or not appropriate. I may not realise this straight away, though I usually do and feel very sorry. When I don’t see it I want to be told, so that I can make amends and learn to not do it again.
I don’t think this dilemma applies only to our behaviour as leaders or managers. Those of us who have power - whether by virtue of our professional position, class, gender, race, and physical attributes (e.g. height) - are all in danger of acting inappropriately. The wise use of this perceived or real power is a significant challenge and all of us will at some time or another get it wrong. It is a huge responsibility for everyone and requires some considerable effort not to misuse it.
In ELFT we are in the early stages of conversations about power and privilege: what it means, how it is manifested, how it impacts on staff wellbeing and therefore, patient experience. There are many questions to explore.
• How do we have difficult conversations with one another?
• How can we disagree with one another and remain kind and respectful?
• How can we effectively manage performance without behaving in a bullying manner?
• How can we speak up and be constructive when we feel uncomfortable about how others behave towards us?
The way in which we are treated by others always affects us. This will have an impact on enjoying work and therefore influence our ability to do the right thing. Our NHS is a complex system, rich with emotion and wonderfully rewarding. It is also too easy to be divided and behave inappropriately when under pressure. We will do well to remember that we are united by a common purpose. In order to deliver, we must care about and be careful with one another, we must quickly see when our own behaviour is wanting and strive to do better.