A Burning Ambition…

 

 

Having managed to free myself from the kitchen, household chores, cooking the dinner for my husband and caring for my 2 children, I sit down and take off my apron to write this blog…..

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I jest somewhat here as I actually work full time in the NHS and am far from a domestic goddess! However an article I read last week (which I won’t give the time of day to promote with a link here) made me feel like I had just stepped back into 1950. The article talked about how the feminisation of the medical profession was the cause for the strikes, basically as women want their cake and to eat it, er yes we do, and why shouldn’t we?

Yes I am a feminist, what does that mean? Well in simple terms, I believe in equality and believe that a more equal gender split in senior leadership within and across the health and social care would enable a different culture within organisations and would change some of the dynamics and traditions we see at the top of our systems currently. This in turn would change relationships with our staff and ultimately lead to better patient outcomes. I also believe that this shift in diversity would enable more innovation and new ways of working which is much needed at present.

We know that inequalities still exist and that society favours the man, women have historically been subordinate and men more dominant in society and the work place. Women are still seen as the main care provider to children and also the ones who have time out of work to have children, society perceives this as a female role, inequality is a disease of society and until we change perceptions and expectations of societal norms, it will continue to be challenging to change the flexibility that is needed within work places to enable more women to grow and develop into their full potential.

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Gender inequality is still very much a disease of today’s society and this is evidenced in pay inequalities which are still present, and by percentage of women in senior public sector roles, you only have to look at the senior teams within the NHS to see that if you are a white, middle aged (possibly middle class) male you are more likely to achieve an executive role. How can we expect to achieve the ambitious challenges that are expected of us if we have the same homogenous group think?

However the NHS performs better on gender equality in senior posts than most sectors with 41% being CEO and 80% of HR directors. It seems therefore that we are ahead of the game in leading the smash of the ‘glass ceiling’ and for me there is now a burning ambition to be worldwide exemplars and leaders of the benefits to our society through closing the gender equality gap in senior leadership positions.

There are 2 main areas I think we need to focus on to make this a reality…

 

Just ‘lean in’ more

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Women are not to blame. This is the key message I want to get across in this blog. How many times have I heard the following used as reasons why women are not reaching senior positions as much as men…

Women…

  • don’t ‘lean in’ as much as men
  • are not as confident as men
  • are not very good at selling themselves
  • don’t aspire to senior roles
  • are not as resilient as men
  • not prepared to work as long hours as men
  • Are unable to network as well as men
  • don’t speak up as much as men in meetings

It’s time to stop blaming women as the cause of the problem. It’s easy to do and I think that many women shoulder this blame relatively easily. I would encourage women to push back on this, is confidence really a gender specific issue?

Where are the men?

I have attended many gender equality events and hardly ever do I see men in attendance? Why is this? I was frustrated and disappointed when the HSJ women’s Network voted to keep men out in order to provide a safe space for women to regroup. Who holds the majority of senior positions currently in the NHS? Who are the people in a position to support, encourage and actually appoint women to these senior roles? Yes its men, so why would you not involve them in the conversation?

We need to be realistic about why gender inequality still exists and we need to work together to realise the benefits and solutions to this. I am interested to know why more men don’t actively support gender equality (actively being the key word), we all have daughters, wife’s, mums in our lives, these influential figures are vital in the future planning and deliver of care for our public and men need to take a more leading role in making this happen, so if you are a male leader I would urge you to not rely on women in your organisation to make this happen, but to be seen as a positive role model, challenge normal practice and the flexibility you offer staff and to recruit people who are not the same as you, because if men don’t join the conversations, I fear things will never change. Equality is everyone’s responsibility.

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Experiential Design

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If ever a picture was to say a thousand words then it is this one. Pretty self-explanatory isn’t it!

What started out as a simple picture shared by myself and Kirstie (co-author), became one of the most popular tweets we had posted.

We are both passionate about service user experience and how we currently co produce and co design our services across local health economies and across multiple sectors which touch the lives of millions of people daily. This is why we both lead the Health and Social Care Voices National Network @HSCVoices. After reflecting and discussing via twitter as to why it stirred up so much emotion, feeling and debate, we decided to put our spin on it and write a blog.

What was a simple share about the difference between what we personally experience and how others think we want to experience, quickly resonated with hundreds of people across social media and with the work we all do across Health and Social Care sectors and adding a new dimension and offering a greater and broader meaning.

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Scott began work in the Criminal Justice and 3rd Sector designing and implementing strategies and processes to better incorporate Service User Involvement, Influence and also Co-Production and it is those values and beliefs he holds which align beautifully with the clear message in this picture.

Having spent her adult working life in the NHS both clinically and managerially Kirstie is fully aware of the need now more than ever to listen and engage with what the public want. Often it’s easy to design services around our own broad assumptions of what they should look like based upon previous service design and delivery and also upon our own internal view of the world.

We know that there are some really innovative forward thinking organisations, both statutory and voluntary who are really embracing partnership and collaborative working with people who use services, this we should be proud of and celebrate, and we know that this is not the case everywhere and so we need to work together to achieve this.

Some of our past experiences have given us a good grounding in how those of us who work within Health and Social Care should always have a good understanding of experience, both from a client perspective and from a staff perspective too. We design services based on need and improve services based on the same principles. If we go back to the picture above, we could question if anyone asked the public which route would be most utilised. Some challenge to this, has been that this is through societal laziness and to ‘cut corners’ literally, however you have to consider if the public want  the quickest route or the most attractive? Seems an obvious question doesn’t it?  Although simplistic in its demonstration, this epitomises the importance of service user involvement at all stages of design, it shows the fundamental importance of real engagement and understanding what’s important to the service user, and frequently this is not the same as what is assumed important to the provider.

It’s easy to find ourselves starting to make the same presumptions in our day to day roles, especially when we become embroiled in what we do and believe we have the expert knowledge, experience and skills. We can quickly start to believe that we have worked with a client group in depth and therefore understand the needs, wants and wishes of this ‘group’ of people and because we have an understanding of the issues faced by the clients we come into contact with we are best placed to design based on that.

At a time when finances are tight, there are projected deficits across health and social care funding, leaving gaps, and efficiencies to be made, it seems fundamental to ensure that what we are doing and the services we are designing are what matter to the public we serve. We can’t presume to know what people want and need without their involvement, they are the experts and we should be there as guest in their lives, working with and for them.

How can we model good practice?, here are some hints and tips from Scott, Community Volunteer Capacity Builder…

  • Don’t replicate what a community is already able to do or already doing
  • Ask what questions you should be asking rather than just designing questions to ask
  • Invite Service Users/Patients/Carers/Community as partners in a wider vision and not in small parts
  • Make sure Involvement and Co-Production is a learning experience and not fully outcomes focussed
  • Listen don’t defend
  • Any Co-Design has to be Mutual and Reciprocal…people know when they are being undervalued
  • No one person has all the answers and like a football league it requires many component parts
  • Identify and invest in the right leaders, not just the corporate leaders
  • Don’t expect linear processes…people not working for an organisation will think differently to Policies and Procedures…work with not against
  • Enjoy the experiences, perspectives and most of all, the inclusivity

It can be easy to misinterpret best intentions for true engagement and partnership and how this is aligned with our core values as a person and our beliefs around the public and voluntary sectors we dedicate our time to each day. This picture reminded us about the importance of making sure we continually value the ‘experience’ and Involve people in the work we do. It has in fact empowered us to spurred us on to ensure we continually take the left path and let the ‘experience do the design’ and not let the ‘design spoil the experience’.

Thanks for listening – Scott & Kirstie

Scott Bell

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Scott doesn’t come from an academic background but he does have in depth knowledge and experience of the 3rd sector where he now works. He is passionate about his job, which is to enable Co-Production and Community Engagement within a project designed to engage clients into services that would give care for the following areas of need, Homelessness, Addiction, Re-Offending and Mental Health.

He is highly motivated by enabling some form of change within traditional services and the way they are delivered and one of his overall ambitions is to see a truly person centred approach and services that are designed with the service users experiences and feelings at the centre.

He is also a Co-Creator and Director of a Social Enterprise and has found lately that he feel passionately about Social Capital and Community Investment and strives to make sure that Health Care of any kind can be started from within a community and filter out. He feels this can be done through Leadership Development and giving people a voice who would, under most circumstances, go unheard.

And last of all, he is a firm believer in the ideal of a free and all-encompassing health service that keeps the patients and their needs at the heart of everything it does.

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The Restoration Project

Last Tuesday I took my 3 year old son to our local park. Having rode his bike from the car park to the cafe, he was well in need of an ice lolly (as was I). As we approached the cafe, I noticed an elderly gentleman (maybe in his 70s) walking towards the same destination, with a pram. For some reason he stood out to me, maybe it was his age and the fact that he was pushing a pram alone, it made me think about how much we (I) rely on family and ageing relatives to look after our children so that we can return to work. Maybe subliminally I felt sorry for him, as looking after a young baby is no easy thing.

He followed me into the cafe whilst deliberating wether to leave the pram outside whilst he ordered, I could see he had asked a lady sat outside to mind the pram whilst he came inside.  Whilst I was waiting for the ice lollies, he had enquired how much a cup of tea was, he had got enough thankfully.  The lady serving asked if he wanted anything to eat, he asked how much the Twix on the counter was, ‘a pound’ she replied. He didn’t have enough, so I offered him the remainder, to which he thanked me and declined.

The gentleman went to rejoin the pram outside with his cup of tea. I added a Twix onto my order and dropped it at his table as we walked to the boating area where we sat and ate our ice lollies. The man had said thank you and looked really surprised by what I had done.

About 10 minutes later he walked over to where we were sat, and said ‘I’m really touched by what you have done, it was such a kind thing to do’. He went on to tell me he had been unwell recently, that a good friend had also recently passed away, and that he was not so happy at the moment. He then said ‘I’d  started to lose my faith in good things and good times, but what you did has really restored my faith in the future, and good people’, ‘there are many bad things happening in the world currently, its easy to lose faith’.

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We then, chatted for about 20 minutes, the baby was his daughters, and he had left his wallet at his home with his wife, hence the shortage of money. We talked about how quick life goes by and how quickly children grow up, he instilled years of experience upon me that day about the things which matter in life (not all what you would expect) and insights I could not imagine due to lack of years and life experience.  As we said goodbye I felt really peaceful, the small thing that seemed a normal thing to do (buy him a Twix) had actually helped him in more than one way and me in return.

Being a reflector at times, I thought about how kindness is possibly one of the greatest things you can offer someone, with love being the first. Also that some people don’t get a lot of kindness in their lives, or that life is so busy that its easy to forget the importance of the basic and simple things, such as kindness, compassion and sometimes just an ear to listen.

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I was recently speaking with someone about missing clinical practice and how sometimes its hard to know if what I currently do, makes a difference for people. As a nurse I could see instantly the difference I made. There is something hugely warm and fulfilling (like a giant bear hug with a huge marshmallow) that you get from sharing a moment with another person, knowing that they rely on your kindness and compassion in their most needed hours. That simple touch of human kindness, physically or psychologically can sometimes be more needed and wanted than any technology or medicine the NHS has to offer.

During my 16 years working in the NHS I have met some of the kindest, most compassionate people who amaze me and inspire me. But I have also met some people who are not so kind, who for whatever reason in their lives are not able to show these qualities. Many of these people have sadly been clinical staff, maybe tired, burnt out nurses who themselves don’t receive kindness from their managers and leaders within their organisations and therefore don’t demonstrate and pass on this feeling of value and being cared for to their patients. People, nurses are not robots, we’re not born or programmed to systematically and routinely be kind and compassionate, we’re human, and sometimes we get hurt and broken too and need the care and attention we give to our patients.  So maybe by caring for staff is a way that I pass on that difference to patient care, maybe my role now is to care for the carers?

The human touch is a funny thing, it can make the world of difference, the NHS is made of people, we care for people, we work alongside people. I believe we are born to love, that of all the advancements in todays society, the thing people value, want and need most, is something which costs no money (or maybe £1 to start the ball rolling) its love and kindness, and with kindness comes respect, trust and a shared connection. Something all the money in the world cant buy.

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My original summer plans for restoration included an old bench and table, however my new plans are to restore kindness in the little things I do and hope its enough to make a difference.

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Take Me As I Am……

Take Me As I Am…….

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Take Me As I Am……

Having not blogged for some time now, I have been waiting for the moment when something really inspired me, or when it captured me emotionally. Yesterday was that day!

I attended the funeral of a beautiful and amazing 15-year-old boy called Adam Bojelian. I had met Adam through twitter; he was a young man who captured my inner child and also who epitomised why I have spent my life working in the NHS. Adam had complex health care needs and had spent the last 18 months in hospital expressing through poetry, tweets and blogs how it felt to be him. Adam tragically died in March from Sepsis.

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Yesterday was heart breaking. I am quite an emotional person but I don’t think I truly prepared for how hard it would be. As the funeral car arrived to collect Adams beautiful casket from his parent’s home, where most people had gathered, I felt the real sorrow begin. We walked behind the car to the church where people paid tribute to him in words, song and music. We then walked to where he would be laid to rest. As I threw soil and my single rose into his grave I sobbed whole-heartedly both in loss of Adam and as a parent, watching his wonderful parents say goodbye.

On the return walk to his home I was walking ahead of my friends when I felt someone put their arm around me, it was Adams Grandma, a petite lady with long grey hair and a beautiful face and eyes which her soul shone through. As I returned the gesture and put my arm around her, I was taken aback at the compassion she displayed towards me in her time of need. I was truly touched by this moment and it is one that will live on with me. As we walked the country lane back to Adams house, she told me stories about Adam and her family, we both cried together.

What struck me was the vulnerability we both shared in those precious minutes. We both laid bare our emotions for each to see and I believe because of that, we made a connection albeit brief that will live on with me always.

Today has been very reflective for me, yesterday made me think about how as humans we often avoid feeling vulnerable. I mean, who wants to feel, open to criticism, rejection, embarrassment and shame? Who wants to be seen as a weak person for having feelings?

I was quite happy yesterday to ‘let it all out’ and be comfortable in front of peers to express how I was feeling; being at a funeral gave me the OK that it’s acceptable. But what about day to day work, what about as a manager or clinician or senior leader? Is it ok to express vulnerability, what about in the boardroom? Or in a consultation with a patient or service user?

Vulnerability for me doesn’t just mean showing your emotions, it also means showing you care, showing you’re afraid, or unsure or don’t actually know or have the right answers… I wonder how many times things have not gone right due to fear of showing vulnerability?

We only have to look at the landscape of Health and Social Care today to see we are all vulnerable, who has the answers? Who is afraid to say they don’t, that actually the NHS is in our hands yet we don’t know if we can safeguard it for our children.

We work in the Health Service; we see it each day in the public we serve, we often unknowingly create vulnerability for people. It’s all around us, but I wonder if we embrace it enough?

A friend who attended Adams funeral, coincidently sent me a link on twitter today for Brene Browns TED talk – on the power of vulnerability . If you haven’t seen this already I would suggest a viewing, its fantastic.

Brene talks about us being hard wired to need connection to give us purpose. That being vulnerable leads to a fear of disconnection and unworthiness. She talks about allowing ourselves to be really seen, being authentic, letting go of who we should be and being who we are. I wonder how many of us take our true authentic selves to work, and if we don’t, why not?

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Brene also talks about having the courage to be imperfect, being compassionate to ourselves first and embracing vulnerability doing things that have no guarantees. She suggests that by doing this, we open ourselves to joy, creativity and happiness. She even made reference to our vulnerability making us beautiful, I would agree, it shows who we are when times are challenging, we open up to show that we are human, that we are all people, after all, isn’t that what the NHS is about – people?

I wonder what we can learn and take from her work in the NHS. If by embracing our vulnerability we could remove some of the fear we feel as clinicians, as managers and leaders when we’re making important decisions, when we don’t know the answers but are too afraid to say. When we’re afraid to speak out about poor care because it will leave us ‘vulnerable’, could it even save a life? Who knows?

So after a day of reflection about Adam, myself, the NHS what I’ve realised is that its ok to be vulnerable, and to believe in yourself, your true authentic self, to be who you are. What I also realised is that actually this is what I admired most in Adam, he was himself, he had no reason not to be, and because of this, he opened himself up to happiness and self purpose through connection. He made me think about his courage and chance taking, he put himself out there, and it worked, people admired, respected and loved him for it.

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Taming the Voice Within

Taming the Voice Within.

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Perfect Moments of Care

Perfect Moments of Care.

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