Being brilliant

I write a weekly blog for staff. It covers all kinds of stuff. This week it was all about – inspiration. The things that resonate. I could have picked any day – but Wednesday was good enough. Brilliant in fact. Here it is –

Last week I mentioned the “leading from every seat” sessions (based on the art of brilliance) that have now been attended by around 900 staff. These sessions have been organised by staff for staff. I overheard one of the team from the Community Intermediate Care Unit discussing the sessions yesterday – “It isn’t like anything I was expecting – it was great”.

My reflection on why the sessions are so powerful is that they reconnect us with our purpose and our values. In the trust, we spent a lot of time creating a vision and a set of values that reflect what we do. For this week’s blog, I could talk about the tough Programme Management Board on cost improvement; the positive and challenging Business Committee meeting; commercial developments; pressures and hotspots in some services; our Foundation Trust progress; partnership and relationships with senior people; national developments; quality measures and safety. These are clearly a feature of my week. You can read about these in the Board papers which are available to view here.

I am taking a different tack.I am going to talk about all the things that inspired me yesterday Wednesday 24 July:

  • All the staff on the Community Intermediate Care Unit that I met for conversations about care, complaints, leadership & their glowing CQC report 
  • A chance conversation with Lauren Woolley, Children’s physio, sharing feedback from trainees & families on great care and good teaching and moving to being paperless
  • Benita Powrie, Head of Service for Children’s Occupational Therapy and Physiotherapy, arranging for one of her patients A to do her work experience with the trust. Then spending time being interviewed by A, who showed Cerebral Palsy was no barrier to her great questions and thoughtful approach, passion and understanding. The fact she has agreed to work on our Youth Council is a bonus.
  • Seeing the work that Emma Dickens and the membership team have done covered in a guest editorial for NHS Managers.Net  [] because it is such great work!
  • Engaging with Janet Addison, Head of Service for Children’s  Speech and Language Therapy, whose professionalism in responding to media coverage with openness and honesty and looking at lessons learned gives me huge confidence
  • Seeing people I mentor flourish in their careers and in their development
  • Reminding myself as we look at the figures and facts in the balanced scorecard that our staff are showing huge commitment under massive personal pressure and making a difference every day

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Of course my day was full of other stuff as wellincredibly challenging and difficult stuff too. Reconnecting with purpose; being inspired by the difference we make and the people I work with is what keeps me focused and energised. I don’t need to look far to be inspired as we face the challenges of each day.

Thanks everyone


Forget the Janitor at NASA, Andy makes people better….

“There is a famous story about President John F. Kennedy’s first visit to NASA’s headquarters back in 1961. While touring the facility, the President’s entourage reportedly came upon a man mopping the floor in one of the hallways. The President stopped to chat with the man, shook his hand, and asked what he did at NASA. The janitor proudly addressed the young President by saying, “Sir, I’m helping to put a man on the moon!” ”

It was our monthly staff indiction this week. I open each of these sessions with new starters to the trust and discuss Vision, Values and Leadership. I ask three simple questions during my half hour slot, giving everyone in the room a minute to discuss the question with their neighbour. We get some great answers from the 30 to 40 people present. The mix of professions, roles and services – from prison pharmacists to community counsellors, rehabilitation consultants to community healthcare support workers, office receptionists to graphic designers – always makes it real. I ask:

Why do you do your job?

What Does High Quality Care mean to you

What’s the best thing that has happened to you this week?

You should try it, in your teams, at least once a month. The answers will reconnect you with purpose, energise you and remind you of the impact you have every day.

And the best thing that has happened to me this week? Was an answer to that first question. One of our HR team was my neighbour. Andy – why do you do your job?

“To make a difference to the people of Leeds. Because I am part of the recruitment team and we make sure we employ the best people, quickly. So, indirectly I make people better. And being from Leeds, that matters to me.”


So it not only “janitors at NASA who put men on the moon”. We call it Leading from Every Seat. More on that in my next blog – because we have it. In spades.

I am not asking for the moon…….

Back in the early part of the noughties, I was a senior civil servant. We had a big debate about where we should focus policy after putting huge increases in staff and funding into the NHS. The answer? “Quality”. We have been improving quality, in broad terms,  since – through National Service Frameworks, Cancer Improving Outcomes Guidance, higher satisfaction….

Yet we still have catastrophic failures in some organisations and, in my view, we are still often missing the point on quality. Quality is personal. It’s about the right care for me. Care that is clinically effective, safe and delivers the experience I want. Which is probably less lavish or demanding than we all fear…

“What does high quality care mean to you” It is a question we ask every new starter at LCH NHS Trust. You can see some of the answers in our gallery here or watch a video here.
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 It’s a question that the NHS England Consultation on the future of services “The NHS Belongs to the People” a call to action, needs to ask…..and we need to listen carefully to the answer.

It’s a question that we need to get right, and get the right people to ask too. Last week, our trust members interviewed consultant paediatricians. Junior staff members, parents and children interviewing doctors and having a real say in their appointment. The world has changed!  We have done the same with senior managers and consultants in rehab too.Our members are also engaged in driving quality through assessments of care environments, service improvement programmes and communication tests. Every one of them has something to offer and a view on quality. Want to join them? You can become a member here.

What does high quality mean to me? Well, I expect well trained staff, working in a team, supported by the best clinical evidence base in the world. Better IT and more convenience would be nice. kindness too. A recognition that I have a life and services are a guest in it. Above all, I want to be seen as an asset, not a disease or an issue. Because I reckon the NHS will need me to look after myself much more  in the future…..and everyone else too.

In an era of austerity, we should keep that focus. Because quality can be better, simpler and more cost effective. ……and if we engage people in the question, and delivering the services that result from the answer, we will have a chance of succeeding. That I hope will be one of the conclusions of the NHS England Consultation.

A quick bonus – here  is my favourite short video of the last year. It is all about quality. What’s the best thing about your care? “Being able to shave my own legs.” Fabulous words from Vicky in praise of Suzanne Henshall and the OT team.

Nana’s Golden Key

One of my colleagues was explaining last week why integration of health and social care is important. Tired of the usual cliches he decided to tell us what a carer had said to him. Let’s call her Nana. She described how her life had become blighted by the illness of her husband. How she had proudly resisted help until he became to much for her to cope with alone. She approached services and was given support. She said it was like

“I had been given a ring with 15 keys on it. But no-one told me which key opened which door. Or what was behind the doors.” It was frustrating and difficult. Then about a year ago services were integrated in one of our demonstrator sites.


She said “Suddenly I was given a golden key. It opened any door and gave me what I needed”.


Over the last two years, I have been writing about the risk of competition and fragmentation of commissioning on care. As part of a Future Forum submission, in briefings for the NHS Confederation, everywhere I could, I have worried about multiple providers serving multiple commissioners for a single patient journey leading to duplication and gaps. There has been a lot of change since. Those risks are receding.

Every day we hear about the importance of integrated services in the future NHS. The Government delivers a welcome £3.8bn pooled fund for integrated health and social care in the budget. Norman Lamb announced a number of “pioneers” to look at integrated health and social care systems – Leeds has submitted its bid along with, some say, around 100 others. Mark Britnell from KPMG – touted as future CEO of NHS England by the commentariat – writing in this month’s Health Services Manager says “Integration trumps competition in terms of delivering sustainable benefits”. Monitor sets out its thoughts on enabling integrated cares in its role as system regulator. The fabulous National Voices have come up with a new definition – at the heart of the vision in Leeds.

Person centred coordinated care

“I can plan my care with people who work together to understand me and my carer(s), allow me control, and bring together services to achieve the outcomes important to me.”

The integration lobby have won the argument, it seems. So why worry? Nana will get her golden key won’t she? Perhaps.

John Appleby writes in this blog about the role of the OFT and Monitor in ensuring appropriate competition. He argues well about the need to make a good case for not competing – with more than a golden key as support. The financial system still supports the delivery of funds to hospitals for activity or part funds urgent care to their detriment, depending on your view. Many agree it doesn’t yet support integrated care or continuity or shifts in care – good King’s Fund Report here.

Which leaves local leadership to sort things out. I have no problem with this. We must have faith in local System Leadership, which is essential in these circumstances. In Leeds we are working really hard to ensure that everyone plays a system leadership role. Our Health and Social Care Transformation Board helps to drive this. Its role in the integration of services has been fundamental to the progress to date. Local politicians have backed change. Commissioners have used the non-recurrent resources to fund change. Providers have thought about services first, not structures. Researchers have been working with us to assess the impact on quality and activity. Lots of detail here.

And change is beginning to happen. Beautiful, impactful, essential change. Change that happens in homes so is not visible enough. Change that transforms lives. Not enough yet to give every Nana a golden key but sufficient to be seen by those who matter. Take Elsie Sykes, one of our patients, talking about being “lifted” in the video on this page.

If you have watched this, you will understand why we must succeed. Because we all know an Elsie and we all have a Nana, don’t we?