GHP September 2015

ghp September 2015 | 61 will only increase to breaking point. Rose identifies three areas of particular concern. Firstly, that there is a lack of “One NHS Vision” and of a common ethos. Secondly, that although the NHS is committed to a vast range of reforms, there is insufficient manage- ment and leadership capability to effectively deal with the scale of challenges associated with these changes. Finally, there is a need for a specific direction and development for careers in managerial roles across the medical, administrative and nursing cadres. “…although the NHS is committed to a vast range of reforms, there is insuf- ficient management and leadership capability to ef- fectively deal with the scale of challenges…” Lord Rose, Better leadership for tomorrow, NHS Leadership Review, June 2015 In 1948, three principles were established to guide the newly formed NHS. In 2011, these three were increased to seven principles by the Department of Health. These were derived from extensive discus- sions with staff, patients and the public. The third of these seven principles states: “Respect, dignity, compassion and care should be at the core of how patients and staff are treated – not only because that is the right thing to do, but because patient safety, experience and outcomes are all improved when staff are valued, empowered and supported.” In 2015 Hillcroft House, the research and training provider, conducted surveys which asked 220 man- agers in the NHS if they were aware of the seven core principles. Did they know principle three? The findings showed that 100% were unaware of its existence. More concerning still, 100% were unaware that their employer, the NHS, has seven core principles that underpin its core values. Further surveys, again by Hillcroft House, have found that the majority of NHS front line staff value thoughtfulness, teamwork, humility, stability and harmony. In contrast, the majority of NHS managers value results, independence, achievement, decisive- ness and success. The detailed work by Hillcroft House shows that the way people behave and communicate dictates which of these values are of highest priority. The impact of this can result in significant misunderstandings. Frus- tration, combined with low levels of self-awareness can lead to unacceptable behaviours. For example, people felt they were being bullied even though, after investigation, it was found that this was neither the intention nor the motivation of the other party. When bullying appears rife, stress levels rise, absences escalate and the duvet days increase. Approximately 9.5 sick days per year per employee are lost accord- ing to HSIC figures for 2012 for total sick leave, and irrevocable damage is done to service provision and morale. Human beings on all sides suffer. Trust in one another is lost. Case studies have shown that when people invest time to understand their own behaviours and their effect on others, they are able to create a culture of success which breeds further successes. Frances Tippett heads up the South West Integrated Personal Commissioning (IPC) programme (a national demonstrator site for NHS England, Local Government Association and TLAP (Think Local Act Personal). The South West IPC team invited Hillcroft House to assist them with understanding differences in communica- tion and behaviour styles and the impact on team and organisational dynamics. They believe this is essential if they are to successfully tackle the cultural changes needed for teams to give people choice and control over their care. Tippett said, “Although no one local area, organisation, or team has got all the answers, between us we have many of the elements needed to make it happen here. We need to enable teams to learn from each other, challenge positively and rapidly adopt changes that will benefit the people we are here to sup- port. To do this we have to invest in increasing our peo- ples’ self-awareness and understanding of the impact of their behaviours. By communicating more effectively they are more likely to positively influence colleagues from a different professional discipline or organisational culture, breaking down barriers to integration”. “…we have to invest in increasing our peoples’ self-awareness and under- standing of the impact of their behaviours…” Frances Tippett, South West Integrated Personal Commissioning (IPC) programme Perhaps extensive reports like Francis and Berwick will initiate a review of the self-awareness levels of all the committed people within the NHS. Maybe learning from the work of South West IPC will lead toward better behaviours, cleaner communication, greater trust, im- proved patient care and a demise of the extensive neg- ative publicity that the NHS receives. Could the solution be as simple as Adam Crizzle, MD of Hillcroft House, believes “Understanding behaviours makes outstanding people, creating extraordinary organisations”? health and social care