New freedoms, new anxieties

Here's me (top) and
Sarah Davidson (bottom)

After being trapped in a surreal covid world for the last three months, where understandably we’ve lived and breathed nothing else, we’re finally seeing other events standing more on their own.

We’ve just had learning disability week, the Windrush anniversary, and even national optimism day! 

Yes, the ‘staying connected’ theme for learning disability week was adapted for the particularly harsh impact of lockdown on this group. But we all need friendship and support, and never more so than during this challenging period. 

The second-ever Windrush Day on Monday marked the legacy of the Windrush generation, as well as a chance to show solidarity and support for the hardships many have had to suffer since coming to this country.

I don’t know if you watched the BBC drama, ‘Sitting in Limbo’, or the documentary, ‘The Unwanted: The secret Windrush files’, but I felt myself wanting to shout at the TV again. I was shocked to hear in this damming documentary that, even before arriving, politicians in Westminster were frantically scheming about how they could prevent a ship carrying hundreds of people with a legitimate right to live here from docking in the UK. 

I’d naively thought that these British citizens from the Commonwealth were wanted and were being welcomed to help build war-torn Britain. But even in the fifties we were already creating the 'hostile environment' that we have seen endure since. No one should feel proud of Britain after watching this programme. 

This week also brought news about the further release of lockdown measures, with our own 4th July 'Independence Day' and celebration when pubs, hairdressers and cinemas can re-open. Even more importantly, families can now visit each other and stay in each other's houses, so long as we still maintain social distancing. This virus has certainly shone a bright light on the things that really matter, with separated partners and families talking of their joy at being able to visit and spend time together.

I do however totally get that there’s still a lot of anxiety about our new freedoms. The lockdown has made many of us anxious, and for a lot of people returning to ‘normal’ might be very scary. I heard a couple of young people talking on the radio about the anxiety they were feeling at the thought of doing 'normal' things like going to the pub. The bottom line is, although the measures are being relaxed, we are far from the normality of three months ago. 

And I know the anxiety people are feeling in general is playing out here within our organisation, and I know you need to know that we are moving forward in a safe and planned way. We will not be rushing to return to how things were back in March. 

Our ‘appreciative enquiry’ work is now almost complete for both clinical and corporate services. We are also close to completing the risk assessments necessary to develop our 'working safely' plan, which will set out how we will deliver services and provide corporate support services for the rest of the year. We shared a communication earlier this week advising that for now, people should continue with the existing arrangements. With schools out until at least September, we know that it is difficult for many of our staff with caring responsibilities. So there is no expectation that, with the recent changes to lockdown, we expect people to suddenly change their working arrangements. As soon as we can, we will share the 'working safely' plans more fully.

As well as working through how people should be working over the rest of the year, we are also working on what we should be focusing on. Using your experience from the appreciative enquiry and thinking about how we can best deliver the expected surge in demand, we are reviewing our priorities to refresh our annual business plan for this year. As I said in an earlier blog, our big ambitions have not changed, but our world has, so we need to reflect that – we hope to have the refreshed plan within the next month.

I’ve had such positive feedback about the guest blogs over the last few months, so here’s the last of the lockdown perspectives from Sarah Davidson in our safeguarding team. A reminder that, even as we gradually move out of lockdown and hopefully away from the most devastating impact of the virus, it was very real and we all learnt so much along the way.

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Sarah Davidson, Head of Safeguarding

When COVID-19 hit the headlines, we realised that the demand on NHS frontline staff and lockdown was going to change the world of work as we knew it.

Our safeguarding team, which consists of a number of nurses, experienced an overwhelming urge to get to the frontline and help colleagues in any way that we could. Most of us, as part of our careers, had worked in a variety of clinical roles across a number of different organisations and felt we had a lot to offer.

Like many people, we were watching the videos of NHS staff trying to shop after long shifts where many of the shelves were empty, and clapping for the NHS and the amazing work our staff were doing on a Thursday.

The modern matrons share our office at Trust Headquarters and we watched as they became busier. We offered support where we could, which mainly consisted of making cups of tea, ensuring snacks were in the cupboard and photocopying infection control and PPE information for the wards.

We talked as a team about how we could get to the frontline at a time of national crisis. In each nurse, there was an uncontrollable urge to want to care for people and support our colleagues, so we were thrilled to be given the opportunity to undertake a clinical refresher, getting us one step closer to where we wanted to be.

So over three weeks, five members of our team attended the clinical refresher course. Uniforms were ordered and we were then available for redeployment. Very quickly, there was a request for support from the Stockport drug and alcohol team and one of our team, who had previously worked in the service, volunteered to support and was off to the frontline.

I was approached on a number of occasions for further redeployment opportunities and those who had undertaken the clinical refresher were on standby.

All along, I was mindful that we had to continue to offer safeguarding support, advice and guidance to staff, so we could fulfil our statutory responsibilities to promote the welfare of children and young people and protect adults at risk of abuse: enabling them to retain independence, wellbeing, dignity and choice. 

A couple of weeks into lockdown, I attended a multi-agency meeting and was able to give assurances that frontline staff continued to have access to safeguarding support through the normal channels, but as demand was reduced that some of the team had been redeployed. At this meeting, a colleague from another organisation said that we have our own safeguarding ‘frontline’ and we’re on this frontline because of our knowledge, skills and expertise. I realised this was an important message to take back to the team: to remind them that, just because we are not on the wards in our uniforms, we are not on the frontline.

The measures to contain and delay the spread of covid are presenting major stressors for families which they can’t control. We need to continue to recognise when children, adults and families are struggling or potentially suffering abuse or neglect and refer them to other agencies, as well as support vulnerable patients where possible.

Children and adults will continue to be abused and neglected throughout this time. Some may be at higher risk. For many vulnerable patients and families, contact with our services might be one of the few professional contacts they have. During consultations, we need to consider if they could be experiencing significant harm and safeguard appropriately: be professionally curious.

For victims of domestic abuse, household isolation could mean they are at additional risk of abuse; trapped in their homes with their abusers and isolated from the people and the resources that could help them. Subtle signs of abuse and/or neglect may not be as obvious during phone or video consultations. Victims of abuse may be unable to speak freely if consulting from home.

It’s vital we keep communication channels open with other health and social care professionals who are involved in the care of vulnerable children and adults. Please continue to share information as you would normally for the purposes of safeguarding.

So as nurses, there is still that urge to don our uniforms and head off to the wards. But like other teams who are working ‘behind the scenes’, we are valuing our contribution and understanding that each and every one of us has valuable knowledge, skills and expertise in our own areas of work that are crucial at this time.

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Best wishes,

Claire

You can follow me on social media @ClaireMolloy2

Feeling angry, being visible

I want to talk about two things in this blog: BAME inequalities and leadership visibility. Also, just to add that my guest blogs haven’t gone for good, as I know they’ve been popular. I just don’t want to bombard you with too much this time round and focus on these two issues.

Black Lives Matter

Let me start by saying that I appreciate I can’t talk about racism from the perspective of someone who has experienced it directly, or had to live with the subtle and insidious effects of indirect discrimination and institutional bias. But I have seen it, and the impact it has on people, and I believe that this is a moment in our history when everyone should reflect on what is happening, what has happened in the past and what contribution we should all be making in the future.

Discrimination adversely affects our colleagues, patients and, at its worst, kills as we have seen in recent events. It is a tragedy that we haven’t been able to do more to redress this unacceptable balance.

Those of us not from a BAME background need to make it clear that this is hugely important to us, that we want to listen to and really understand people’s experiences and perspectives. It requires us to explore our own role and behaviours in history, both personally and as a nation. It’s time to be comfortable with being uncomfortable. We need to remember that it's a privilege to learn about racism instead of experiencing it your whole life.

We have a personal responsibility to know how BAME colleagues feel and the impact of anything we may be doing. We all have unconscious biases. They are learned stereotypes that are automatic, unintentional and ingrained within our beliefs, and have the ability to affect our behaviour.

I recently re-watched ‘Black Lives Matter - 50 years on’ from the truly appalling 1968 ‘Rivers of Blood’ speech made by Enoch Powell in which they showed the speech to people from a range of BAME communities who then talked about what it’s like for them to live in modern-day Britain.  It highlighted how some things have changed for the better, but clearly nowhere near enough.

We need to understand the covert racism, not just the overt racism, which can be more damaging given that it’s often unchecked, undetected and so insidious that it presents itself as normalised, everyday behaviour. Only when we know our triggers can we check ourselves.

Professor Michael West talks about the two aspects of compassionate leadership. The first is feeling empathy and stepping into someone else’s shoes to appreciate their positon. But the second, and more important, is taking meaningful action. Empathy on its own is not enough to change things.

The protests have brought into stark focus the fact that there is a huge amount of empathy and I have taken some small comfort from the fact that people at the protests have been from many different racial backgrounds. But, although we have talked about inequality for a long time in the NHS and public sector as a whole, there has clearly been too little action.

Many white people are letting fear of getting it wrong get in the way of working for change. It’s time to get over this and do something.

As recent events following the death of George Floyd have unfolded, I’ve been thinking a lot about what I should and shouldn’t say and I’m actually feeling pretty angry about some things. 

I’m angry with people using inflammatory language to describe peaceful protesters. I’m angry with commentators defending statues of slave traders.

I’ve actually been really wound up about the statues. Honouring is very different from remembering, so the history argument doesn’t wash with me, it just highlights our imperial blind spot.  These statues normalise the past. They make injustices easier to defend and harder to see.

Take Cecil Rhodes for example. Yes, he was a noted philanthropist and his Rhodes scholarships have done a lot of good, but he stole land, massacred tens of thousands of black Africans, imposed a regime of unspeakable labour exploitation in the diamond mines and devised proto-apartheid policies. This balance definitely doesn’t warrant being immortalised in bronze. Our statues are symbols of our values and what we hold important, so I strongly believe it’s time for us to talk about who we want to represent our country and make a statement by taking down those that no longer reflect our values.

Despite our diverse population, we had to wait until 2016 for the first statue of a named black woman, Mary Seacole. These acts of symbolism are important. It should be a democratic decision, but removing a statue is not erasing history. It’s about placing them in a museum where we can still learn about them, just not glorify them.

But enough about my statue rage. This global demonstration can't be a fad. There must be momentum once the news cycle ends.

I get that the deep, multi-layered nature of systemic racism means there is not an overnight fix. But, if the NHS is part of the problem, then it is part of the solution. As an organisation there are things we have to do.

We’re planning to have a board session with our BAME staff network, as well as our other networks, so we can look at all the positive additional actions we can put in place.  We want our staff networks to hold us to account. We want them to be stubborn and unapologetically shine a light on issues, but most of all we need to turn warm words into actions. 

Visible leadership

I’ve seen some awe-inspiring examples of leadership across our organisation over the last few months.  I’ve never been more impressed or felt more proud. It’s also made me think all the more about the visibility and presence of our leaders.

And as we expect the ‘living with covid’ phase to last for a significant period of time, we need to really think about what visible leadership means in the context of covid.

We’re currently doing an ‘appreciative enquiry’ across our organisation to understand how the pandemic has affected teams, and one of the themes that has emerged is about exec directors not being as physically present as people would have liked.

To be honest, we’ve found it difficult to find the right balance between keeping people safe, adhering to government and infection prevention guidance, not using up PPE resources especially when they were scarce, not turning up in clinical services when you were really busy, and leading by example for the 1000+ colleagues having to work from home.

We therefore tried to be visible and make contact through other ways, for example phone calls, personal emails, zoom chats, videos. But I fully appreciate if we didn’t get this balance right, and that many of you would have valued seeing more of us during this difficult time. Your feedback is important and we take your observations completely on board.

Henry, our medical director, is now working a couple of days a week in Stockport and some of the execs have started to visit various clinical teams - we’ll try to do more of this going forward. With around 200 different locations, it was a challenge before covid, so I’m really interested in what feels right from your point of view.

I’d like to find a way of hearing your views and opinions on this matter so will be asking the question in various different forums and channels. We want exec director visits to be informal but meaningful, helpful but not stressful. Definitely not Royal Visit style as I know some have described it in the past!

So thank you for sharing your reflections through the appreciative enquiry. Your observations have been fully heard and taken on board, and we will work through how we can be more physically visible over the coming months. It's important we demonstrate how much we stand alongside you.

Best wishes

Claire

You can follow me on social media @ClaireMolloy2