Friday 27 March 2020

The NHS is facing its biggest ever challenge

It feels as if the world has been turned upside down.

A third of the global population is currently on lockdown, while incredibly dedicated healthcare staff are out there caring for sick and vulnerable patients.

The NHS is facing its biggest ever challenge since it was founded in 1948. Business as usual has been thrown out of the window.

People in our organisation are now working in very different worlds. Those of us who are able to work at home are following strict government guidelines; seeing and speaking to people remotely to urgently progress plans and complete tasks. But a lot of our clinical colleagues are not able to do this and are selflessly still seeing patients face to face and having to cope with the anxiety this must inevitably cause. 

If you are feeling stressed, scared, sad, overwhelmed, helpless or even numb, then that is totally understandable.

I’m acutely aware of your anxieties, especially around personal protective equipment, staff testing and workforce shortages.  But there is a massive amount of work going into responding to coronavirus and people are trying really hard to ensure our patients and staff stay as safe as possible.

We are all having to get used to working in very different ways and managing the impact on our lives and those we love. I can see a lot of people making immense sacrifices to care for others.

I hope that everyone heard or participated in the clapping across the country for all NHS workers last night at 8pm and felt the love. The dedication of people and sheer hard work that is taking place is heart-warming and inspiring. I am so grateful to everyone for the part you are playing.

This virus has forced more distance, yes, but also more connection, as we find ways to communicate with people who are physically further and further away - and who feel safer to us because of that distance.

I live in the ‘Plague’ village of Eyam in Derbyshire that has been on the news a lot recently. In the 17th century, people in the village self-isolated and cut themselves off from everyone to stop the spread of the Bubonic plague. Little did I realise when I moved there, that I would be doing something similar myself!

My husband is one of the 1.5m people who are most at risk of severe illness if they catch coronavirus and so he got his text on Monday about having to stay indoors for 12 weeks.

He’s been told that he can’t go outside (but is allowed to open the window!), and we’re not even supposed to be in the same room. Sleeping in different beds after 35 years of marriage feels a bit weird, but at least it’s a bit of respite from his snoring!

But on a serious note, all of this is incredibly anxiety inducing: whether you are working in a place where you are more exposed to the virus; or whether you are worrying about loved ones who are vulnerable. We have to find ways of staying connected and supporting each other now more than ever.

So, I am going to do weekly blogs rather than fortnightly ones until this is over, and use the blog as an opportunity to hear first-hand stories from our frontline staff. I’m also hoping to start regular video updates, and I’m even trying to tweet a bit more (follow me on @ClaireMolloy2).

We’re changing how we work at an accelerated rate that could never have happened in other circumstances. We’re fast-tracking technology for clinical and corporate teams, for remote working and putting so many other changes in place.

A crisis on this scale can reorder society in dramatic ways.

It’s already reorienting our relationship to the outside world and each other, but I honestly believe that when this is all over there will have been plenty of change for good. More sophisticated and flexible use of technology, less polarisation, a revived appreciation for the outdoors and life’s other simple pleasures.

Support for each other is more important than ever.  Please remember that “it is ok to say you are not ok”.

In these times, our relationships with others become even more important. Thank you for everything you are doing at the moment and for your continued care and kindness.

Best wishes,
Claire

Friday 20 March 2020

Let's hope kindness defines this crisis

These are unprecedented times. So outside of our ordinary experience.

It's unbelievable how rapidly the coronavirus crisis is growing right now. It’s descended before most people have had time to learn the facts, much less process or properly contextualise them.


The more we read, the more anxious we become. I’ve felt a little bit helpless watching the news, worrying about what it means for those I love and care about.


In lots of ways, I don’t think the reality has fully hit home for everyone yet. We are seeing a mixture of people panicking - the empty toilet roll and pasta aisles in supermarkets being one such example - but also some people still trying to pretend everything is normal. 


It’s surreal and feels like we’re in a film. It’s interesting to read that the 2011 film Contagion (which I watched a few years ago) is now one of the most watched films online.


People are feeling frightened, worried about their loved ones, losing their jobs and wondering about getting basic supplies.


Consequently, there are lots of different reactions on display and we are all having to make ethical decisions. Responses are varied. There are lots of examples of people showing kindness and compassion by looking out for neighbours and vulnerable people; but equally there are lots of examples of people’s anxiety reflected in a ‘me and my family first’ attitude (hence the stockpiling approach to food).


Seeing people’s response to the crisis reminded me of a position I found myself in when my kids were little. We were on our way to a hotel to stay overnight before heading off to the airport for a holiday and, as we got onto the motorway, it started snowing heavily. Over the course of the next hour the motorway gradually ground to a halt under about six inches of snow.


Finding it hard to sit still, I told my husband to come off onto the side roads, thinking it would be easier to find a back way to the hotel. Mistake. We soon found ourselves trying to get up steep hills through quiet woods in thick snow.


We passed a number of elderly people stranded in their cars and on every occasion my husband stopped, jumped out and offered to help them push.


This was absolutely the right thing to do, but my anxiety levels were rising, as I selfishly didn’t want us all to get stuck in a car overnight in the middle of nowhere without any food or warmth, and I started to get ratty with my husband for being such a ‘good Samaritan’. We finally made it to the hotel after 12 hours and our flight was cancelled!


This example doesn’t show me in a great light compared to my husband. But it’s stayed with me as, under pressure, I temporarily lost sight of the values I hold true about caring for others and just wanted to look out for my own family.   


I’m sharing this because our values of kindness, fairness, determination and ingenuity are more important now than ever; and we will have to work hard to stay true to them.


In terms of kindness and fairness, I was worried to hear that some people are blaming individuals or countries for the virus. This blame is misplaced.


Seneca, the Roman philosopher said, “we are waves of the same sea, leaves of the same tree, flowers of the same garden.” It’s no coincidence that when the Chinese sent boxes of medical supplies and face masks to Italy, the crates were all stamped with this quote.


I was also taken back to hear about stocks of alcohol gels, paper towels and toilet rolls going missing from our clinical areas. I know anxiety levels are high, but we must ensure nothing happens which puts patients and other staff at risk. The handwashing and hygiene messages remain as strong as ever and are critical in the fight against coronavirus.


And in terms of determination and ingenuity, we are working really hard to ensure that we keep you and our patients as safe as possible and find innovative and flexible work solutions as the virus escalates. I can’t thank you enough for everything you are doing to help manage this situation.


There is a massive amount of work taking place and people are developing plans for how we can continue to effectively run our organisation with large numbers of staff off or working from home. We especially need to ensure we put arrangements in place to protect our staff in the ‘at risk’ categories.


It’s a tough balancing act prioritising our coronavirus response, while keeping all our other work going. This pandemic is having a huge impact on us, particularly on our frontline staff, but we have a duty to all our patients to carry on providing high quality services.


We’re so lucky to have such a resourceful workforce. We will need to draw on our deep reserves of compassion and determination, because a storm is approaching and we don’t know exactly how hard it will hit or how long it will last.


We were due to hold our second Just Culture conference in a couple of weeks but, after careful consideration, have made a decision to postpone it. I emailed Professor Michael West who was speaking at our conference to let him know and he responded with these very wise words; they really hit home, so I thought I would share them with you.


‘Here is what I thought yesterday, contemplating the situation for the NHS: I think this is a moment where the light can come pouring in. A recognition of our interconnection with each other, with other nations, species and with the planet we are blessed with. It feels so important to grasp it and model and promote compassion and inclusion in an enduring way. And to change our ways of being together. Particularly through emphasising that compassion is the most potent way we can deal with what feels frightening and isolating for so many. Connection, inclusion and compassion are certain, unchanging and provide a safe refuge. And I hope we will focus that on the heroes of the NHS - the people who provide our healthcare services.’


It’s so important that we don’t let our compassion be a casualty of this crisis.


Best wishes,
Claire

Friday 6 March 2020

Tell-tales and snitches, holding hands and International Women's Day

Amidst the blanket media coverage on coronavirus, we’ve also had the Priti Patel allegations story.

I certainly don’t want to get political or comment on this specific case, but the heat and noise has sparked a wider debate about a culture of silence in Westminster and whether people working there feel able to speak up.

From the ‘tell-tale‘ at nursery and ‘snitch‘ at school to the ‘super-grass’, the cultural narrative is that those who speak up are sneaks and trouble-makers. Whistleblowing has been portrayed by some as disloyal and even betrayal.

This could not be more wrong. Silence is dangerous. It’s also perverse, as many who raise concerns do so out of loyalty, compelled by a sense of justice and a desire to ‘do the right thing’.

Speaking up is part of good governance and can act as an early warning system for potential risks. That’s how we keep people safe, learn and make improvements. And why we want to encourage everyone to speak up when they have concerns.

We recently had a Board session about our freedom to speak up work where we heard from our guardian and ambassadors. We have done some benchmarking against best practice and those organisations who are really getting it right, and this shows we’re making progress, but that there’s room for improvement.

So, we know we need to continue to focus on this important issue. This includes working with Professor Michael West, a leading national expert on creating work environments of psychological safety and the role that compassionate and inclusive leadership plays in supporting this. Professor West will be talking at our annual Just Culture Conference in April and helping us in our leadership development following the changes to our organisational structure.

It was surprising to hear that three quarters of the cases that Lisa Ryder, our freedom to speak up guardian, deals with are people who initially tried to raise the concern through their line manager.

The speaking up journey begins with a conversation, but we can’t just encourage you to speak up. We need to listen to what you are saying and act on concerns.

It’s not easy. Managers themselves can also feel unsupported or unsure of how to handle concerns from others. It can be difficult to manage our own feelings, especially if we perceive the concern as undermining or even criticising us. We need to have the training and time to be able to sensitively and constructively respond when issues are raised.

Trust is paramount and speaking up will only become business as usual if there are sufficient positive experiences across an organisation.

We’ve also just had LGBT+ training session for all our board members. So, a big shout out to Michelle England who led an engaging and entertaining session. Some of the statistics, which Michelle included in a quiz to test our knowledge and understanding, were pretty shocking.

For example, surveys show that about 50% of LGBT+ people have mental health issues.  For most people, talking about themselves, their lives, their partner is a relatively easy conversation. And yet, for too many LGBT people it means asking themselves: Will I be judged? Will I be treated differently? Will I face hostility?

Research also shows that over two thirds of LGBT people avoid holding hands in public. A simple expression of love and affection is abandoned to save hassle and dodge confrontation.

Everyone will have a different story, but you can appreciate why even these every day “little” things might affect the health and happiness of an LGBT person. ‘Coming out’ isn’t something they have to do once. They do it continually, giving that part of themselves over to new people they meet.

We need to ensure that the needs of LGBT people are considered at all levels. That’s why the work of our award-winning LGBT Network and our launch of the new NHS Rainbow badge scheme is so important.

Everyone should feel welcome, safe, and accepted for who they are. Only then will we improve the lives of people in a real, transformational way in years to come. We have to get this right for people to be able to thrive.

I also wanted to quickly say thanks to everyone who has given feedback on the proposed leadership structure. We’ll be sharing a summary of this feedback and how this has been considered within the final proposals. The formal consultation has just started and we’ll then look at any issues raised during this.

I know I’ve said it before, but I’ll say it again. This is about building on our already strong platform of leadership to help deliver our new five year plan, with more visible clinical and professional leadership and greater devolved decision making. We really value our leaders and want to get this right for you.

And finally, I just want to finish this blog with a call out to International Women’s Day on Sunday. It feels like coronavirus is the only show in publicity town at the moment (and I do need to plug the sensible and scientifically proven ‘wash your hands’ message), but this is a day of celebration and commitment.

My hope is that one day we won’t need this special day, but sadly many women still face barriers which means society is missing out on the full value that half of the population can make. We want everyone to be able to maximise their potential.

Best wishes,
Claire