Small words, mighty impact

Sorry. Thank you.

Small words that, when genuine, can have a mighty impact.

As we witness the fall-out from the exam grades debacle, and the inevitable blame-game, I’ve been thinking a lot about people’s responses when things go wrong.

Elton John put it simply in 1976 when he sang, ‘Sorry seems to be the hardest word to say’. And it still seems to be true in many cases today

The education secretary has said he is ‘incredibly sorry for the distress’ that has been caused, but he hasn’t apologised for having caused it. I’m not making any political points here, as we can all appreciate how challenging it is at the moment and mistakes are things we’re all likely to make. But I do struggle to understand why people find it so hard, having messed up, to not immediately apologise and admit they got it wrong.

Saying sorry is about taking responsibility and showing that you appreciate the impact your actions have had, but it is also about saying ‘What can I do to make things right?’

Our board had a session this week on the feedback from our ‘appreciative enquiry’. The enquiry was about identifying what has worked well for you during the pandemic, as well as what we could have done differently, so we can build on the strengths, possibilities, and successes.

There was a lot of feedback about things that worked, but also about areas we can improve which we will totally take on board. One of the key things you fed back was that there should have been much more executive director visibility, especially at the profoundly difficult height of the pandemic in April, and this is clearly an area where we need to say ‘sorry, we got it wrong.’

It’s difficult to hear criticism, but so important to see it as constructive feedback and not be defensive. If we’re tempted to explain, justify or defend our actions, then it’s not really an apology at all. A defence is often an abdication of responsibility, and some would say that ‘non-apology apologies’ are worse than no apology at all. Even if we talk about reasons, we must still own our failure.

Some leaders think of apologising as a sign of weakness or, worse, indecisiveness or a lack of confidence or courage. We all have to get over ourselves. Not admitting a mistake is a bigger mistake.

The best way to apologise is by letting go of our egos, speaking as soon as the time is right and holding ourselves accountable. We need to do solid post mortems on tough situations so we can figure out what happened, what we could have done to avoid things that didn’t work, and then figure out how to not let it happen again. But I like the language of the ‘appreciative enquiry’. It is about asking tough and direct questions, but in a way that is kind and non-judgemental, and from a place of curiosity and appreciation.

What we find may be personally hard to hear, but when we own a situation and apologise for our role in it, being as specific as we can, then our apology means more and makes us much more effective as leaders moving forward. No one has ever choked by swallowing their pride and admitting they were wrong!

So, quite simply, our learning from our initial response to the pandemic is that myself and the exec director team should have done more service visits through this time. Not for assurance checking, but to show we were ‘with you’. The same goes for being in Trust HQ, to show colleagues who were still working there that we were also with them and supporting them in a very obvious way.

We have heard you and we hope we are now taking more of the right actions to support you. Apologies aren’t meant to change the past, they are meant to change the future.

We also want to show our gratitude, which is where the second powerful and positive word comes in; thank you.

Some people might think thank you “goes without saying” or that a pay check is the thank you. It’s simply not the case. There’s never a downside to expressing gratitude when it’s been earned with good work or kindness. You need to hear it; you need to feel it.

I know there have been countless thank yous from countless corners throughout this time, but we hope our ‘Great Big Thank You’ week provides an opportunity for our board to stand up and shout it from the rooftops. To explicitly say thank you to every single one of you.

If we are committed to an open culture, saying ‘sorry’ and ‘thank you’ needs to be part of the daily fabric of our relationships. 

Best wishes,

Claire

You can follow me on social media @ClaireMolloy2

Turning complaints into 'gifts'

I missed my last blog as I was on annual leave - practising what I preach and pushing the pause button - with Henry, our medical director, stepping in with a fabulous guest blog. Perfect timing as it was also an opportunity for him to say goodbye before he retires. 

I thought I’d come back from holiday to more information about the refresh of national mental health framework and financial framework, so I could then update you on our own business plan in this blog.  But this national steer, which we need to guide and refresh our own plans, is still delayed.

So although we’ve got a sense of what’s going to be in it, we still don’t know what money we will have to focus on our priorities going forwards. Once we get clarity we’ll let you know, so please bear with us and watch this space as they say.

Anyway, the weather was rubbish on my week off, so I binge-watched a drama mini-series called Safe. Created by crime author Harlan Coben, a lot of it was filmed in Manchester and, after his 16-year-old daughter goes missing, it’s about a father uncovering a web of secrets as he frantically searches for her.

The central theme of this drama is about the devastating impact of keeping secrets. They’re like a cancer in the soul, eating away and leaving destruction behind. The drama highlights that hiding them causes so much more damage than their disclosure. 

And so, when I came back to work to hear about our results from the national Freedom to Speak Up index, the negative consequences of not bringing things into the light was strongly on my mind. This index is based on a number of questions in the annual staff survey that show how well trusts are encouraging and supporting people to raise concerns and speak up about poor practice.

Don’t get me wrong, our overall results aren’t bad, in that we’re just above the national average for NHS Trusts. They show that nearly all of you know how to report poor care (95%) and a significant majority feel that we encourage you to report errors, near misses and incidents (85%).  We also have a fairly reasonable majority who feel able to raise concerns (nearly 72%). What worries me is that less than 60% of you feel we treat staff fairly when a concern is raised or an error is made.

So, basically we’ve got a mismatch between you feeling you can raise a concern, and then how we manage it.

Our Freedom to Speak up Guardian always says it’s not just about supporting people to speak up, but really listening with curiosity and an open mind to what they have to say. 

Compassionate leadership is about showing empathy, but without positive and supportive action it simply isn’t enough. So we need to put a lot more effort into handling and concluding things, as it must be frustrating when people have spoken up and feel it’s not been satisfactorily concluded or that they have not been treated fairly. We’ve got a couple of cases, for example, which have already had multiple reviews, so we do need to focus on improving this. 

People want to feel that they have been listened to and understood, and that their concerns have been taken seriously, and very importantly, people need to feel that they don’t suffer as a result of speaking up and highlighting poor care and practices. It’s about responsiveness, fairness and timeliness.

We’re still progressing our Just Culture work, but there’s lots more to do. The pandemic forced us to cancel our second Just Culture conference a few months ago and so we’re now looking at how we can set it back up. We need to push forward on building an open culture that learns and grows from mistakes, not brushes them under the carpet.

If we don’t listen then we’ll eventually be surrounded by people with nothing to say.

There is a popular philosophy in business that says complaints are a ‘gift’ because they offer an opportunity to improve. When we are open to criticism, what we get is good information and advice about how to change things for the better.

I know that dealing with concerns and complaints can be challenging, emotionally demanding and at times frustrating. It is hard not to take things personally. But we want all our leaders to see them as valuable insight into what is not working as well as it might be, and as an opportunity to put things right and improve practice. There are often common themes which are of wider relevance and an awareness of these themes can inform approaches and help prevent issues arising in the first place.

On the subject of leaders, it’s positive that we’re strengthening the clinical and professional voice in our new leadership structure. All the evidence shows that clinicians from the different professional backgrounds have so much to offer as leaders. You will have seen the recent announcements about posts appointed to, and we are hoping to appoint to all posts in tier 2 by early September.

And talking of good leaders, we say goodbye to two of our executive directors, Dr Henry Ticehurst and Suzanne Robinson next week. As you know, Henry is retiring after ten years as medical director and many more as a consultant, and Suzanne is joining Greater Manchester Mental Health Trust as their new finance director. Suzanne has been our whirlwind romance, sweeping us off our feet for a short period of time as she wowed us with her energy, ideas and sparkle. And Henry has been the long-term relationship that has totally enriched and changed our lives.

Henry leaves a legacy of his unique style and impact. He has a superb perspective on life, which is worth its weight in gold in the difficult moments. He’s been a great support to me, as well as to the medics and many others, and we appreciated him staying on during the covid crisis. We will really miss his fantastic sense of humour and fun and his great warmth.

Thank you Henry and Suzanne. We’ll be cheering you on all the way.

Best wishes

Claire

You can follow me on social media @ClaireMolloy2

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A few weeks ago it was wonderful to have Muhammad Khan, a resident at one of our rehabilitation units, contribute to my guest blog.

I’m delighted to see he now has his own blog, which you can read here: http://inmywords.co.uk/

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Guest blog from Henry Ticehurst, medical director

Dr Henry Ticehurst

I’m on holiday this week so I've asked Henry, our medical director, to do a guest blog. It’s only a few weeks before his retirement, so it makes this one all the more special.

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Dr Henry Ticehurst, medical director:

I’m sat in Stepping Hill Hospital about to see some of my last patients, trying to write a few paragraphs about my time at Pennine Care.

It’s not easy – trying to distil some 20 years in to a blend of anecdote and reflection. In the words of Vinny Jones – it’s been emotional!

The best bit of advice I got, when I was looking for a consultant job, was that colleagues were the most important factor. That still holds true.

My early years in Rochdale, when it was still part of Rochdale Infirmary and pre-Pennine Care, where (and I struggle to believe that I remember this correctly) we had a consultants dining room and the ring of the bell would herald in the next course. I think we live in slightly more egalitarian times now. The dining room went many years ago, probably about the same time as we entered the 21^st century, and the hospital farm was derelict before I came along, along with the insulin coma therapy room and the industrial therapy unit.

Times change but, by and large, people don’t. The sense of all being in it together for a common purpose, having colleagues you know you can turn to and a team which will support you, and which in your way you can support. These are all the intangibles, the absolutes which keep us going, and which I hope define how Pennine Care works.

I have worked in Rochdale, Bury, Tameside, HQ and Stockport, in various roles – in community mental health teams, inpatients, early intervention team, rehab and high support, psychiatric intensive care, access, home treatment, and of course as medical director. And at every juncture I have met with individuals and teams who have really helped me to understand my role, and to be fair have been incredibly patient as I have driven them mad (professional term) with my own disorganised way of doing things. I remember driving to HQ from Birch Hill Hospital for my appraisal, only for the then medical director to phone me to ask where I was as she was sat in my office waiting for me at Birch Hill Hospital. A career limiting move you would have thought, but something that for those of you who know me will come as no surprise!

Perhaps this would be a good time to thank those who have supported me and put up with me through this. With a special thanks for everything you have done these last few months.

I have been so immensely proud with the collective spirit and response to covid. I can’t help but think that the NHS I joined back in the day is the one I see responding to the pandemic with humanity and a sense of collective purpose – and, really importantly, a sense of recognition from the outside world.

These have truly been interesting times, where we have had to seek certainty where none is given, to live with a degree of uncertainty amidst the confusion, and somehow portray a sense of carrying on regardless. It’s the collective spirit that will stick with me, the sense that we are all in it together – from the covid dance in the corridor as we try to maintain that distance, to the mutual moans about face masks and hand sanitisers.

We’ve done things differently, and we’ve done them in a way that we haven’t been able to in the past. A mixture of permission giving and a lack of what is absolutely right has been a fertile ground for improvement and innovation. The key is surely how we don’t lose that spirit of innovation, of shared accountability, as we move on to what is now generally described as the ‘new normal’.

And I think, as the ‘novelty’ of the pandemic wears thin and the collective spirit runs low, we need to remember what we have achieved. It has been amazing and we can’t allow the collective behaviours to be forgotten, nor the means by which we have achieved these things be extinguished. That’s why we’re really keen to learn and not lose either the great achievements and innovations, or the means by which they came about.

As we enter the next phase, I think it’s right that we have a new leadership structure, with Nihal as our new medical director helping to forge a new clinically led model. The focus on mental health and learning disability has brought our organisation back to its natural home, where we are the expert at what we do, and where our voice is now loudest. Loudest to act on behalf of those whose needs we represent. Nationally, mental health has a voice and a presence which it has lacked over the years, and mental health is also seen as a top priority within Greater Manchester.

My plan for now is to have no plan (again, no surprise there), take some time to unwind a bit and reassess. I have always loved natural history and so I will immerse myself in walking, bird watching, fishing and gardening and await inspiration or opportunity. I suspect that working in public service doesn’t let you off the hook that easy and so, in some guise or other, I will reappear. But in the meantime, if you should happen to see an odd figure walking along with a fishing rod and binoculars, say hi.

Thank you for allowing me the opportunity to be part of this journey. I truly wish Pennine Care and all those who sail in her a bright and happy future.

I need to go and don my PPE for clinic now. Goodbye and thank you so much.

Best wishes

Henry

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

Joining together, while staying apart

Here's me (top) and
Claire Warhurst (bottom)

Partnerships have always been important, but this crisis has highlighted more than ever the importance of working together to help keep people safe. 

We’ve seen bucket loads of innovation, ingenuity, determination and goodwill across the board, with so many impressive initiatives and developments. It’s the only way to solve the major challenges we all face in the NHS and care sector.  

Partnerships will never work as a bolt on; they have to be at the heart of what we do. I don’t just mean with other organisations, but also with patients, carers and community groups. 

And let’s not forget our volunteers. It's Volunteers' Week next week, and our 70 volunteers give their time for free; working in partnership with us, to help others. They are such a hugely valued and priceless part of our team.

We can’t solve things on our own and need to build on our collective strengths as well as this momentum. This is how we will truly make a positive impact on the world we live in.

The Stockport improvement board took place yesterday and is a positive example of partnership working. We’ve now got a memorandum of understanding with Stepping Hill Hospital around how we support people with mental health problems who come into their A&E department.  This week’s guest blog is from Claire Warhurst, our liaison mental health service manager in Stockport, and her personal and powerful account of the last ten weeks highlights some of the fantastic partnership working that is taking place there.

Our resilience hub, which is now supporting essential frontline workers, is another outstanding example of partnership. Our learning disability team has been researching Covid-19 distress in people with learning disability jointly with the Cheshire and Wirral Partnership, which is hugely important. We’ve also extended our helpline to take calls from the Greater Manchester clinical assessment service, which means working closely with Greater Manchester Mental Health and North West Boroughs. 

There are too many local examples of superb partnership to mention, with our associate directors across the five boroughs leading the way in establishing place-based approaches to recovery.

We need to keep building on our partnerships across our communities, boroughs, region and beyond, but also with you. Given that you are our most valuable asset, it’s essential we keep on moving forward together.

Despite the coronavirus restrictions and challenges, we’re doing everything we can to engage with you in meaningful ways to hear your views and listen to your ideas.  Maybe, as some have suggested, that’s why we should refer to it as ‘physical distancing’, not ‘social distancing’. It seems like semantics, but social distancing is a phrase that triggers our minds to think of isolation, solitude, loneliness. It suggests that this challenging period is one in which we are alone. And, although it has definitely felt like that on occasions, we are also together in so many ways.

Keeping in touch has never been more important and the technology we have at our fingertips is playing a crucial role in enabling us to remain socially together, despite the need to stay physically apart. It was so great to hear that we had over 200 people sign up for the two remote conversation sessions on home working. 

We’ve got a huge task ahead of us in terms of implementing our recovery plan, but we’ll make sure we keep on working in partnership with you. Two heads are better than one (well, many thousands in our case) and by sourcing views and ideas from each other, we have a better chance of overcoming all our challenge, as well as grabbing the opportunities.

As well as keeping the good bits we put in place to deal with the pandemic, we’ll also be tweaking some things as our ‘new normal’ becomes more established. For example, our new Together update, which we put in place at the start of lockdown to share heart-warming stories and sterling shout outs, is now going down to three days a week instead of daily. We’ve had great feedback, so know there’s an appetite for sharing the love, but we’ll reduce this by a couple of days as we beef up some other ways of communicating.

I’m also going to go back to fortnightly blogs, as we don’t want to add to the email overload and this now feels right. Again, I’m looking at other ways to keep more in touch, for example a live Q&A session once we’re a little more advanced in our recovery plan.  

And finally, I’m sure you will join me in welcoming Nicky Tamanis as our new director of finance. We had an impressive calibre of candidates which is so positive, but I am sure Nicky will add a huge amount to the organisation.  It was weird not being able to shake their hands at the start of the socially distanced interviews, but these are strange times as we know.  There was no elbow bumping, Namaste bowing or waving in its place for the interviews, but plenty of smiling and nodding, especially at the outcome!

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Claire Warhurst, Liaison Mental Health Service Manager at Stepping Hill Hospital, Stockport

I worked in mental health liaison during the Manchester Arena bombing, so when the coronavirus took hold of the UK, I knew that trauma would be coming our way. It wasn’t just patients that would need care during the pandemic, colleagues would need it too.

I’ve been working as a mental health professional on the general side, in medical wards and A&E with doctors and nurses in main hospitals and acute trusts that deal with physical health – so it’s been an unusual position to be in. 

We’ve really got involved with what has been happening at Stepping Hill Hospital. A lot of their feelings are the same as ours, feeling that we’re all a bit lost, that sometimes you’re doing your best but it doesn’t feel good enough. For any member of staff, for example, the idea that they couldn’t do any more to make sure a person still has their relative with them at the end of their life is very hard to take.

It does feel odd to get positives out of such a difficult and incredibly hard time, but there are positives that will come of this. The progress around mental health in A&E during the time of the pandemic has been rapid, we’re assisting with the development of new pathways and processes around mental health and risk assessment – an improved culture of keeping people safe. Such progress would have been very difficult to do before, but the current conditions have made this positive work possible.

We’ve been supporting hospital staff with our skills in mental health, as their job has been hideous at times. It’s involved a lot of human kindness and a lot of time, but it’s made a massive difference to relationships with colleagues and friends in the acute trusts.

There is a very different culture in physical health hospitals - they’re not always great at looking after wellbeing and mental health, so it can be challenging addressing them. They don’t generally do talking about how they are, but things have changed through this pandemic for the better. 

A big part of making this change is by being human: seeing them in person, saying hello and being supportive where needed. Anxiety is shared across all staff, lots of nurses have been scared, exhausted emotionally and physically and have experienced so much grief. They just need a human to be there for them, be kind and understand.

There have been lots of moments I never imagined I would see - some of it is traumatic for us as well as them - so sharing those experiences has bonded us as professionals. For example, we’ve supported grieving relatives who have come to pick up belongings of their loved ones, stood with nurses who are caring for dying patients, spoken to intensive care unit staff doing 12 hour shifts in full personal protective equipment and much more. 

Our team has done everything they can with the highest level of human empathy. Working in liaison on the front line means you’re having to do very quick, high pressured assessments and make big decisions for people. You have to be a special kind of person to do that and it’s made us such a tight bunch. We were a close team before, but during the pandemic we have eaten together, laughed together and cried together. It’s been a privilege to share that experience with them and the hospital staff we have worked with.

Overall, the whole experience has been phenomenally human and the positive reception we have had has at times made me want to weep. I take my hat off to everyone on the front line who has dealt with the coronavirus crisis, both in the acute hospitals and our own wards. 

I hope going forward we’ll be known at Stepping Hill as the mental health team that were with them during that difficult time and this culture of talking will stick. 

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Best wishes,

Claire
You can follow me on Twitter @ClaireMolloy2

Mindfulness Matters

Here's me (top) and Suzanne Lynch,
with her home-grown spinach:
"finally ready to harvest, although
I've grown so attached to it now
I might find it hard to eat!" (bottom) 

I mentioned in my previous blog about taking annual leave during this pandemic to rest and recharge, and also the importance of being kind to ourselves as well as to others. As you know, ’kindness’ is the theme for this year’s mental health awareness week, in addition to being one of our four values.

Henry James, the novelist, said: “Three things in human life are important: the first is to be kind; the second is to be kind; and the third is to be kind”.  But why is it so easy to be kind to a loved one, a friend, a neighbour, a stranger – and not ourselves?

We appreciate kindness. We welcome kindness. We value kindness. But we tend to dismiss the value and healing quality of kindness directed toward ourselves.

The little voice in our heads says, “But if I’m too kind to myself, I won’t get anything done!”. This just adds to our stress and anxiety. Surely if our compassion does not include ourselves, then it is not complete?

So, in the true spirit of ‘being kind to myself’, I’ve taken a bit of space to switch off and had a few days of annual leave this week.

I’ve therefore not done a lengthy blog this week, but I’m delighted that we have Suzanne Lynch from our staff wellbeing service for the guest blog. Suzanne has been doing some fantastic work around the power of meditation, so I thought it would be very timely to hear from her.

***********************************************************************************

Suzanne Lynch, counsellor & mindfulness teacher, staff wellbeing service

The Mindfulness Lessons of Lockdown

Lockdown has been a different experience for everyone; nearly nine weeks on, being asked to contribute to this blog has given me an opportunity to pause and reflect on the mindfulness lessons I’ve learnt from lockdown.

The week immediately before lockdown, like many colleagues, I was using up my annual leave entitlement before the end of March; I thought I’d be doing a spot of decorating and some relaxing with a capital R – instead, I was pelting up-and-down the motorway visiting elderly relatives as far-flung as Essex, making sure they had everything they needed before their 12 week shielding began.

There was nothing mindful about my state of mind at that time; I was stressed, confused about different advice coming from various health officials and hyper-vigilant about protocols, since my partner has an underlying health condition.

In the mindfulness courses we teach, we talk about the seven pillars that underpin mindfulness.  Once lockdown properly began, I was forced to slow down, reconsider priorities and learn more about the pillars of mindfulness from the lessons that lockdown presented to me:

Lesson - Acceptance
Acceptance that I have no control over current circumstances and no control over when this situation will come to an end – acceptance that abiding by the guidance will keep us all safer, acceptance too that I may as well adjust to the new routine and rhythm of life for now.

Lesson 2 – Letting go
Of what I am not able to do and what is not within the remit of my role… accepting that guilt may be a consequence of that. Thank you psychologist, Jo Black, for your hugely helpful article Dealing with guilt during Covid-19: NHS staff not on the frontline.

Lesson 3 – Curiosity/Beginner’s Mind
I thought I lived in a fairly suburban area because I always turned left out of my front door for a walk. I never realised that if I turned right instead, less than 10 minutes’ walk away there is a field with cows and buttercups.  Also, I now know where and in what order wild garlic, bluebells, tulips and cherry blossom grow in my neighbourhood; it’s been an education.

Lesson 4 – Non-striving
Working remotely from home: Citrix anyone? Installing Outlook? Scheduling a meeting in Microsoft Teams? Getting on to ESR? I’m technology averse at the best of times; sometimes, doing these basic IT tasks feels like threading a camel through the eye of a needle whilst my temperature rises, shoulders tense and teeth grit.  Mindfulness has taught me to recognise these symptoms of stress and to take a breath, call a colleague to ask for help or leave it for now, focus on another task and try again tomorrow...

Lesson 5 – Non-judgment
…of teenagers who walk or cycle three-a-breast down a narrow lane whilst us oldies are dedicatedly trying to social distance…non-judgment is always a work in progress…

Lesson 6 – Trust
Trust that change and situations we cannot control can sometimes turn out for the best. Last weekend at the supermarket a new team member told me that due to Covid-19 he’d been made redundant a month ago. He’d been a supervisor in a completely different job for 15 years, he’d had to commute to work and was stressed out by the workplace politics.  As soon as he was let go, he contacted his local supermarket and started the very next day. Now, he says, he walks five minutes to work, has more time with his family and has a laugh everyday with his workmates.

Lesson 7 – Patience
Be patient - the spinach seeds you’ve planted in the back yard as your first foray into gardening will eventually grow…

Extra Lesson – Kindness
Kindness has been all around.  Each week at the Thursday Clap for Carers, as neighbours we all check in on each other especially those who live alone and have socially distanced chats. Compost has been shared over fences for vegetable planting – and I now know all my neighbours names.

Extra Lesson – Gratitude
I’m grateful to all my mindfulness teachers over the last five years at Pennine Care – Peter, Christina, David and Paddy – for giving me the tools of mindfulness practice to help ground and anchor in difficult or uncertain times.  It’s not a wonder-cure and it’s not necessarily going to change anything, but it might change how I react to situations - sometimes for the better.  I’m grateful for the comradeship of the team I work in at Pennine Care.  I’m deeply grateful and in awe of our frontline staff in every area and department. Please take good care, wishing you all well.

***********************************************************************************Best wishes,
Claire
You can follow me on Twitter @ClaireMolloy2