I hope you’re all coping well in the heatwave we’ve been experiencing this week! It’s certainly been a challenge at Harrogate and District NHS Foundation Trust (HDFT) and as the mercury rises it’s been humbling to see colleagues step up and continue to provide high quality patient care despite the circumstances and discomfort to themselves.
A couple of weeks ago I marked my 100th day here as part of #teamHDFT. I’m new to Yorkshire in a professional capacity, although I did grow up in Sheffield so I do know this beautiful area reasonably well.
I’ve met many colleagues across the West Yorkshire and Harrogate Health and Care Partnership already, and thank you for the warm welcome you’ve given me. You’ve helped make my first Chief Executive role that little bit easier to settle into. Given that I’m relatively new; this is more of a ‘hello’ than a leadership message!
I thought it may be helpful to briefly introduce myself. Before coming back north my most recent job was Regional Director for London at NHS Improvement, and prior to that I had been Chief Operating Officer at South London Healthcare NHS Trust and Deputy Chief Executive at Barking, Havering and Redbridge University Hospitals NHS Trust. I originally started my NHS life in 1997 as a trainee in Northumbria Healthcare, where I worked for 11 years.
So, this is my first Chief Executive role which of course brings with some interesting and exciting challenges!
I’ve said to colleagues at #teamHDFT that I’m not coming in with a plan or a blueprint and that most of the ideas and answers reside with them. People who do the work are the experts, they know what works and what doesn’t in their areas, and they know how to improve what they do for themselves, their colleagues and the people they care for. I think my job is to encourage and enable colleagues to share, debate, refine and improve their ideas so that together we can make the Trust a great place to work and an outstanding place to receive care – whether in the community, in one of our hospitals or online.
I’ve been in the privileged position of being able to visit teams right across our patch which has given me a really good understanding of what we do and how we work. It’s worth noting that we’re not just a hospital in Harrogate – our services stretch all the way up to Gateshead and Sunderland and across to the east coast (hence Harrogate and District). We are fairly evenly split between acute and community services in terms of staff numbers.
It’s been a really positive experience to hear from colleagues with lots to consider, and that is now shaping our future direction.
We care about the health and wellbeing of our population through people and relationships between people (whether they work in HDFT or not) and one of the things that stands out the most is the work we need to do to enhance what we do to look after each other. I think that this is built on really strong relationships and our behaviours and we are trying to emphasise five things at HDFT.
Firstly, that one of the most important jobs of anyone in a leadership role is to care about the health and wellbeing of their colleagues – so that people feel safe, supported and happy in the work that they do.
Secondly, that every role is of equal importance and that there isn’t a hierarchy of how important any one role is. Healthcare (and indeed pretty much any other area) is a team sport and we can’t succeed without each other. Most people work in teams, both within and across organisations, and I see success as being when anyone in the team feels safe and encouraged to ask for help from their colleagues. Everyone has different experience and we should feel asking for help when we’re not sure what to do is celebrated and not seen a sign of weakness.
Thirdly, we need to acknowledge up front that we will all make mistakes, and to create an environment where we celebrate learning from experience, not criticising people. Most mistakes happen because of the systems we ask people to work in and the processes we ask them to use - and not because of people themselves. We still focus too much on the ‘root cause’ with a lens of looking to see who didn’t get it right, rather than the system and environment that didn’t allow them to get it right.
The fourth thing is one of the most important which is about behaviour and how we behave with each other and I try to emphasis three things that I ask colleagues to try and reflect on. Being kind to each other, to people we work with and to people we are looking after. Being compassionate which means recognising that what becomes normal to us as we do our work every day is not normal to people who we look after or those we work with from other organisations. And valuing different perspectives and experiences, and encouraging different views, whilst ensuring that they’re always expressed in a respectful manner, and that all of our many interactions are conducted in a civil manner.
The final thing is emphasising that people who do the work know how to improve it, and encouraging colleagues to see this as equally important as actually doing the work. Leaders don’t usually have the best solutions, but we can create or hinder the opportunity to unleash the talent, energy, innovation and enthusiasm of the people who do.
Whilst this is what we’ve been talking about in respect of our work within HDFT, this also applies to how we work with others because to create the sort of health and care system that focused on healthy lives and reducing inequalities, we have to define success in a different way and apply all of those things (and more) to how we work with others. We’re incredibly fortunate to have great colleagues in our local Borough Council, County Council, Clinical Commissioning Group and many others. We’re relentlessly focusing on being a great partner and this is something we are trying to emphasise as the only way we do our work well, and that supporting others to do their work well is also part of our role. It’s easy to say, but making sure we do it daily, and that lived experience matches intent for all is quite hard! And it’s a bit like painting the Forth Road Bridge – it’s a job that never ends, and is something that has to be part of our daily work.
Many of the teams our active or prospective patients and their families see are not limited to the teams we directly lead and part of our leadership role is to make the barriers and boundaries invisible to our staff because their lived experience will directly translate into the lived experience of people we’re looking after. Boundaries create rules, handoffs and generate friction and can stifle improvement and innovation and now more than ever we need to reduce the friction caused by these boundaries.
I also wanted to just say a huge thank you to colleagues in the West Yorkshire and Harrogate Health and Care Partnership and West Yorkshire Association of Acute Trusts (WYAAT, also known as ‘hospitals working together’). I think we’re incredibly fortunate to operate in the environment that is created and fostered by the Partnership and by WYAAT. In my first 100 days or so it has felt as if that is an environment in which collaboration, respect, support and peer challenge are promoted and I think that’s an incredibly important enabler for us to do our work in our places.
I won’t say that it doesn’t bring its challenges, but with challenge comes an equal offer of support and I think both of those are welcome as a dual approach.
The work in our place is exciting and there is lots going on as there is across all other places. We’re just about to launch our provider alliance - the Harrogate and Rural Alliance, which sees us working with local health and social care partners to transform the way adult health and social care services are delivered in the district. It isn’t a new or unique concept but in the work with teams who are coming together from health and social care it has again reminded me of the importance of creating trusting relationships, a common goal, widening what we’ve thought of as success before and that we have to work on that every day.
You’ve probably had quite enough of me, so I wanted to sign off by saying a very big thank you to Amanda Bloor (Chief Officer for the three North Yorkshire CCGs (Hambleton, Richmondshire and Whitby, Harrogate and Rural District and Scarborough and Ryedale) at who is a great colleague and a great friend and without whose help and support my first 100 days wouldn’t have been nearly as much fun.
Finally, I really believe in agile sharing learning, knowledge (and the occasional cat photo) and what better place for that than Twitter? Please give me a follow at: https://twitter.com/steve_r76. It’s a great way to see what is going on and I have probably stolen an idea from each of your organisations from there – so thank you!
I hope you have a great weekend, and the weather is a little bit kinder to us all!