Earlier this year the three authors of this blog were in virtual attendance at the HSJ Awards. We were very surprised to hear the words that Leeds Community Healthcare NHS Trust had won the Freedom To Speak Up Organisation of the Year. Our surprise was because we were in competition with some of the best health trusts in the country who had strong records for good culture.
It was a happy and pleasant surprise for us.
We welcome the opportunity to share our story here with colleagues from across West Yorkshire and Harrogate Partnership and to learn from them going forward.
Sometimes in our wider systems we keep repeating the same things and expecting different outcomes. When we don't receive the expected results, we continue to repeat the same process (often with new names and bits of tinkering). The eminent Jungian therapist James Hollis describes the process well in the people he works with - 'This isn't working but I do it very well'. To create new paradigms we need to break old patterns and explore new dimensions.
In the speaking up work at Leeds Community Healthcare NHS Trust, we have tried to build a new paradigm and pattern - a paradigm and pattern built on people, leadership and process.
In terms of people, we seek to fully support all staff who speak up. Every staff member receives a programme of pastoral support from the moment they contact the Guardian whether they raise a concern or not . We try to offer deep listening and deep care to everyone who tells their story. This includes wellbeing checks during the journey where the concern is looked at.
The stories and concerns of our staff help shape our practice. We have seen this happen with our work with colleagues who are from Black. Asian and different ethnic communities, staff who shield, staff who are suffering domestic abuse and violence and all staff who struggle with issues at work. A fundamental part of this work has been to have Speaking Up Champions from our Race Equality Network.
One of the most beautiful things about the work is that the highest referral source (around 90%) of new people speaking up is that they have been recommended by someone who has already used the service. Those who use the service recommend it.
On leadership we have focussed on creating a leadership model which works non -defensively when concerns are raised. Our senior leadership team models this and has grown to hear and hold concerns and support full exploration and learning from concerns. We seek to build this across the organisation. In July we will be running 'Leadership and Speaking Up' sessions for managers and leaders which will create a space for a frontline and senior manager to share best practice on hearing and responding to concerns.
Lastly there is process. We have created a quick and easy way of work. The target is for the Guardian to contact s staff member who speaks up in one hour (a target we usually hit). Concerns raised to the Chief Executive are replied to usually within minutes and then the wider work begins. Recently a nurse said in all her years in the NHS she had never seen anything as quick and effective. We were able to say to her that we do this because she matters and what she says is vitally important to us.
We believe this focus on really listening to the stories and struggles of our staff, offering positive support to staff who speak up, creating inclusive learning leadership teams and making quick effective ways to work with staff colleagues are fundamental to more human and humane systems emerging. If we can flow and flood our systems with these deep human practices, we will create new and better paradigms and experiences.
We are still on a journey with this work and have much to learn. Thea's wish for a Freedom To Speak Up Guardian and Champions who aren't busy because there is no need is still in the future but we are slowly getting there.
Thea Stein, Chief Executive, Leeds Community Healthcare NHS Trust
Kulvant Sandhu, Chair, Race Equality Network ( 2018 - 2021), Named Nurse for MCA and Dementia, Leeds Community Healthcare NHS Trust
John Walsh, Freedom To Speak Up Guardian, Leeds Community Healthcare NHS Trust
We are system made of people, in organisations that serve people. We exist to improve outcomes for local people, with a big focus on tackling health inequalities, managing unwarranted variations in care and using our resources wisely. We do this, knowing we have an impact beyond health too.
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