Values Category

Are you FREe?

Checklists, Front foot, Improvement, Organisations, Reflect, Teams, Think, Values No Comments

Earlier this week I attended a concert at Kings College Chapel. As I sat there in the dark stillness a storm raged outside that rattled the ancient doors as a nearby college clock chimed the hour. I recalled how exactly 27 years before I had first been in that place.

I remembered I had been a little shocked to find myself in higher education – as a working class lad who struggled a fair bit at school. Yet in my mid 20s I had applied to study at tertiary level. When interviewed, some of the alternative angles I shared from my experience as a front line NHS worker, plus the insights from my union activism seemed to appeal to those who selected students.

Over the years I have found sitting in that building to be a powerful place for reflection during times of significant personal change.

So, I was thinking – but on this occasion about my work. My studies all those years ago were the start of my deeper interest in how organisations perform (or don’t). Over the last few months I have been crystallising what I now know about institutions – from larger networks to smaller teams, from commercial enterprises to noble purpose initiatives – based on my experience of working across sectors and continents. What makes an organisation worthy of commitment? What are the features that make them likely to succeed? And fail?

After a quarter of a century, I think there are just three things that are crucial. I summarise these with the word FREe (actually FRE, as you will see below).

Firstly, FOCUS. Is the purpose of the organisation shared? Is the strategy clear – is it understood? Has the governing group set out its intentions (and limitations) for the wider staff to work toward and within? Do individuals know how their particular role contributes – and do they realise where their personal motivations fit, and where they do not?

RESPONSIBILITY: are staff expected to use their initiative to sort out issues? Do they have freedom to act? Do governing boards avoid overstepping the mark and resist micro-managing the executive – and do line-leaders avoid constraining their staff with overly detailed instructions or the expectation of involvement in all decisions? How clearly are all staff held to account for how they have used their autonomy?

Crucially, EXAMPLE highlights the role of senior leaders in setting the cultural tone for an enterprise plus the part played of line managers in re-iterating this – and the importance of peers in reinforcing the ‘right’ behaviours. Most of us are not saints or sinners, rather we absorb the ways others work. This extends from basic ‘pro-social’ interactions to do with decency and civility through to the modelling of focus and responsibility and other important attributes like curiosity. ‘Example’ also concerns how the implied attitudes at the core of a business’s purpose are demonstrated by staff in their dealings with each other as much as with customers: be that caring in the case of health services, learning for an education provider or speed for a high street fashion brand, for example.

I am discovering how this simple framework is powerful in a range of settings.

It helps individuals: it is useful in ways from coaching leaders through to prompting those being interviewed for new jobs to ask useful (and interesting) questions.

With teams it is a checklist to test that the platform for achieving positive results is in place.

For organisations it highlights three important factors to work to get right in all places – to ensure well-served customers, content staff and a fulfilled mission.

Are you ready for FREe business?

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Fake compassion (in)action?

Organisations, Values No Comments

I am just back from Sweden, where I found all train, hotel and airport staff hugely kind and helpful.  I loved the cheery greetings of ‘hay’.  I was so struck by the culture that I looked on Google to see if online troll-like behaviours, or ODE, were less likely in the land of the Trolls .  Sadly I couldn’t find anything to support this hunch!

However, when on the train to the airport (with phenomenally fast internet speeds, by the way), someone sent me this piece on compassion in health care from the Daily Mail.  At the end of the piece, I note some comments verge on the uncivil – and interestingly the ‘worst’ rated comments are the ones supporting Dr Smajdor (with some of the early trollish ones apparently removed at the time of publishing this blog).

Having read the piece, it makes me wonder more about what the vilified author was actualy trying to convey.  For me, the piece made me reflect on the difference between compassion (a feeling) and kindness (an act).

You might know of our interest in compassion in health care, at from 2008 and this, a bit more recently. Actually, with hindsight, we would have probably been much better to be part of a social movement for greater warmth and kindness…and maybe the NHS Constitution is not that helpful using the ‘C’ word.


Some days it is hard to feel compassion (even after hours of mindfulness or Buddhist meditation)….and some people are hard to love at any time.

So kindness is good enough.

Actually this is true in all sectors: civility and helpfulness is the benchmark in a shop or restaurant too. The author Caitlin Moran argues that at the heart of all civil rights movements is the demand to be nice to each other. US academic Bob Sutton points out that jerks in teams are the bane of organisational life.

So all any of us need to do (in any sector and any role), is to act kindly to our customers and co-workers – act warmly, even if frustrated.  This is something I have personally learnt (and keep relearning) the hard way (!) through conflicts and judgements I would now rather avoid.

And what we might find is, that when we overrule our emotions with our logic (as in CBT), our feelings actually change.

For a few decades now, in western countries, we have all had to to be nice in public to those who are gay or from a minority ethnic community, for example. I don’t think it is unrelated that now opinion polls support gay marriage and we are more tolerant to people with different non-white skin colour.

This ‘fake it till you make it’ route might work in health care too…

…in today’s UK health system, post Mid Staffs, it is increasingly the case that staff are no longer allowed to appear unkind. However, it should be ok not to feel compassion I reckon – and be open about this in 1:1 supervisions, for example (honesty that will help avoid burnout and cynicism along the way too).  This act first (and feel it later) approach will end up shifting the culture faster, I predict.  And if you are doing this surrounded by colleagues acting the same, it actually might be quite easy…

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Example of level 4 and 5 (values) leadership

Values No Comments

You know of our ideas on getting values into practice – with our 5 level model outlined here.

This recent example from Australia, is a powerful illustration of level 4 and 5 leadership: senior staff modelling the values and also reinforcing them with who they hire and fire, recruit or promote.


Getting rid of the mess

Values No Comments

The impact of the Francis inquiry in health care in the UK continues to reverberate. We like the very practical things (speak – act – lead) that individual doctors are being encouraged to do by a bunch of their peers.

And in a recent blog we posed the question of what can be done– and offered a teaser of an example to learn from…

We think the improvements that have led to a reduced nuisance of dog fouling is due to a number of ‘nudges’ that make it easy for people to do the right thing, every time.

Looked at through one of our favourite frameworks – SPP– there are a number of things that have helped sustain progress in cleaner streets and parks over the last few decades:

There was change in three dimensions:

1) STRUCTURE change – by laws to regulate some action, set a path and direction – with prosecution of (human) offenders

2) PROCESS change – town planners listened to local people and put in dog poop bins and systems to empty them+++

3) BEHAVIOURAL pressure for personal responsibly – from other dog walkers to do something pretty unpleasant with a plastic bag (even when no one is watching)

So, how does this help in thinking about getting rid of the mess in health care? For example, on improving compassion in health care, I think there are things to do at all three levels:

a) STRUCTURE: Promoting leaders for their values (plus thorough regulation of professions too)

b) PROCESS: Investing in the capacity for bottom up staff and patient led improvements – leaders listening and helping

c) PATTERN: Building a cultural campaign amongst staff for calling unproductive behaviour by peers on the wards, etc. This is something that is pretty hard for many to do – and not for just when others are watching. But it is essential to get beyond the sort of verbal ‘window dressing’ (“we are here for the patients”) that can happen in ‘noble purpose organisations’.

I walked over a verge in the dark the other night and realised I no longer worry about what I might stand in like I did when a lad delivering papers during early winter evenings. It reminded me again of this inspiration for health service improvement post Francis. An example based on 3 levels of ‘nudging’ – structure, process and pattern of behaviour. A model on what has helped eradicate dogs mess on the streets.

(btw, I think the process improvements of the bereavement system (with the one stop shop approach to cancelling passports, driving licences, etc) is another example of a study of success change/improvement with the SPP framework in mind: new integrated IT system, more time for registrars and a willingness of staff from hospitals to town hall to help make it work for relatives….but maybe that is another blog…)

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Global customer service??

Personal productivity, Values No Comments

From this hotel chain customer service programme (see the third section: People-ology) marketed nicely to staff with this high end video production (which, by the way, I think is making a difference to my experience of their hotel group)….

…to this concern for important consumer issues around the world from the campaigning organisation CI.

From the sublime to the ridiculous? From the service to the haves, to the exploitation of the have not’s?

Consumers? Users? Buyers? People?

‘Customers’ unite??

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The power of connectedness

Values No Comments

Two top TED talks on the power of connectedness…this one emphasises the importance of living wholeheartedly. The second shares some unexpected results when asking for help.

Thanks Gema for pointing them out.

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Venns in action: Where is the horsemeat in health care?

Values No Comments

Over the last few weeks there have been a number of key stories in the UK press. Two are especially notable: the Francis inquiry into health care standards and the scandal of unlabelled horse meat in burgers and ready meals.

What do these have in common, other than their prevalence in media minutes and column inches?  Both are about unexpected and once hidden failings in the quality and supply of a good service.  Both raise issues of legality and individual practice. Both raise issues about who you can trust in the supply chain – in terms of both its management and regulation.

Where do they differ? One affects human health. And the other is not a lot more than a bit of a yuk to many – and only worthy of a laugh.

Sadly, the NHS story is the one that is more profound. Already there are politicians in Europe decrying the scrapping of perfectly ‘good’ food (if labelled differently), at a time when increasing numbers of people face food insecurity. The health care stories raise issues that are, surprisingly to some, more rotten and that can’t be labelled away quite so easily.

Many are now talking much more worriedly and openly about health care culture and standards – probably a good thing.

In contrast, the horsemeat scandal has largely led to plenty of photo humour – and is already leading to improvements in supply chains that value more local sourcing and fair trade.

So, maybe the question is not ‘where is horsemeat in health care’, but

1) ‘why the scandal in health care’ (maybe it is a result of the sort of management promoted since the mid 80s…an example of values in action where generalist leaders have been promoted to achieve a certain narrow set of things, and have done so pretty well) and

2) what can be done especially at a time when no individuals are being held accountable by Francis.

To help think about this second question we will go somewhere pretty unsavoury – but illuminating too. Where might that be? From one animal to another. Not dodgy cuts of horse, but what comes out of a doggy. Something has changed quietly and profoundly on UK streets, namely the cleaning up of dog mess…more on this analogy later (but in the meantime, can you guess what the learning points are – let us know).

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Now is the moment

Values No Comments

As you may know we have been interested for many years to see ‘values in practice’ – for example, a health care system that puts some of the stated concerns (quality, safety, kindness etc.) into practice (see this earlier pro-bono work).

We notice, post the seismic impact of the Francis Report into care failings in part of the UK National Health Service, more and more initiatives that are working to get ‘The Culture’ right, such as this which we see as helping the most critical level of activity in our values model – Level Four (where leaders work very hard and truthfully to model the values they want).

We are encouraged – and wish all those seeking to bring about positive changes for patients/clients/users/customers/consumers/parents/children etc. (in whatever sector) the very best.

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