As the leaves begin to darken, rivers swell and days shorten, it can be challenging to look forward positively and say to oneself ‘I’m looking forward to this’.
As many of you will appreciate, Winter doesn’t do sentimentality, empathy or thoughtfulness. Its chief accomplices of influenza, pneumonia and, since 2020, Covid, will conspire to create real, direct challenges to the already challenging environment in which health and social care finds itself. Wherever you work across the sector, you’ll be thinking ‘here we go again’, but this time perhaps with more anxiety than usual.
It is a brutal financial environment in which all of us are required to operate. The new government’s honeymoon period is absolutely over and all the sound bites that I am hearing from Secretary of State, Chancellor and even Prime Minister lead me to the conclusion that an oven ready plan, designed and refined over years as they waited to assume power, is a mirage. The Darzi review was an exercise in time-buying
that told us nothing that you and your colleagues didn’t absolutely know already.
So as the temperature outside falls, the demand builds, the queues lengthen and the beds become ever more scarce, allow me to introduce a note of hopefulness.
First, you are good at what you do. All of my travels around the country to visit, encourage and train tell me so. I have looked into the eyes of hundreds of you and I know with certainty that you have the capability, commitment and skill to do what you do well. Certainly we can all learn and adjust to create further improvement, but we need to remind ourselves, with pride, of the good that we do. You can’t do anything about the nation’s perceived finances. You can deliver what you do with real aplomb.
JON WILKS Chief Executive
Secondly, the NHS and social care has never, certainly in my lifetime, been perfect. To gaze wistfully for some unachievable utopia is a waste of our time. Better, much better, to work with colleagues and peers to figure out the incremental improvements that we can all contribute if we adopt an open mind and an honest heart. Stuff the big picture. Sketch your own miniature.
Third and final, let’s not allow others to endlessly denigrate and run us down. Respond with examples of the good stuff we do. Look people who would find fault in the eye and explain to them how you work and what you do with the resources you are given. They will marvel at it. In terms of value for money the NHS and social care beats every metric you can chuck at it from elsewhere in the world.
Yes it’s going to be a very tough few months. You can do this. Show them what you’ve got.
Stay safe, stay strong and thank you for the brilliant work you are all doing.
EDITORIAL
A New Type of Reform: Empowering and Motivating from Ward to Board
As calls for another NHS reform echo through the corridors of power, many of us might roll our eyes and think, "Here we go again."
But what if this time it was different? What if we seized the opportunity to focus on what really matters?
Peter Bullivant, MSc Work Psychology, BSc Mathematics
Reform:
For nearly 25 years, since "An Organisation with a Memory" was published, we've struggled to create environments that empower those who can really affect change. Every day, countless individuals and teams work tirelessly to support patients, armed with invaluable insights and experiences. The real challenge for leaders is to nurture an environment where those closest to patient care feel truly empowered to drive positive change.
Despite countless reorganisations, negative cultures persist with bullying behaviours that stifle innovation, generate fear, and contribute to failures in patient care.
The key to meaningful reform isn't redrawing organisational charts—it's creating a positive change in how people feel about their work, not just who they work for.
Can we do this? Yes, by drawing on the wellresearched concept of psychological safety. This helps us understand the foundations of high-performing teams, enabling members to take risks, share ideas, and challenge each other to create better solutions. According to renowned researcher Amy Edmondson, psychological safety is the most important factor in effective teams.
It's not just a "nice-to-have"; it's essential for an NHS that aspires to be safe, effective, and patient-centred.
Imagine a ward where a junior nurse feels confident to question a senior doctor's prescription, potentially averting a medication error. Picture a board meeting where no one is afraid to speak up. Envisage a team where everyone participates in open discussions on failures and opportunities, leading to innovative solutions. This is the power of psychological safety—changing how people feel and act.
You might think, "Changing culture is impossible!", however, my recent research shows how to tackle this: focus on climate instead. Unlike culture, climate is the more immediate, observable environment shaped by leadership behaviours, communication patterns, and team interactions. My recent work in partnership with Simon Brake at University of Warwick provided greater insight to the value of a psychological safety climate in building collaboration across teams and systems, offering practical steps for leaders to nurture it.
Here's the provocative truth: achieving this requires a fundamental shift in leadership approach. Can we shift from a traditional command-and-control approach to facilitative leadership that nurtures trust and empowers teams? It's time for a reform that begins with usthe leaders.
It stems from the ability to:
• Start with self-reflection. Are you creating an environment where your team feels safe to speak up?
• Embrace vulnerability. Share your own mistakes and learnings.
• Reward speaking up and constructive disagreement.
• Build a demonstrable, common, valued purpose.
Are you ready to be the leader who transforms your team's climate? Do you know if your board or team feels psychologically safe?
Find out more by contacting me at collaborate@psychologicallystrong.com and S.Brake@warwick.ac.uk
Become an Expert in the Science of Safety
The Role of Human Factors and Ergonomics
Human Factors (also known as Ergonomics or HFE) is a multidisciplinary applied science which seeks to understand interactions between humans and other elements in work systems. HFE is applied across many safety-critical industries and occupations and this ‘systems approach’ is becoming increasingly influential in supporting patient safety and service quality in health and social care.
Our MSc in Human Factors for Patient Safety
Staffordshire University’s cutting-edge MSc in Human Factors for Patient Safety is offered over three years on a part-time, distance learning basis. Our students are health professionals from clinical and non-clinical backgrounds who want to learn about applying HFE in safety, risk, and improvement contexts.
We teach people to become systems analysts and to use HFE approaches to design tasks, equipment, procedures and environment to improve day-to-day working practices. We hope this can make a real difference to the lives of patients, service users, families, carers and staff.
As an alternative to the MSc, students can complete a one-year, part-time PGCert, fully accredited by the Chartered Institute of Ergonomics and Human Factors (CIEHF). We also offer a 13-week, 20-credit course in Human Factors and Ergonomics.
• MSc/PGCert:
• Human Factors 20-credit course: Contact us
To find out more about HFE at Staffordshire University, please contact our HFE leads:
• Professor Al Ross, C.Erg.EF (e: al.ross@staffs.ac.uk)
• Professor Paul Bowie, C.Erg.EF (e: paul.bowie@staffs.ac.uk)
The Anti-Hero of a Healthy Mindset –Meet Burnout
Many of us find ourselves feeling exhausted by the world around us. Often, we’re not even sure what it is that’s tiring us out. Why can’t we just carry on functioning at optimal as usual?
We have things to get done, an ever-growing todo list to tend to. Nevertheless, we can sense our bodies and minds telling us to stop. Sleeping, attempts to relax, warding off colds with some hefty vitamins, nothing helps. What could have gone so wrong?
It’s hard to tell when people first started to experience this state, but we finally have a phrase for it. We’re face to face with burnout, and it’s a serious problem.
Despite burnout becoming a major buzzword in recent years, much of the content out there seems to avoid a major aspect of the problem – us. As uncomfortable as it may seem, burnout comes from one common place. A lack of respect for ourselves. For our time, feelings, energy, and much more, resulting in a reduced capacity to get things done, a total overwhelm and exhaustion physically and/or mentally.
Picture a very demanding manager, who does not care for the effort you’re putting in, only that you can do more, always more, and that what you’re achieving so far isn’t good enough. Except this person isn’t your manager, spurring you on to feel terrible about your hard work. It’s you. We share disheartening and unkind messages with ourselves, through our internal monologues, all day, every day. The emotional toll alone that this could cause us over time is enough to wipe us out.
Catch up with yourself, reflect on your behaviours, and identify whether burnout is something you need to get in check. Below are some quick tips to get you started, but make sure to head over to Hapstar to continue your reflective journey.
Understand Burnout:
• Burnout is often self-imposed through constant self-criticism and unrealistic demands on oneself.
• Viewing burnout as a lack of selfrespect for your time and feelings can help in identifying the root causes.
Intervene in Negative Thinking:
• Challenge and reframe defeatist thoughts into more positive and constructive ones.
• Practice self-compassion by treating yourself as you would a friend, with kindness and understanding.
Prioritize Self-Care:
• Engage in activities that promote joy and relaxation, such as exercise and hobbies.
• Self-care is essential for maintaining a positive mindset and overall well-being.
Seek Support When Needed:
• Don’t hesitate to reach out to others, whether friends, family, or professionals, for support and guidance.
• Involving others in your journey can provide valuable perspectives and emotional support
IHSCM members have access to the Hapstar platform and all their resources here.
Uncovering the Impact of Admin on Nurses: Technology Can Ease the Burden
I recently spent time at a large London hospital as part of an assessment to identify areas of improvement. One situation stood out to me: the hospital’s ENT clinic had 17 daily appointment slots, but staff regularly booked up to 25 different patients.
I learnt that, with the huge backlog and the high likelihood that patients do not attend, overbooking was seen as the best solution, despite the number of extra appointments being nearly twice the hospital’s did not attend (DNA) rate.
Ryan Reed, Head of Public Sector and Digital Transformation Expert, SPSv
Of course, if these extra patients did buck the trend and arrive, the clinic was suddenly overbooked. One appointment running over its allotted time delays the next, and suddenly clinicians are skipping lunch and staying late to get through the day’s work. And if those patients do not arrive as expected, it’s those same clinical staff getting on the phone to reschedule appointments. It is a lose-lose situation, and tends to be caused by the NHS’ outdated and manual approach to admin.
Recent developments in technology and particularly generative AI give us the capability to solve these operational headaches, but where should we be prioritising?
Workloads dominated by admin
A recent survey from the RCNi showed that 42% of nurses spend at least half their working week (20 hours) on non-clinical admin tasks. The same survey, which was supported by SPS, also found most nurses (64%) work at least six hours of overtime every week.
A direct impact of this workload is that clinicians’ face-to-face time with patients is limited. However, there are less visible, indirect effects too. Just like the ENT nurses rebooking appointments for patients that DNA, much of the day is spent manually addressing oversights. The clinical role that nurses are trained to do is unfortunately diluted by admin.
Embracing automation
Digital technology is capable of making a huge impact on clinicians’ admin workloads. Automation can be introduced directly into the admin process, logically coordinating appointments and communicating directly with a patient. Even different specialties within the same hospital can communicate
differently with patients – some might call with reminders about appointments and others might not. Some consistency would limit the need for so many rebookings.
This may seem like an ambitious upgrade, but the new government has committed to a modernised, patientcentric health service in its manifesto. Research has shown that placing the current admin workload on nurses costs an estimated £13 billion. Releasing this workload to admin specialists or automation could generate billions of pounds in savings for the NHS to reinvest, with the added benefit of improving the patient experience and letting clinical staff focus on their day jobs.
Change from the ground up
For the government to achieve the change it is aiming for across the NHS – and action the feedback that doctors and nurses have given since Covid –a true reengineering is required. The focus must be on embracing digital technology and moving to a more datadriven NHS.
Building a health service that enables clinicians to focus on care and gives patients more agency cannot be left as an empty electoral promise. Wes Streeting has committed to delivering a ten-year plan for the NHS this coming Spring, but it is vital that change is implemented sooner rather than later. Tens of thousands of clinicians are counting on it.
My journey into midwifery
My journey into midwifery began in 2010, I had moved from Yorkshire to the Midlands with my 18-month-old and partner when I decided that I wanted to take my life in a different direction. I worked in a sales office in Leeds commuting daily in a 9 to 5 grind.
Keely Shires BSc (Hons) FHEA, PMA,
PgDip Registered Midwife, Midwifery Lecturer, Course lead for apprenticeships in midwifery, School of Health, Education, Policing and Sciences, Staffordshire University
intoI saw this move to the Midlands as an opportunity to reinvent myself, be the first in the family to go to university and so it all began.
I applied to university and was told my ALevel qualifications were too old, and that I would need some recent learning so off I went back to college as a mature student to complete an access to higher education course. During this time we expanded the family with another daughter, and I completed the course and reapplied to university at the earliest opportunity. Eventually I was successful in gaining a spot on the Midwifery course in cohort S11. I remember my first day like it was yesterday. All my fellow students were excited about starting the daunting but very exciting journey to become midwives. The three years flew by with placements, study and managing a home with a 1-year-old and 3-year-old was busy, but I loved every second.
Upon completing my midwifery degree, I entered a new phase of my life as a single mum and a newly qualified midwife. My little girls were getting bigger and mum working shifts looking after women and their babies was the norm.
As the girls became older and they started to think about their own career aspirations, I decided life was more settled and it was time for me to pick up the baton again and take another step in my career. I loved working on shift with students and aspired to become a lecturer, but I needed to add
a few strings to my bow before my aspiration would become a reality.
Off I went on the pathway to fulfil my goals. Through hard work I became a PROMPT team member, teaching the midwives and doctors where I worked. I then secured a position on secondment as a practice facilitator as a direct link from the trust to the university. After a year working in this role, I secured a role as a midwifery lecturer my dream was finally becoming a reality. I started my academic career as a midwifery lecturer, teaching midwives and helping them achieve their dreams and complete their life goals.
Being a midwifery lecturer is special. I feel like I need to pinch myself daily, this is not the end of my journey by any means. I have completed my Education PgDip and enrolled on a Masters course. I feel I have the best of both worlds now being with woman, promoting women’s birth rights and choice, whilst also shaping the new midwives of the future.
I see now how me striving to go further in my career has now inspired my daughters to follow in my footsteps to achieve their own aspirations to go to university and the benefits of a career that requires lifelong learning and challenge. keely.shires@staffs.ac.uk
Josh Sutton, Personal Development Coach
We all want to feel motivated. Apparently.
What is feeling Motivated?
Motivation is that feeling of really wanting to take action in the short term. Example: if you’re feeling ill, you may have lay on the sofa for hours, barely able to move. If you suddenly feel the need to be sick however, your motivation to run to a toilet would skyrocket. You wouldn't say, “Urgh, I know I should be sick in a toilet rather than on the sofa, but I’m just struggling for motivation at the moment.”
See, motivation is that short term feeling, often based on emotion and often accompanied by hormones such as adrenaline and dopamine.
To an extent, it's great: it increases our focus; it makes us feel excited to be making progress. It's good.
The thing is, you're probably wanting the motivation to bring about some kind of change in your life. If that's the case, you don’t need more motivation. What you really need is a ‘Big Why’. This ‘why’ is the bigger picture, the thing that your action contributes towards.
I regularly go to the gym at 5am. I do it to start my day well, because I enjoy pushing myself and hitting goals, and because I believe that physical health is foundational in living a good life. Almost never have I got up and gone because I felt ‘motivated’. I might feel motivated once I get there and start, but rarely before.
Whatever it is you want greater motivation in, explore the greater purpose - why do you want more motivation to do this action? What’s the bigger picture of what you’re trying to achieve? I've painted motivation in a bit of a negative light so far. Motivation is not a bad thing at all; it's the chasing of it in order to get something done, or worse, waiting around doing nothing until you do feel motivated, that's the problem.
When can motivation be useful then?
Well, if a ‘Big Why’ is the fire within us that keeps burning, ‘motivation’ can be the spark to get things going.
Here’s 4 ways to kickstart your motivation:
1. Just getting started: What is the absolute starting point for the thing you want to be motivated for? Putting on your shoes? Reduce the ‘thing’ to the absolute starting point.
2. Music: What’s your go-to energy music? Write down your three favourite tracks. Play them and see if they have the desired effect.
3. Visualisation: Imagine what it would be like to finish the thing you want to get started on. Where are you? What does it look like? How do you feel? What are you saying to yourself? What’s the impact on yourself and others?
4. Movement: Which exercises are you capable of doing in the moment? What will be your agreed go-to exercise? This need not be any longer than 5 minutes!
Email me at josh@joshsuttoncoaching.com and let me know which one you're going to try out
Accelerating Innovation for a Healthier World
As a global human data science company IQVIA is at the forefront of unlocking the potential of health data to drive key advancements for future health improvements and delivering transformative benefits to improved population outcomes.
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Develop new medicines and prove they are safe, effective and valuable to patients
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Demonstrate the value of medicines, launch effectively and ensure uptake to reach the right healthcare professional and patient at the right time
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