I am sharing my experiences of leadership and the journey of a healthcare entrepreneur. I hope that this will inspire others into following the same journey and create opportunities for all!

The Maslow Foundation aims to ensure social inclusion, using the voice of lived experience to create services that meet their ambitions and I am proud to be Chair of Trustees creating hope, joy and meaning in our lives. Our services include creating safe spaces to ensure meaningful conversations, being able to connect individuals into wider services with a model of trauma stabilisation and connection. We are pleased to be offering housing to those who cause harm from domestic violence and enabling their partners to remain in their local community. This has revealed the challenges with employment and our move to creating an entrepreneurial laboratory and microbusiness support. We are champion the Child Impact Assessment to support mothers who may be sent to prison and their children to inform judges and provide a robust plan for the family. To support the charitable sector I have launched Urban Nest Housing Solutions to access housing with safety at our heart.

Nurture Health and Care Ltd has been co-founded by myself and my team to nurture workforces across the public sector. This is built on a model of Psychological Safety and recognises the need for connection, sense making and action. By creating sense making structures through our supervision model or decision making groups in our investigation team, we can enable people to make sense of risk and uncertainty. We are proud to be offering services to the NHS for investigations and the Prison and Probation Ombudsman/NHS England for clinical reviews. In addition, we are providing sexual offence examiners to sexual assault referral centres, with a unique workforce strategy which includes the accredited Sexual Assault Nurse Examiner programme (SANE) and our inspection ready governance delivery. We use our four ways of knowing to help provide understanding, equality of voice and values based decision making to create new insight for our services. We provide post graduate preceptorship programmes and enjoy the contribution of our Nurse Ambassadors and run a Nurture Ripple and Cultural Architect Programme generating psychological safety to embrace the ambition and creativity of our workforce enabling success.

I am interested in how language can represent culture and be measurable through artificial intelligence and have set up a new organisation, the Centre of Artificial Intelligence Interface (CAII), with the launch of our new website and first product which acts to create different perspectives as a basis of decision making: https://www.3friends.ai/ and looks how ethical AI solutions can contribute to healthcare.

As a Trustee for Survivors In Transition, I continue to support my passion of providing services to those who have experienced sexual violence and am lucky to work alongside Fiona Ellis, who as CEO has created a values based innovative organisation to provide therapeutic interventions.

I am also exploring setting up a microgrant funding system to create financial support, coaching and an incubator of change recognising how passion, entrepreneurialism and the agency of people can support change in our services. I look forward to sharing this journey.

Alexis Hutson (https://www.alexishutson.com/) facilitated the Faculty of Medical Leadership and Management course – Tomorrows Strategic Leader which I attended and highly recommend. She was an excellent resource and identified the concept of ‘Taking a Thought for a Walk’ which I have named this blog after. Simon Bennett (http://www.simonbennettcoaching.com/) is my personal coach and I advocate this support, It enables us to explore the journey that we are all undertaking in a psychologically safe space.

I believe that without aiming for the impossible, miracles cannot happen and through authentic leadership, we can enable every person to be able to reach their own potential.

A few years ago in relation to my role, I was informed I had to be professionally curious. My assessment and management plan needed to include this skill especially when safeguarding children and vulnerable adults.

Professional curiosity is commonly cited in serious case reviews, regulatory inspections and now included as a core skill in many roles but currently there is no clear definition of what this means.

In safeguarding, professional curiosity includes not accepting information at face value, seeking further information, disguised compliance and our assessment needs to consider if we have normalised behaviours and chaos, attributed exceptional crisis situations as appropriate actions and the presence of people as protective.

Burton V and Revell L wrote ‘Professional Curiosity in Child Protection: Thinking the Unthinkable in a NeoLiberal World’ where being professionally curious was critical to risk assessment and risk management.

How to Practice Curiosity and How Does This Overlap with Continuing Professional Development

Professional curiosity has also been aligned to a growth mindset and active open-mindedness.

People with curiosity have a desire to explore, learn and understand.

As such, they are flexible in their thinking and recognise that there may be different ways of doing things from what they have always done and are willing to explore different options.

This requires:

• Self-awareness to be able to critically evaluate ourselves and understand our own minds
• Persistence to pursue and explore information verifying it to ascertain its validity 
• Active listening and asking questions
• Being analytical to identify and define a specific problem, gathering key information from a range of sources to develop a deeper understanding and include different confirmatory evidence – triangulation
• Critical thinking to enable weighing up evidence, to discern the true from the false, the real from the unreal, and the facts from the fiction and identify solutions

In addition, we need to consider the wider perspective of others and how they weight and frame the same evidence. Individuals will interpret information differently through their lens of culture, heritage and identity, alongside appreciation of context and the influence of power.

Utilising the skills above correlate with continuing professional development and learning journeys.

Our Learning Journeys should be Built From Curiosity

When we create our own learning journey, we become masters of self-initiative and self-motivation and through reflection and reflexivity, understand and become skilled.

We can identify our own learning goals, identify resources for learning and create personal learning pathways.

Group and connection with others is important to consider as part of our learning journey. This builds self esteem, self-confidence, social communication, greater sharing and wisdom.

Organisational Training Needs Analysis should also be Built From Curiosity

Organisations, should be self-motivated and through organisational reflection, become thought leaders creating a learning community.

Their training needs analysis should be identified from their own experience of being an organisation and create a unique footprint of learning.

Where environments encourage competencies and compliance, they inadvertently discourage curiosity and exploration.

Our organisations should be curious to understand theories that help to make sense of their purpose, social need, disproportionality, effective use of resources and assist in decision-making especially in relation to taking risks where there is uncertainty.

Our Challenge is to Increase Curiosity in Those Around Us?

We need to ask questions:

• What’s the best way to challenge long-held views?
• When was the last time you changed your mind?
• What makes you say that?
• You have said that a few times, what does that mean to you?
• Please explain that to me?
• What evidence supports this?
• How else could you look at this?
• What are the positives and negatives of this viewpoint?
• How might someone else see this differently?
• What could happen as a result … and how would that impact on you and others?

Curiosity helps people explore new ideas, take risks, and adapt to change.

Models of supervision, through diverse groups creating distributed wisdom utilising mechanisms to create curiosity are critical going forward.

Nurture Health and Care Ltd has developed a new model of supervision to bridge this gap and make curiosity a priority.

“Curiosity is the engine of achievement” – Sir Ken Robinson.

 How does it Overlap with Learning and Education?

Society and professional knowledge often dampens our innate curiosity.

Children are curious about the world. They ask endless questions about how it works and constantly ask the question, why?

As you get older, society drums this out of you. In school, everyone follows the same curriculum, universities feed us core information in relation to a topic and as a professional group, you acquire competency in a role.

I would argue, we have become compliant learners and have no time to practice curiosity. Rather, we are designed for productivity and routine not curiosity and exploration.

When you replace curiosity with compliance you lose your creativity.

Mandatory and statutory training are organisational requirements for learning and the modules which we are expected to undertake is increasing.  This is often due to the need to cover the recommendations of the mistakes of the past acting as tick boxes rather than true understanding.

Our competency frameworks attempt to describe job roles and tailor critical knowledge, skills and behaviours to be safe and effective practitioners but fail to stimulate innovation.

Success may be seen in the simulation play drill of Basic Life Support and Intermediate Life Support. This is when it is not delegated to an e-learning package. When scared and adrenaline pumps round our bodies, the ability to still remember how to call for help and do chest compressions from our deep memory is life saving.

Critical skills will need to be taught and other specific knowledge, skills and behaviours may need more traditional teaching methods but there is a balance to be struck between competency and encouraging creativity, adaptability and curiosity.

Following our genuine personal curiosity must be a better foundation for career building than following what has been laid out before us, albeit safety and risk need to managed, skills demonstrated and capability to undertake roles effectively important.

Our workforce strategy, due to shortages of people, have new roles evolving to meet gaps, staff are rapidly promoted and loss of experienced practitioners is apparent. When time and exposure to events builds our intuition, how are we creating wisdom in our systems.

We need Time to be Curious

If we are busy with the tasks of the day, the constant background chatter of social media and do not create any times free of routine to find those curious moments, when will true learning occur.

When People are Curious to Learn the Answer to a Question, they Remember More

Researchers discovered a connection between memory and curiosity levels. There key findings were that participants had greater recall of unrelated, extraneous or incidental information present at the time when people were curious. https://www.universityofcalifornia.edu/news/curiosity-helps-learning-and-memory

Scans revealed when people were more curious, brain activity rose in regions associated with memory and reward. When we are curious, we are open-minded and learning feels positive and we remember more.

When we are rote learning and undertaking facts acquisition, curiosity is low, we become task orientated, unstimulated and closed to inspiration.

What is the impact when we roll out mandatory and statutory training or competency frameworks for roles without creating curiosity. We will only acquire the minimal information and are highly unlikely to create true understanding or be able to apply our new knowledge to different situations.

When Faced with Something New, Our Brain Weighs the Risks and Rewards

It is human nature to ask the question – Is this worth my time?

If the world feels risky, you close down learning something new in favour of the status quo and as we tend to see new knowledge as a threat, we are therefore naturally closed from curiosity as adults.

We therefore need to practice curiosity.

When was the last time we discovered something new in our favourite topic? If we are not learning every day, we need to appreciate that our experience of education is hampering our ability to be agile, flexible and change.

Interestingly, people who are curious, have increased patience as when you practice curiosity, the  answers are not immediately available and we have to wait.

If people are closed to learning, we remain in our bubble of custom and practice but are rapid decision makers wanting to jump straight to the answers.

​Practicing Curiosity: The Internet Is Your Personal Curiosity Machine.

Whatever you’re curious about, the internet has an answer and now we have Open Source AI, which is amazing. In creating this blog, I conversed with AI to explore this topic and although have written my own conclusions, had a fun weekend acquiring new skills.

Our technology may not always identify the right answer, but with exploration and some critical thinking, you can learn almost anything and it’s open 24/7/365.

It is not the means of education or the means of learning that are scarce, but the desire (or time) to learn that is lacking.

People with a growth mindset have a desire to explore, learn and understand – they are curious.

This requires:

• Self-awareness to be able to critically evaluate ourselves.
• Tenacity to be determined to pursue and explore information, verifying it to ascertain its validity. 
• Active listening and asking questions recognising the unique experience of others and their wisdom which we can learn from.
• Situational awareness and appreciation of context to frame out thinking.
• Being analytical and utilising critical thinking skills.
• Using our imagination to explore the ‘what if?’ and ‘think forward’.

All of these correlate to the purpose of continuing professional development

Learning Journeys should be Built from Curiosity

Self-determined learners have self-initiative and motivation and through reflection and reflexivity, they become masters of their subject.

They can identify their own learning goals, identify resources for learning that meet their own learning style and create personal learning pathways.

Group and connection with others is critical to gain self esteem, social communication and different perspectives.

Our workforces need to create a learning community and curiosity must be a critical feature of this.

Our Curiosity Approach

Organisations should review their Curiosity Approach and consider using models of supervision, distributed wisdom and other mechanisms to create curiosity to meet our future system needs.

Nurture Health and Care Ltd has developed a new model of supervision to bridge this gap and make curiosity a learning outcome, with generation of your own learning strategy to identify mechanisms of managing complexity, risk and uncertainty alongside restorative approaches.

We should all seek to have a light bulb moment where we changed our behaviour, thoughts or a belief and came to a new conclusion.

What is Clinical Supervision?

Over the last few decades, Clinical Supervision has become part of the requirements of nursing and wider professions such as therapists and is recommended in public policy statements alongside regulatory inspections.

Credible research evidence has accumulated to demonstrate that supervision has a positive effect on the well-being and workplace burnout (studies such as Tomlinson: BMC Med Educ. 2015; 15: 103 – Using clinical supervision to improve the quality and safety of patient care: a response to Berwick and Francis).

However, much less data is held on the quality of the supervision and therefore evidence of long term impact is minimal.

Logic would predict that it is unlikely that a one size fits all approach will work. This recognises that we are all individual in our learning style and therefore research needs to explore how practitioners best access supervision, how they best learn and how they can experiment and embed new knowledge, skills and behaviours.

The contemporary priority is to document the volume of supervision activity to ensure we are compliant with regulators, to count how many and how often staff access supervision but they do not focus on the quality of provision.

The NMC revalidation requirements includes practice-related feedback, written reflective accounts (Gibbs templates provided), reflective discussions (https://www.nmc.org.uk/revalidation/resources/forms-and-templates/)

Tthe GMC has quality improvement embedded with documentation of continuing professional development that has collection of information, reflection and discussion included as part of annual appraisal and revalidation https://www.gmc-uk.org/education/standards-guidance-and-curricula/guidance/reflective-practice/the-reflective-practitioner—guidance-for-doctors-and-medical-students

Wider professions utilise supervision as part of their standards, https://www.bacp.co.uk/events-and-resources/ethics-and-standards/competences-and-curricula/supervision-curriculum/ and social workers have included supervision as a critical part of their practice – https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/778134/stengths-based-approach-practice-framework-and-handbook.pdf. The HCPC identifies CPD as core to registration. https://www.hcpc-uk.org/cpd/your-cpd/our-standards-for-cpd/

It therefore makes sense, that supervision models are transferrable across the health and social care landscape but we should consider how this incorporates wider non clinical roles, strategic roles alongside registered professionals. Integrated Care Systems create an opportunity for multi-organisational supervision.

As a practitioner who has worked in justice settings, consideration should also be given to whether wider public sector roles would also benefit namely policing in light of their cultural challenges.

How do we measure success of supervision?

We need to evaluate what is the measurable impact of supervision?

Is there a model which creates better outcomes?

How much do these cost?

And which groups would benefit from supervision?

• What are staff retention rates in groups experiencing supervision vs no supervision?
• What are the staff retention rates between models or if a range of models are accessed?
• How confident are practitioners in managing a scenario which includes risk and uncertainty  with supervision vs no supervision?
• How has the organisations staff survey altered in response to introduction of a model of supervision?
• Can we demonstrate that those who experience supervision continue to create their own personal supervision opportunities in the future?
• Does group supervision Vs Individual supervision improve outcomes of supervision?
• Is supervision better delivered at peer level?

It is critical for successful implementation of a workforce strategy that clarity on the nature of supervision is needed.

The Clinical Supervision Evaluation Project (CSEP; Butterworth et al. 1997) utilise The Manchester Clinical Supervision Scale© (later the MCSS-26©; Winstanley & White 2011) but has not been developed to consider the elements of inclusion, shared perspectives, freedom to speak up and complex decision making.

In recent times, supervision has become used as a term for coaching, mentorship, peer review, competency assessment, preceptorship, clinical teaching, buddying, debriefing and other oversight encounters. Not uncommonly, it has involved ‘personal performance review’, case review and even therapy.

In addition, organisational culture and supervision interface in how the confidential nature of supervision has to acknowledge the contexts of a ‘duty of candour’ and Freedom to Speak Up, which may or may not be trusted

What do our practitioners consider important?

Supervision is a resource that people feel is poorly delivered and rarely use as a safe space to explore how the flow of experience leads to a state of arousal, our emotional response and enables decisions to be made through intuition and pattern recognition, alongside critical thinking and judgement.

It is important to explore these aspects as much of this occurs at an unconscious level and interestingly rather than becoming more confident and resilient through experience, evidence suggests we are overwhelmed and unhappy.

Situational Decision Making has been included in the NHS People Profession Map https://peopleprofession.cipd.org/Images/full-standards-november-2022_tcm29-112150.pdf and The Messenger Review: Leadership for collaborative and inclusive future explores skills required for our practitioners. https://www.gov.uk/government/publications/health-and-social-care-review-leadership-for-a-collaborative-and-inclusive-future/leadership-for-a-collaborative-and-inclusive-future.

The other consideration, which should be addressed in the model choice for supervision is how this could support the loss of experienced staff and their contribution to complex decision making and regain the insight that has been lost to enable our junior colleagues to ‘catch up’.

Nurture Model of Supervision

With skilled facilitators of supervision, we have opportunities to create new models of delivery and would consider anyone interested in this topic explores Ian McGilchrist work: https://channelmcgilchrist.com/home/ which considers insight, intuition and imagination.

Our Nurture model of supervision has built on Models of Reflection (Gibbs), Seven Eyes and restorative clinical supervision, alongside reflexivity and psychological safety to explore how to make decisions where there is risk and uncertainty.

Our model explores the four types of knowing:

• Propositional (facts)
• Policies and Procedures
• The perspectives of others
• Context, intuition and imagination

In addition, we consider connection, arousal response, emotions and empathy by understanding how we think and feel, how others think and feel and respond to distress with compassion for ourselves as well as others.

This allows us to understand context, value intuition, respect other perspectives, celebrate uncertainty and create a workforce that can manage risk feeling confident to apply strategies and achieve goals.

In the Matter with Things (2021), McGilchrist raises many fascinating points which are relevant to expertise and practice. McGilchrist’s research is focused on the role the left and right hemisphere of the brain play in human existence. The left side likes procedures and processes. The right side of the hemisphere is concerned more with context and establishing the bigger picture. Synthesis of these two sides, enables us as human beings to make sense of our surroundings, and work out what to do.

When we discover and try something new, we use the right side of the brain. The new situation requires us to draw from our intuition, what does this experience feel like, what feels right and what feels wrong. We use our imagination to try and make sense of the situation and how we could effectively participate with it.

As you became more proficient the left side of the brain becomes more dominant. You develop routines based on what works well and what doesn’t. You do not need your imagination and intuition because you know what will happen.

We need however to ensure that expertise does not become our automatic default, as we will miss cues and should attempt to use our imagination regardless of our familiarity with situations. We must always ask of ourselves and others, what else could this be? Does this feel right or wrong? If we do, then the mind is likely to remain far more receptive to the external environment, and we’ll be using both hemispheres of brain.

So lets explore models of supervision to provide creative solutions to retain our workforce, enabling them to be confident practitioners, who enjoy exploring and documenting their thinking in relation to risk and uncertainty and find new ways of practicing.

Lets celebrate using our imagination.

Elon Musk has provided an interesting perspective, focusing on productivity and achievement without recognising human wellbeing, burnout and how belonging counts so I will observe how his organisations move forward.

I believe we need to challenge the hero status of sleeping in the office and how hard we are working to how good our decisions are and how much of a difference we are making.

COVID has changed us – CEOs are discussing our wellbeing, athletes are talking about recovery for peak performance – and we all recognise the need to work smart – not just working hard.

I believe we need to prioritise alongside our own health and well being, our families and our loved ones.

In The Maslow Foundation, in keeping with the hierarchy of needs and our own values, joy, hope and meaning, we commence meetings with what has given us joy this week. The majority of the time, this has celebrated our wider connections, rarely work tasks – so holidays, new puppies, birthdays and anniversaries, buying a house and simple time spent on beaches, walks or eating together creates our joy, hope and meaning. We have also noticed the sadness of our teams, with deaths of loved ones, illness and sharing frustration or just simply our tiredness. This has been a welcome addition to our meetings so we that we can reach out and help.

At Nurture Health and Care Ltd, our purpose to Nurture You to Nurture Others, has also been built on foundations of psychological safety, ambition, belonging and creativity and through sharing our proud moments and exploring our behaviours with psychological safety, the trend continues, family achievements have meant everything to us, first jobs, GCSE results, more dogs and puppies and a sports day including success in a judo competition have all featured in our lives and given us a shared experience of happiness.

This reminded me of sitting in my grandads shop waiting for customers to be served and therefore vicariously learning about customer service, or going to work with my mum, a Sister on a Care of the Elderly ward and how talking to the older people became a skill set. Many businesses are family run and the rise of the corporate entities has challenged this as a model of safe and effective practice.

Health and Safety, confidentiality and all the rules of work have divided our worlds, with work and home forming compartments rather than being part of our whole selves.

Our connections are a standing agenda item on all our meetings and we look forward in 2023 to bringing our families to work.

Our board meeting was held at a water-ski park and we celebrated with our families alongside setting our priorities for the year.

Our achievements should acknowledge our loved ones who often make sacrifices behind the scenes and offer their expertise or support.

I believe we need to re-imagine our work and bring our families to work.

Watching the success of Richard Branson and many who have lives of accomplishment, they delight in the contribution their families have made acting as sounding boards and forming the safe space for confidence building. Confidentiality is still in place with situations, not names often featuring in our what if scenarios.

Lets stop celebrating an outdated model of working.

The Victorian era and Mr Ford and his production line has created a world where we perceive ourselves as machines who need to run optimally – but humanity means we need to belong, involve our wider loved ones, enjoy creativity and look to imagine new ways of working.

My Learning Journey and Clinical Governance

As some-one with a lengthy career in health, I have had governance in my roles as both a nurse, doctor and in strategic leadership.

My first experience of governance was being the COSHH representative on ITU and being part of the implementation team for closed suction systems in the early 90s. We followed pre-prepared written policies, developed education programmes for people to be informed and demonstrated evidence of successful change being embedded through ongoing audit.

I had the support of the team leaders and used my positive personality to sell the changes and had easy topics to disseminate so negotiation was minimal and change was easy.

My next career move was to a research sister and the development of the nurse practitioner role which led to more governance conundrums. Many people felt nurses should not be undertaking roles with clinical examination and differential diagnosis which was outside our traditional competencies and core training. Interestingly the debate is ongoing today, thirty years later!

In order to establish the new service model which was transformational in nature, the business case for the role was established by the consultant and I was recruited. My job description included these new areas of development and I was supported by the Consultants to run a number of ‘nurse led services’. I did not think of my role as governance, however it was important to demonstrate the service outcomes were not detrimental to patient care and that the addition of nursing to the medical team freed capacity to undertake the work they needed to do. Medicines prescribing limitations were problematic and I was on the pilot MSc in Advanced Nursing Practice at Essex University to further evidence the capabilities needed to undertake this role.

Policies and protocols were written, proformas designed, new pathways communicated to GPs and wider teams and audit underpinned practice. These included demonstrating how accurate my digital rectal examination and detection of abnormalities was compared to the medical team, the volumes of patients seen and how waiting lists were minimal with the new services. We published our findings which showed safe and effective services and monitored any concerns and identified gaps and led to the potential for research – https://pubmed.ncbi.nlm.nih.gov/11119092/

On reflecting, I recognise that despite a solid evidence base of safe and effective practice, that we did not appreciate the possible unintended consequence of specialist roles removing nurses from the wards or the boundaries that professional identity confer.

Moving into primary care, occupational health, forensic healthcare and out of hours care, alongside training as a doctor, my roles included performance management of individuals and services, supervision and appraisal, disciplinary investigations, serious incidents and case reviews, root cause analysis and quality improvement building from audit to educational frameworks, policy development and implementation of services. https://pubmed.ncbi.nlm.nih.gov/20851355/

Governance therefore was at the heart of everything I did, as a golden thread, ensuring that our patients were safe and that we were current in our practice and that our staff were competent.

How Passion Based Learning enabled me to Discover My Purpose

Although currently leadership and training opportunities are available to me, my initial career pathway had little formal leadership or management education. My learning journey explored new topics through trial and error, with a leadership style where I wanted to befriend the world, avoiding confrontation and achieving success despite lack of delegation and goal orientated behaviours.

My values were always shining bright and I believed that we all came to work to do a good job. If things went wrong, our systems had let us down. I recognise that I demonstrate values based servant leadership, with psychological safety and creation of ‘a just culture’ as principles of practice throughout my career but now this has become on-trend.

As I have become a strategic leader and a healthcare entrepreneur, understanding leadership, management, followship and skills in governance are passionate topics and I try and ‘do something better every day’ as part of my routine.

I have needed coaching, undertake many courses including the FMLM Tomorrows Strategic Leadership course which I highly recommend: https://www.fmlm.ac.uk/tsl and explore new ideas to discover how to be better today than yesterday.

My new ventures, The Maslow Foundation and Nurture Health and Care Ltd mean that I continue to have an exponential learning curve and now include philosophy to my passion-based learning journey.

My inspiration comes from being able to support amazing people and enabling them to be the very best they can.

My current exploration is to shift away from the ‘one Job Description fits all’ to enabling people to focus on things they are naturally good at and build teams that cover the entirety of workload sharing accountability. How we can demonstrate this within a governance framework which embraces culture and values is yet to be discovered.

Sharing Our Passions and Purpose to Create Safe Systems

Within Health and Social Care, the new patient safety strategy, Just Culture and our wellbeing and equality priorities have created the right environment for a new direction. We now need to create the learning cultures to tackle change and support our institutions to be the best they can be.

Passion-based learning is meaningful and by sharing our ideas with others we create collaboration. Through asking for help, co-creating and co-innovating and learning organically through action and reflection, we can deliver the new generation of services to the best of our ability.

Education, will need to motivate and provide the information to inspire change, but with our workforce who are tired and fatigued with exposure to yet another e-learning course and fearful of failure, we need to offer education in a different way. Social entrepreneurship, systems thinking, cognitive and human factors to understand ourselves and others, with situational awareness to be able to manage risk and uncertainty will prepare us for an ever-changing environment. This should be fun and practiced so no longer a certificate and Multiple Choice Questionnaire but real life participation.

The resulting interpersonal skills of empathy, respect, cooperation, negotiation, leadership and social awareness with hard work, doing something better every day and tolerance will form our new competency set.

People need to be encouraged to understand learning styles, ensure everyone has their perspective acknowledged and amplified if needed, adopt learning mindsets, share mistakes, successes, unlearning and enjoy celebration of our progress. Governance will naturally flow from these teams, without a policy or procedure written or an audit being undertaken.

By creating a purpose-inspired learning community in health and care, we can all align and share narratives and experiences to understand our world and make a difference.

By watching children, we can observe an enthusiasm for learning, for play and for making mistakes but in our educational system and working environment, we are encouraged to see the world in black and white, with correct and incorrect answers, following rules and protocols. We are discouraged from play and experimentation and have lost our own understanding of how we learn.

In my own experience, understanding topics such as contextual safeguarding and exhibiting professional curiosity, was not an easy skill to acquire and in many of our practitioners asking them to think the unthinkable appears beyond their reach.

Emotionally Bruised Learners

Many of us are emotionally bruised learners, so education and learning create feelings of failure rather than joy and the concept of curiosity is something that feels unsafe to practice.

As organisations, we are being asked to increasingly look beyond the ‘obvious’, whether as part of the new patient safety strategy or in buzzwords as part of leadership. Curiosity, creativity, and critical thinking are all now skill sets that we need to be able to master.

We have to encourage our workforce to play, to experiment, to formulate questions that activate learning, to re-frame problems and slow down our decision making to explore and discover. We need to share ideas with others and identify new possibilities.

Dr Steve Suckling blogs are great resources to consider why we need to explore and think differently – https://themaslow.foundation/category/steves-thoughts/ and how our imagination is critical in reaching our potential. https://themaslow.foundation/expertise-and-imagination/

Brian Sutton-Smith, a dean at the University of Pennsylvania stated that “THE OPPOSITE OF PLAY IS NOT WORK; IT IS DEPRESSION”

Serious Play and Meaningful Work

Serious play and meaningful work generate ideas, improve performance, motivate, and should be a critical workstream for businesses.

These concepts enable:

• The ability to participate
• Being able to learn and develop
• Produce creativity and fun
• Provide inspiration and vitality

Stuart Brown, MD, author of Play: How It Shapes the Brain, Opens the Imagination and Invigorates the Soul, Penguin Books, 2009 and founder of the National Institute for Play: https://www.nifplay.org/about-us/about-nifp/ promoted play as an absorbing activity that provides enjoyment and a suspension of self-consciousness and sense of time. It is self-motivating and makes you want to do it again.

We need the newness of play, the sense of flow, using our imagination, and the energy of being in the moment that play provides.

We also need the purpose of work, the economic stability and sense of meaning it provides and being competent in a role that gives us worth.

Through both play and work, we connect with others and generate strategies, we face challenge and exhibit resilience. If we deny our need to play, we succumb to stress and burn-out which is a feature of our current health and care world.

Curiosity as a Skill Set

Wisdom comes from combining our factual and procedural knowledge, our life experience with situational awareness and utilises active open mindedness with reflection to value view points, appreciate and aspire to change.

In order to create meaning, we need to understand our own minds, the minds of others and the eco-systems in which we exist and ask questions.

Doing what we have always done may feel safe, but it prevents the spark that can lead to new possibilities which can be created through curiosity.

Curiosity improves decision making because it reduces our susceptibility to stereotypes and to our cognitive biases, it fuels our engagement and collaboration with others and fortifies our resilience by prompting creative problem solving in the face of uncertainty and pressure.

Innovation

We encourage staff to “innovate,” yet what does that truly mean? https://www.england.nhs.uk/ourwork/innovation/

The art of innovation is the creativity and curiosity to think outside known parameters and systems. In order to embark on such creative journeys, health and social care organisations must look inwards and ask ourselves questions.

• Where in our organisations, do we value inquisitiveness and play?
• Where in our protocols do we value common sense and intuition?
• Where do we discuss our different perspectives and balance tradition, risk taking and innovation?

In order to change the world, we need to campaign for the right to be curious and use our imagination and play as part of our roles and responsibilities.

So lets co-create play, curiosity and meaning making together

Understanding our own play personality can help us look at ourselves. Am I a collector? a competitor? a creator? a director? an explorer? a joker? a story teller? or use movement in play?

By participating with others and sharing our thoughts and feelings, we can think about how we all come to different choices. By exploring these together, we can generate insight from the analysis of other people’s perspective. By being active learner we can participate in shared activities, ensuring we can understand how we can find a shared meaning and distributed cognition.

As an active learner identifying new ways of being able to approach activities and manage both negative and positive social interactions such as judgement or self-critical thinking helps us feel safe in exploring choices and enabling new possibilities to emerge.

So what Key Performance Indicators capture our culture.

Having an appetite for knowledge and shared understanding creates curiosity. By contrast, when are not curious, we become deceived, acquiring false beliefs which generates rigid structures trapping us and making us feel anxious and distressed.

As leaders and entrepreneurs we need to move beyond the open door policy or our reliance on dashboards and create new mechanisms on how we measure success.

I propose the following:

• Hearing Laughter
• Creative Enjoyment
• A Common Sense of Meaning
• Caring Contact
• Inspirational Activities

By creating active open mindedness and challenging rigid mindsets, by understanding our own selves and that of others and being confident rather than bruised, we can share our thinking and broaden our range of responses by gaining insights from others.

Learning how to learn | Barbara Oakley | TEDxOaklandUniversity – YouTube

So lets relook at the role of play and having fun together, creating a learning journey and seeing the value in camaraderie and coffee!

In the last week, we have had interesting discussions about civility and its role in improving safety and quality of care and was presented at a Freedom to Speak Up conference. https://www.civilitysaveslives.com/

This led to further conversations about rudeness and manners and how those who have good manners seem to do better than those who are impolite.

We also recognise that there are cultural norms and those with neurodiversity that could be disadvantaged within this convention. We discussed how  teaching negotiation skills was critical as part of communication style and that these could bridge these gaps.

The research cited in Civility Saves Lives included randomised trials such as ‘The Impact of Rudeness on Medical Team Performance: A Randomized Trial’ Riskin et al Pediatrics. September 2015, VOLUME 136 / ISSUE 3, where teams participated in a training simulation involving a deterioration in a patient. Participants were informed that an expert would observe them. Teams were randomly assigned to either exposure to rudeness (in which the expert’s comments included mildly rude statements completely unrelated to the teams’ performance) or control (neutral comments). The videotaped simulation sessions were evaluated by 3 independent judges (blinded to team exposure) who used structured questionnaires to assess team performance, information-sharing, and help-seeking.

Rudeness had adverse consequences on the diagnostic and procedural performance of the team and other research also reinforces that effective communication is critical for patient safety and threats to communication such as incivility should be eliminated from our organisational culture.

“Incivility often occurs when people are stressed, unhappy, and rushed. When these coincide, anything can happen. Incivility erodes self-esteem, damages relationships, increases stress, contaminates the work environment, and may escalate into violence.”

People are less creative when they feel disrespected, and people will reduce the quality of their work ‘quiet quitting’ or even resign.

Understanding how to negotiate may create different communication strategies available to us as an alternative to rudeness when under stress. It is noticeable that these are not taught in our traditional health and social care environments.

Negotiating Skills

Competitive      

This competitive style which is often seen in our environment prioritises outcomes, adopting a position to succeed in goal achievement at the compromise of relationships. It can be characterised as a win-lose strategy.

Collaborative    

The collaborative style of negotiation reflects a high importance for outcome, and a high concern for the relationship. This strategy tries to identify win-win opportunities and creates out of the box thinking to generate positive outcomes.

Accommodating              

The accommodating style of negotiation reflects a low importance for outcome, but a high concern for the relationship and can be referred to as a lose-to-win strategy, where the accommodating party will back-off or give-in to preserve the relationship.

Avoiding             

The avoiding style reflects a low regard for both outcome and relationship. A person adopting this position will withdraw. While this can be characterised as a lose-lose strategy, it usually involves ignoring the problem or walking away or may be perceived as ‘passive aggression’.

Compromise     

The compromise approach to negotiation recognises both the relationship and outcomes, but rather than creating additional value so that both parties can get what they need, this style will “split the difference”. It is a useful fall-back position but does not always solve the problem.

Other forms of negotiation can be seen as borrowing, where the rules of reciprocity are not followed and solutions are presented as their own, without acknowledging the origin. This contrasts to the ‘con’ which is an unethical style that reflects a high importance for outcome, and deliberately inflicts damage on the relationship in order to achieve that outcome.

https://www.negotiations.com/articles/negotiation-style/

More complex styles of negotiation are captured in approaches such as ‘Walk in the Woods’ which is a method in which the parties identify the problematic issues and resolve the conflict through a systematic four-step process. This method is focused on a multidimensional approach to problem solving through interaction and creativity in order to reach to a mutually beneficial ‘shared solution’ and can be used with groups or between organisations.

The four steps of the ‘walk in the woods’ model are:

Step 1: Revealing Self-Interest

The first step is designed to break the ice between parties. At the very outset, the parties actively listen to each other in a non-adversarial manner in order to reveal the underlying interests of each party. This step helps to build trust, create self-awareness and better understanding between disputing parties.

Step 2: Enlarging Interest

In this step, the parties are directed to identify and list the points on which they agree or disagree. Then, the lists are compared to determine whether the agreements outnumber the disagreements or vice versa. This step helps the parties to focus only on the areas of disagreement and plan accordingly.

Step 3: Enlightened Interests

Once the points of disagreement are recognised, the parties brainstorm to identify preferable completely new and innovative ideas which were unlikely to be considered before.

All the new ideas are then categorised (1 = Consensus, 2 = Ambiguous, 3 = Complete Disagreement). The ideas in Category 2 are further reviewed before finally reaching a decision on acceptance or rejection. Now the parties are ready to approach the final stage.

Step 4: Aligning Interest

This is the conclusive bargaining phase, where the parties prioritise both what they want to ‘get’, and what they are willing to ‘give’. Based on the prioritisation, the parties finally negotiate and reach a conclusion that is mutually advantageous.

We recognise that negotiations often fail because of not understanding each other’s perspective and lack mutual respect. Trust and building relationships to see each other as connected not separate, is part of finding new solutions.

Marcus, L. J., Dorn, B. C., & McNulty, E. J. (2012). The walk in the woods: A step-by-step method for facilitating interest-based negotiation and conflict resolution. Negotiation Journal , 28(3), 337-349

When people become frustrated, rudeness is often seen and where this appears within teams or organisations, toxic cultures at work are the result.

Bullying, fear and burn-out are all consequences and further cause mental health challenges and distress. This leads to NHS safety (or wider organisations) issues and quality of care suffers.

In order to address culture, we need to relook at our human side ensuring psychologically safe spaces and consider how kindness, respect and empathy as a strategy are important foundations. Role modelling, coaching and understanding ourselves, others and the world we work in, alongside negotiation skills and creating a shared perspectives can enable us to move forward.

I have rewritten this in line with the understanding on delivering supervision to our workforce and its role in creating confident practitioners who are able to be flexible in a changing landscape.

As part of our Wisdom Academy, we have delivered educational content to support continuous improvement and a personal learning journey. At the heart of this is the art of reflexivity moving away from reflection.

Uncertainty is not valued in our systems and we are taught frameworks that believe in right and wrong answers, yet we live in an uncertain world where decisions need to be made based upon our experience, emotional responses, intuition and instinct and is a skill which needs to be practiced.

So this blog is to think about how we view the world, make decisions and are able to look at things in new ways using supervision as a forum to develop this talent.

Healthcare has become increasingly complicated creating systems designed to reduce risk and improve quality. We produce new policies, additional risk assessments, templates, pathways and procedures. Every intervention is created with good intent: to make people safer and reduce uncertainty.

Yet there is a paradox.

As systems become increasingly designed, the people working within them often describe feeling increasingly overwhelmed. The answer to uncertainty frequently becomes more information, more documentation and greater procedural control, despite the reality that no human being can consciously hold an ever-expanding number of competing activities in mind at one time.

There appears to be an underlying assumption within many systems: if we can sufficiently control process, we can sufficiently control outcomes.

But human life has never worked in this way.

People do not live in predictable environments. We live in a world of changing relationships, competing priorities, incomplete information, emotions, power structures, histories, beliefs and contexts that continuously evolve. The reality of practice is not linear; it is dynamic and uncertain.

From early education onward, we are often rewarded for certainty. We learn that there are right answers and wrong answers. Competence becomes associated with knowing the right answer. Expertise becomes associated with confidence. Errors become associated with failure.

Yet professional life often asks something entirely different of us.

It asks us to make decisions before we possess certainty.

It asks us to act while information remains incomplete.

It asks us to tolerate ambiguity whilst carrying responsibility for others.

This creates tension.

Because while organisations frequently seek standardisation, human beings navigate the world through judgement.

Long before we consciously think, we are already experiencing.

We are scanning environments for threat and safety. We are noticing emotional signals. We are recognising patterns from previous experiences. We are responding to relationships and social expectations. We are attempting to understand our place within groups and systems.

Only afterwards do we often create a rational explanation for what occurred.

The story we tell ourselves frequently arrives after the decision has already begun.

This is important because many of our approaches to reflection assume we can simply revisit an event objectively and identify where things went right or wrong.

Traditional reflective questions often ask:

“What happened?”

“How did you feel?”

“What would you do differently?”

These are useful questions.

But perhaps they are not sufficient.

Because they risk creating the illusion that events emerge from isolated decisions rather than from interaction between individuals and their environments.

Perhaps a deeper question is:

“How did I come to understand the world in this particular way?”

This moves us from reflection towards reflexivity.

Reflection looks backwards.

Reflexivity looks inwards and outwards simultaneously.

It asks:

• What assumptions was I carrying?
• What was I paying attention to?
• What did I fail to notice?
• Who held power?
• What emotional responses were influencing me?
• What did my environment encourage me to do?
• What previous experiences shaped my actions?
• What possibilities was I unable to see?

This matters because professional practice does not emerge solely from knowledge.

Two people can possess identical information and arrive at entirely different conclusions.

Not because one is necessarily right and the other wrong, but because human beings do not simply process facts; we interpret reality through different lenses.

Perhaps this is where restorative supervision becomes important.

Restorative supervision is often described as creating emotional safety and providing a space for support and wellbeing. This remains critically important. Human beings do not learn effectively when operating in states of shame, fear or exhaustion.

However, emotional release alone may not be enough.

If supervision simply becomes a place to feel better before returning unchanged to the same thinking patterns, we may reduce distress without increasing understanding.

The deeper opportunity within restorative supervision is not only restoration. It is discovery. It becomes a space where uncertainty can be explored rather than removed. A space where people can say “I do not know.”

This requires psychological safety, but perhaps more importantly it requires openmindedness.

To do this, we need to move beyond seeing ourselves as detached observers of events.

• We need to understand ourselves as participants within living systems.
• We influence situations and are influenced by them simultaneously.
• We shape environments whilst environments shape us.
• To notice our own reactions.
• To recognise assumptions.
• To listen to perspectives different from our own.
• To tolerate discomfort.
• To remain curious.
• To create space for imagination.
• To continue asking questions.

Mastery in complex environments may therefore have little to do with achieving certainty. Instead, it may involve developing wisdom: the ability to integrate facts, experience, emotion, intuition, relationships and context into action.

By understanding our own minds, that of others and the context we are able to make sense of complexity.

Expanding our questions

I propose the following questions to ask yourself wehn writing reflexive accounts.

• What was I paying attention to?
• What was going on that I was not aware of and do I have a sense of this?
• What did I feel and was it a stress response?
• What was my mind thinking?
• What was my body doing?
• How was I connecting to others?
• What was I saying?
• Was this in any way related to knowledge that I have been taught or acquired somewhere?
• Was this in any way related to processes, procedures, custom and practices which I followed?
• Was this in any way connected to wanting to do what others wanted or rebel from what others wanted?
• Who held the power in the relationships?
• Who else has relevant ideas and what would they say?
• What did the context tell me – what is the unknown or the surprise?
• Did I use my imagination to identify a way forward from first principles?
• Did I use intuition and felt it to be right or wrong?
• How did this align with my values – did it feel fair or unjust?

Using a wider questioning technique allows us to understand our experience.

Through self discovery and practice, we will become more confident decision makers to make decisions.

The relationship between leadership, management and organisational performance is well recognised. Less discussed, but equally important — is the relationship between leadership and followership, and how both shape culture, safety and success.

Over time, I have become increasingly interested not simply in leadership itself, but in the ethical responsibilities that sit beneath it: servant leadership, values including gratitude, stewardship and the ability to both lead and follow well.

No one leads all the time.

Even those in senior leadership positions are still followers in many aspects of life. We follow legislation, professional standards, evidence, system leaders, communities and values. We are influenced by those who model integrity, courage and humanity well.

For me, leadership has never been about status or authority. My natural style is servant leadership, creating opportunities for others, supporting people to grow, and trying to build environments where individuals feel valued and able to contribute fully.

At the centre of this approach is servant leadership and gratitude.

The strongest organisations I have experienced are rarely built around charismatic individuals. They are built around communities of people who feel connected to a shared purpose and who understand that every individual matters.

This is where followership becomes important.

Followership is not passive compliance. Good followership requires judgement, courage and integrity. It means understanding the mission, contributing meaningfully, challenging ethically when needed, and supporting collective goals even when circumstances are difficult.

When followership breaks down, organisations become distracted and fragmented. Morale falls, opportunities are lost, and quality and safety can suffer.

Good followers — much like good leaders — demonstrate:

• Ethical judgement
• Competence and accountability
• Honesty, trust and courage
• Engagement and critical thinking
• Compassion for themselves and others
• A willingness to support growth and change

Leadership and followership should never exist in opposition to one another. They are interdependent.

This aligns closely with the philosophy of servant leadership first described by Robert K. Greenleaf in 1970:

“The servant-leader is servant first.”

That idea continues to resonate today.

Servant leadership is less a toolkit and more a mindset. It asks leaders to place service before ego, influence before authority, and stewardship before control.

For me, servant leadership means:

• Listening before directing
• Creating space for different perspectives
• Supporting others to succeed
• Leading with humility rather than status
• Taking responsibility for the culture we create
• Recognising that people are not simply resources, but human beings with strengths, vulnerabilities and potential

Importantly, servant leadership is not about avoiding difficult conversations or unpopular decisions. Leadership still requires accountability, challenge and clarity. However, those actions can still be undertaken with kindness, fairness and respect.

I also believe leadership styles must adapt to circumstance. In crisis situations, more directive approaches may sometimes be necessary. But even then, our ethical principles should remain constant.

The leadership attributes I value most are:

• Justice
• Humility
• Trust
• Respect
• Shared vision
• Collective responsibility
• Gratitude

Perhaps most importantly, we must recognise the power of collective voice.

Real and lasting change rarely comes from one individual alone. It emerges when people feel heard, connected and empowered to contribute. Communities, teams and organisations become stronger when leadership is shared and when people believe their voice matters.

Some of the most meaningful leadership moments I have witnessed have not involved authority at all. They have involved courage, compassion, honesty and ordinary people choosing to support one another well.

In increasingly complex and uncertain systems, that may matter more than ever.

I am reviewing this blog, a year or so after its initial writing and pleased to say psychological safety is embedded at Board level and how we enable it at a frontline.

What is psychological safety?

Psychological safety creates a space where we are included, safe to learn, safe to contribute, and safe to challenge the status quo – all without fear of being embarrassed, marginalised, or punished in some way.

Stage 1: Inclusion Safety

Inclusion safety satisfies the basic human need to connect and belong. Inclusion safety allows us to gain membership within a social unit and interact with its members without fear of rejection, embarrassment, or punishment, boosting confidence, resilience, and independence.

Stage 2: Learner Safety

Learner safety satisfies the basic human need to learn and grow. It enables us to feel safe as we engage in all aspects of the learning process—asking questions, giving and receiving feedback, experimenting, and when we make mistakes.

Stage 3: Contributor Safety

Contributor safety satisfies the basic human need to contribute and make a difference. We lean into what we’re doing with energy and enthusiasm. We have a natural desire to apply what we’ve learned to make a meaningful contribution.

Stage 4: Challenger Safety

Challenger safety satisfies the basic human need to make things better. It’s the support and confidence we need to ask questions such as, “Why do we do it this way?” “What if we tried this?” or “May I suggest a better way?” It allows us to feel safe to challenge the status quo without retaliation or the risk of damaging our personal standing or reputation.

https://www.leaderfactor.com/4-stages-of-psychological-safety

So how did we reach challenger safety as a team in Nurture Health and Care Ltd and in The Maslow Foundation.

Shaney Ann and I will share our experiences of creating challenger safety in a new business.

We recognise we are small teams however we still practiced the skills to role model psychological safety.

We have become used to teams that are resistant to change and leaders who are frustrated or through fear, shut down and create distrust and their teams who feel over-whelmed and ‘stuck’ unable to find new solutions.

What we have discovered is that our own teams are flexible and excited to try new ideas and experiment.

Our values in the two organisations have psychological safety at their heart, directly in Nurture Health and Care Ltd, with Belonging, Creativity and Ambition. The Maslow Foundation built on Maslow’s Hierarchy of Needs, recognising that belonging and safety are crucial which creates self esteem and Hope, Joy and Meaning.

Our meetings start with what our joyful moments and what we are proud of and although initially was an alien experience, learning about each other outside work and appreciating and celebrating our experiences enables us to understand each other and gave us the opportunity to support each other when things were hard in the outside world. A year later, we have not continued the agenda item but it is noticed.

We have held our meetings in great locations, included our families and have organised opportunities to have fun together.

How do you create inclusion safety?

We believe passionately that every person has value, has strengths which we can champion and as facilitators in meetings, ensure that those who may feel an outsider are enabled to have their voices elevated. Those who are shy, are enabled to sharing their opinion. Those of us who have opinions, stand back and listen.

We practice embracing differences of opinion, differences of style and sharing personal information about ourselves which started with our profiles – and I was proud to be a warrior!

Everyone was welcome – there are no silly questions and no ego.

Inclusion safety is created and sustained through proven acceptance and respect to the group. This reinforced why onboarding is critical when we recruit and this includes an introduction to your group and as leaders we should demonstrate how important you are to that group. A year later this is more embedded, with our investigation model includign equity of voice and co-production at the core of the Maslow Foundation.

How do you create learner safety?

As some-one who loves learning and is constantly exploring the world, I have taken on board philosophy, technology and really seen the value of proactively role modelled note taking, sharing what I learn and most importantly identifying when I was wrong and when I felt I had changed my mind.

I do need however to remind myself that others experience of learning is often traumatic with failure being showcased and ridiculed and challenged their self esteem.

Our teams bravely collaborate and demonstrate exciting moments of discovery. Our teams always exceed our expectation and imagination.

We need to practice being quiet and allowing others to express their own ideas, disagree and not only champion our own ideas which often do not have the quality of our collective wisdom.

We showcase our wrong assumptions and errors so we can feel confident in the reactions of others when things do not go as planned.

A year on, learner safety continues to be a challenge as people feel strongly about that evidence base and process is the way to understand. Our introduction of a module on psychological safety and reflexivity is important for Nurture Health and Care Ltd, whereas understanding how are own minds work forms part of the core training for The Maslow Foundation.

The joy we experience by watching others thrive beats any other investment that we have made. Realising how every person brings greatness to our team is inspiring.

How do you create contributor safety?

Within our small teams, we moved away from job descriptions and accountability to what things have we got to do this week and who is best at what.

We know that it is our differences that enable great ideas to be formed and that the totality of tasks were completed by those who enjoyed them most. Paul Jennings (Operations Director -Nurture Health and Care Ltd) became our telephone agitator chasing placements, James Westwood (CEO – The Maslow Foundation) enabled us to bring together the diverse voices of a team and ensure we all pull together in the same direction.

We ensure everyone has a role and aligned this to their strengths and talents and we mucked in and celebrated our achievements.

In a nurturing environment that offers respect and permission, we entered the stage of contributor safety, which invites us to participate as an active member of the team. Contributor safety is an invitation and an expectation to perform work in an assigned role with appropriate boundaries. Competency and mastery is another topic on which we have blogged.

Contributor safety is another area which is currently an area of development as by creating independence and respect but still not a frontline team that feel accountable leads to decision making which often prioritises the staff not the clients. Our current training delivery is hoping to create self-discovery of accountability alongside freedom to make choices.

How do you create challenger safety?

The final stage of psychological safety allows you to challenge the status quo without retribution, reprisal, or the risk of damaging your personal standing or reputation. It gives you the confidence to speak truth to power when you think something needs to change and it’s time to say so. Armed with challenger safety, individuals overcome the pressure to conform and can enlist themselves in our improvement processes.

If you can banish fear and create a nurturing environment that allows people to learn and grow, they will perform beyond your expectations and theirs. Our mission is to ensure we have clear activities and goals and a shared purpose to enable us to deliver results.

I feel as leaders we can be flexible in our approaches and offer many different styles of leadership however for us the presence of fear in our teams, is a failure of our leadership.

At all our meetings, we are able to explore what went wrong alongside what went well safely and consider why this was and learn. This creates a feeling of positivity and moving forward.

The bi-product of this successful adoption of practice also means as the leadership team, we are the first to be criticised so therefore being able to absorb this and create new solutions that can be co-produced.

What prevents human flourishing?

In blogs I have discussed power, desire for individual merit or organisational greed, and the need to work with collective wisdom to enable us to navigate the complex unpredictable environments in which we work. It is connection, not targets that allow us to flourish.

Creating silos of activity is not our normal response to situations. Belonging and connection are far more valuable however our own insecurities and need to feel good enough or the power dynamics leads to exclusion. When we form communities, this leads to differences and loyalty to the group. In our society, this leads to different niches, teams, organisations and systems and comparison becomes embedded, empathy is ignored and fear or envy emerge. Conflicts then start and the impulse to win, compete and foster malice appear.

 ‘Ironically, in our digital age, we connect and feel alone, compare and feel inadequate’.

Understanding how we are all amazing and that we all belong to the same community overcomes this desire for separation.

Looking at the stagnation of statutory bodies and watching commercial organisations that fail, they frequently cannot change and respond to new sets of circumstances. They are entrenched in habits, custom and practice and create infrastructure which continues the status quo.

The NHS momentarily in COVID gave permission to transform, pivot and change regardless of results but this quickly reverted to blame and sanction.

The process of challenging the status quo should experience conflict, disagreement, and sometimes chaos. When there is punishment and intellectual debate turns into interpersonal conflict, when fear becomes a motivator, the process collapses and people go silent.

How to create Psychological Safety in your team

• Start with yourself, admit that you are human and make mistakes and that we do not have all the answers.
• Be grateful for things the team do for you and others.
• Talk about non work-related matters with your team members and recognise its value.
• Talk about our feelings, we have trapped ourselves into third party communicators divorced from our emotions, but understanding our thoughts AND feelings is important to enable people to reach their potential.
• Make psychological safety an explicit priority, facilitating people to speak up, practicing celebration of things going wrong so we can manage experimentation and ‘reasonable’ risk taking and creating space for new ideas, especially out of the box thinking.
• This builds trust and underpins psychological safety.