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.

You can change an organisation to adopt a new culture changing people in organisations to be cultural architects and you can create whole systems change through culture.

We know that this is achievable as we watch social influencers, technology companies and people adopting their latest craze and we see transforming communities across the world. They use technology, phones and self driving cars. We have a computers on our wrist and wecommunicate virtually.

So transformation is possible, happens and is achievable.

So why has changing organisational culture been so challenging.

Many of these blogs explore why we have found change so challenging.

We have put systems, policies and processes in place, hoping these will enable us to implement change however change is about people, with a shared mission not rules.

What are the first steps?

To create a different culture, we need to share a common vision. This vision needs to make sense and be logical. Even where individuals, are sceptical, they can be followers and build the foundations as a legacy for the future.

The flip side of leadership is followership.  It stands to reason that if leadership is important, followership must have something to do with it too.  But curiously, followership is not spoken about and will be negatively framed as ‘sheep’ and ‘being easily led’.

Followership is the ability to take direction well, to get in line behind a plan, to be part of a team and to deliver on what is expected of you. 

Good followers have a number of qualities:

• Judgement

Followers have an underlying obligation to follow only when the direction is ethical and proper.

• Work ethic, competency and being a team player

Followers are diligent, motivated, committed, pay attention to detail and make the effort to participate.

• Courage

Good leaders are grateful for constructive feedback and followers need to have the courage to be honest and share wisdom and experience

We need to understand how to include, not exclude individuals, and create a momentum of change which embraces followship alongside leadership.

Using this strategy of enabling people to step back and see the wider picture, identifying threads and relationships, a new common vision, goals and behaviours can be achieved with shared understanding.

Do not underestimate the dynamic of Power

Power lies at the heart of change and understanding where power is held or who is experiencing marginalisation is critical to success.

Power in organisations is often captured through professional identity or department identity but can be economic, political, social, cultural or symbolic. People’s experiences of power depends on their identities, related to age, gender, race, class, ethnicity, religion, sexual orientation or disability status.

A common conception of power is control over others, having authority and control over individuals, groups or institutions which can be backed up by action – often loss of a job.

Visible power is when decision making is observable and leads to formal and recognisable rules, laws, structures and procedures.

Resistance is a form of power often influencing of the agenda from behind the scenes.

However, power is subtler and can be positive.

• Collective Power is the strength and capacity gained from joining others in working towards a common goal.

• Power within is personal self-confidence and role modelling can be a form of power.

• The norms, values, attitudes, beliefs and ideology that shape a person’s way of thinking can influence decisions and form a powerful opportunity.

So looking into the organisation to identify how power can be understood and utilised to create a positive optimising effect is important.

What is Needed to Build a New Culture across Systems?

To create whole system transformation, organisations need to share a common vision, role model successful application and create win:win changes recognising the value we all bring to the whole community.

We can create powerful workforces to drive change and role model improvement.

Finding Inspiration in a Journey

With cultural change, embrace the journey and focus on making small, incremental steps and work closely with your workforce to create a movement of change.

Even when you are struggling, walking creates a pathway of footsteps and others can follow.

Listening to Steven Bartlett’s podcast: The Diary of a CEO, he discussed how time is more precious than gold and diamonds and yet we do not think about time as a precious resource.

If you google the qualities of an ‘inspirational leader’, you will rarely see the word patience.

Patience means having time to ask questions, explore answers, and going with the flow to see what happens.

Patience helps you resist the tendency to create urgency when there is none, allowing space and time for creativity, insight, and judgment. It is more than time management.

Patience has contributed to many great leadership successes. Gandhi demonstrated extraordinary patience in working for a free and independent India. For more than thirty years, Gandhi worked, never varying from his commitment to non-violence. His patience resulted in a free India.

This reminds us, big ideas will take years to achieve.

This made me think about my own relationship with time.

• I am often impatient, achieving goals and enjoy the positive feeling of the energy of ‘doing’.

However, this leads to poor decision making, without considering the consequences of quick decisions. In addition, completing the actions yourself, prevents others from achieving their own successes and worse still usually is a short term fix.

• I have practiced being patience, both as a strategic leader and entrepreneur. This means focusing on the long term vision and understanding our purpose.

We need to have the ability to wait to achieve our longer term goals, staying calm in the face of disappointment and creating space to think when we are processing urgent decisions especially in face of risk and uncertainty.

• Time Management, is more than understanding what to prioritise, how to delegate and consider when, what and where we schedule our attention. We also need to use every minute wisely.

 My view is that you can only juggle 3 big actions at any one time and wisdom requires space for reflection, free from the distress of anxiety.

We should end our working days positively so doing the hard things in the morning and fun things later are simple tips for creating a better day.

Strategies such as do, dump, delegate or delay for the to do list are a good way to organise the tasks and decisions.

The unintended consequence of instant gratification?

In leadership, the expectation is to take action quickly and decisively, creating action plans and targets to measure compliance. Patience is often thought of as a weakness and considered as being slow and sometimes even incompetent.

Split-second decisions and moving on to the next problem becomes the norm but this means that often the incorrect actions are taken and there is not time to reflect or alter the direction of travel.

People demand action and the greater the crisis, the greater the push to act! A leader who makes the decision to wait, has to wait for the time to pass to see success but often businesses move staff on before we see results.

Patience should not to be confused with inactivity – far from it, patience requires overwhelming effort, not to jump in and react.

Many of the roles and responsibilities associated with leadership require patience!

• People Management and the ability to continuously notice the small things, celebrate achievement but manage poor performance takes enormous energy and patience.
• Strategic planning and the understanding of a wicked issue requires thought and patience and may take years to resolve.
• Collaboration, building the wider community or networks of people and organisations takes time to build trusting relationships.
• Changing Behaviour and organisational culture is not a quick fix.

So despite the importance of patience, many senior leaders, especially those whose careers are in rapid ascent, need results for their portfolio and become distracted for short term glory over long-term results.

Self-awareness and giving yourself permission to wait, is an important skill to build.

The more self-aware you are, the easier you will recognise the warning signs of impatience, such as quickened pulse, growing irritation or a sense of jumping in to save the day. You will be able to counteract your physical reactions by using strategies to delay decision making and just by taking some deep breaths or mindfully adjusting unhelpful behaviours and destructive thought patterns, you can change your own actions.

So in conclusion, time should be treated like gold and patience an important leadership skill.

Our current landscape of organisations appear unable to change, are overwhelmed by the unpredictable and struggle with the current regulatory oversight. There are significant pressures in workload and workforce with toxic culture continuing to feature in serious case reviews and in wider national reports.

The Patient Safety agenda which champions ‘Just Culture’ and ‘Being Fair’ ensuring that we are learning organisations bult on continuous improvement.

How do we make a difference?

I am a fan of the rule of marginal gains and believe we have to remember no change is an overnight transformation but often a series of small positive steps over time.

Click to access ABriefGuidetoProcessImprovement-2.pdf

How can we make a difference every day?

Understanding the principles of wisdom is a strong foundation to doing something different everyday.

With distributed wisdom, shared risk and psychological safety as our new core knowledge and skills, we are able to create change in our organisational culture and do things differently.

Just a reminder about how our bodies are geared to scan for danger!

As humans, we are evolved to be able to feel safe and connected to others.

An understanding of our nervous system gives us insight into why we we often feel danger, overwhelmed and anxious and have poor habits of defensiveness and conformity.

When you see a danger, our nervous system leaps into action.

If any of you have the opportunity to see Zoe Lodrick, please take the time as she will present the trauma response in a way that you will never forget.

https://www.zoelodrick.co.uk/resources

This has been called the “fight, flight, freeze, flop and befriend response,” and is managed by the sympathetic and the parasympathetic nervous system.

We may fight back (verbally or physically), or we may retreat. When we feel as though we are in danger, we may shut down and “freeze up.” Reactions can also include dissociation and behaviours such as ‘befriending compliance’ are all strategies to keep us safe.

All these responses have evolved to maximise our chances of surviving life-threatening situations but we are still using the same strategies and patterns whenever we are confronted by our modern day challenges.

Being connected to people creates a feeling of safety which is part of our evolution and a critical element to be present for our own wellbeing.

Our workplaces have become complicated systems which often create fear and therefore anxiety. We become defensive, withdrawn and compliant.

Before we can do anything different, we must create psychological safe spaces in which to thrive and this forms the basis of a ‘trauma informed culture’.

Psychological Safety First

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

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 allows us to feel safe as we engage in all aspects of the learning process—asking questions, giving and receiving feedback, experimenting, and even making mistakes, not if but when we make them.

Stage 3: Contributor Safety

Contributor safety satisfies the basic human need to contribute and make a difference. When contributor safety is present, we feel safe to contribute as a full member of the team, using our skills and abilities to participate in the value-creation process.

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.

Then when you feel safe – we can move forward with doing something better every day through the principles of wisdom.

Wisdom builds on our factual knowledge and procedural compliance.

We manage uncertainty through being open minded and having humility and taking the time to understand others perspectives.

This enables us to craft a collective narrative which is adaptive and flexible. It takes into account the context of the situation and welcomes risk and uncertainty.

However even where we have wise people, with collective discussions, in safe spaces – we still need the aspiration to change!

Over my career I’ve written, reviewed and formally evaluated loads of job descriptions and specifications.

I have interviewed and onboarded many people and realise that the use of job descriptions is a long list of tasks but not inspiring or reflecting our workforce and their strengths.

Job specifications on the other hand are critical but should focus on behaviouurs we would like as muich as skills that we need. How people then evidence these creates insight.

In a strength based inclusive workforce, do we need to reconsider job descriptions?

When you are embedding positive psychology, strength based practices and inclusivity, I realise how damaging job descriptions can be!

They are static documents which box people in – they don’t encourage innovation or personalisation and are often are used as a reason for why they cannot go the extra mile.

They are out of date as soon as they are written.

They are often works of fiction – they don’t describe how a job is actually done.

They don’t capture the true value or purpose of a role.

They get lost in the organisation Human Resources files.

If our weaknesses are celebrated and accommodated – does a job description work?

I believe the job description prevents inclusion.

They limit a sense of personalisation, individuality and personal growth which are the very things that give people joy and meaning.

They tend to be used if we are trying to flag an area of performance and form part of the performance management process.

They are often used by those employed, to refuse to do something new as it is outside their job description.

What’s the alternative to a job description?

If job descriptions aren’t fit for purpose and don’t reflect our modern ways of working what’s the alternative?

In The Maslow Foundation and Nurture Health and Care Ltd, we are describing our purpose, identifying the gap that is needed and the vision we have and asking our teams to define their own job roles and personal development plan including their own measures of success.

We believe in dynamic teams which work together to achieve goals, building on individual strengths and accepting our weaknesses. The wider team absorbs the needs of the organisation and we pull on our team mates to achieve success.

We are job crafting, creating mastery and supporting our strengths with a plan for those areas we find challenging.

We can create opportunities to achieve balance and ‘flow’ in our work. This needs appropriate levels of stretch with problem solving and challenge and should create opportunities to network and connect with others.

We believe you can have accountability and clear achievement of goals with good communication and a healthy action plan when the ‘to do’ list is divided amongst the team.

We have written our own ‘job canvas’ and this includes identifying our challenges, building on our strengths and identifying our goals to achieve in the next 3-6 months which align with the organisational vision.

Many roles include core competencies to be able to be safe and effective but these can be captured in a competency framework. We record our Mandatory and Statutory training and our compliance with legislative and organisational policy in our education portal and staff handbook.

So lets roll out job crafting and include in our job canvas, our passions and ambitions, with innovation and quality improvement documented with our values and shared goals.

https://tailoredthinking.co.uk/jobcrafting

Choose a job you love, and you never have to work a day in your life                         Confucius

In order for our teams and staff to achieve their very best, we can create a sense of fun and happiness in our workplaces. This is often referred to as positive psychology and encourages a strength based focus to our practices.

I believe that we have forgotten how to do this so we need to learn to have fun again.

• How can we enjoy doing the tasks assigned to us, do them better and in new ways if we feel change is needed?
• How can we feel we belong with those who we are working alongside?
• How can we feel respected and noticed?

Happiness at work is critical and those who spread happiness and joy enable others to be motivated and build positivity in our teams.

When we become stressed, we lose focus, and have negative thoughts like “I have to quit”, “I cannot take it anymore”, “I am not worth it”. This drains our teams of energy.

Finding happiness and fun encourages team building and enables people to work together for the common good.

Self Determination theory identifies that individuals need autonomy, need to be competent and connected to others in order to be motivated.

• Problem solving and creativity can be completed in brainstorming in our teams.
• Team work can create recognition and conversation allows time to explore others views.
• Success in noticing our achievements is important.

Making Change Happen

My experience of being in a strategic leadership position, is that as a team, you have an idea which needs to be implemented but then gets stuck in roll out and fails to embed. The Ockenden review and many national reviews all show that there is a failure to change practice despite an overwhelming reason to do things differently.

I feel that rather than speeding through our action plan, which is the expected approach when recommendations are requested to be implemented.

These often build on a library of recommendations, audit action plans, continuous improvement projects: https://www.hssib.org.uk/patient-safety-investigations/recommendations-but-no-action-improving-the-effectiveness-of-quality-and-safety-recommendations-in-healthcare/report/#:~:text=The%20Recommendations%20to%20Impact%20Collaborative%20Group%20(referred%20to%20in%20this,recommendations%20made%20by%20other%20organisations.

How do we alter this – we need to step back and empower others to find their own path to creating solutions.

As part of Nurture Health and Care Ltd and our new investigation strategy, we have introduced the concept of Safety Bridging Statements.

Traditional investigation recommendations often aim to be decisive and reassuring. But in complex health and justice systems, they can unintentionally oversimplify problems that are anything but simple.

A single recommendation can imply there is a single fix. In reality, safety failures usually emerge from interacting pressures: workload, environment, policy, culture, technology, and human judgement, all evolving over time.

Safety Bridging Statements are our response to this complexity.

Rather than prescribing a fixed solution, a Safety Bridging Statement:

• Names the system risk clearly
• Explains why it matters for safety
• Creates a bridge between learning and action
• Invites discussion, design, and local ownership

In other words, it shifts the question from
“Have you implemented the recommendation?”
to
“How will this risk be understood, addressed, and monitored in your context?”

This approach recognises that:

• Different organisations face different constraints and capabilities
• Sustainable safety improvements are co-designed, not imposed
• Learning is strongest when professionals are engaged, not instructed

This is how investigations move from closing cases to opening conversations and from compliance to learning.

As projects grows in complexity and size, there will need to be more oversight but by creating insight in our teams, we will enable achievement of real change.

Project Management, Leadership and Followship

Even with improved project success rates and more technologically advanced tools project management tools including the introduction of artificial intelligence, organisations face many complex challenges in setting and achieving their strategic goals.

Management is all about creating stability and embedding systems and processes.

Leadership is about achieving change.

We rarely remember the critical elements of inclusion and followship in creating sustainable change.

I am interested in the concept of followership as a positive asset alongside leadership skills and project management. This should be inclusive and representative for the whole team and the community they serve.

Psychological Safety and Insight

Improving the teams ‘productivity’ and ‘efficiency’ is a difficult task to achieve.

Is this the correct language to use when we are looking at improvement in a humanistic service.

Teams are made up of human beings, people often with diverse personal culture, different skills, strengths, weaknesses, and different personalities so creating safe spaces to discuss and plan is the skill that we want to expand.

Participating in teams, both as a leader and a follower requires an open mind, the ability to listen and being open to challenge.

Providing a safe space where each individual can thrive creates a happier team who can be more creative and ensures a supportive environment which enables insight.

Psychological safety and the different models all enable people to feel included, to enable participation and challenge.

If we create fear, which is often where the culture is grounded in criticism; this is where we get stuck, fearing the outcomes of change which prevents us from fully participating in the solutions.

When our teams feel comfortable asking for help, sharing suggestions informally, or challenging the status quo without fear of negative social consequences, we are more likely to innovate quickly, unlock the benefits of diversity, and adapt well to change.

Leaders build psychological safety by creating the right climate, mindsets, and behaviours within their teams. People should be able to be honest, authentic and trust is created through a consistent, predictable and safe space.

By empowering your team to be the best they can be and enabling them the freedom to define their own journey to a shared vision, we can create new ways of working and embed the insight from all.

Building a team is a common area where mistakes are made as we recruit or choose skills and pick the ‘doers’ rather than recognise the wider characteristics which are important for a happy and productive team.

We can always bring in individuals with specific skills and expertise later.

There are a number of models which consider the way that we work together.

Belbin Model: https://Belbin.com/

• Action-oriented roles
• People-oriented roles
• Thought-oriented roles

Debonos Thinking Hats: https://www.debono.com/

• Blue Hat: organisation and planning
• Green Hat: creative thinking
• Red Hat: feelings and instincts
• Yellow Hat: benefits and values
• Black Hat: risk assessment
• White Hat: information gathering

With my own summary of people having strengths in relation to:

• Exploration
• Connection
• Creativity
• Achievement
• Risk Spotting

We need all of these ways of thinking to be captured within our teams.

We need our explorers to look for the data, being interested in the world and giving us information for us to act on.

We need our creative thinkers to create solutions and think laterally to consider options.

We need our connectors to see the positives, to be able to engage with others and bring people together to collaborate with our vision.

We need our achievers, who can identify the processes we should follow, create our action plans and hold us to account.

We need our risk spotters to prevent us from making mistakes.

By considering the strengths and weaknesses of each individual, we can organise our teams in a way that utilises everyone’s talents and fosters productive and creative collaboration.

No project or challenge will be achieved through one way of thinking and only by recognising and celebrating our diversity of talent will we succeed.

From my experience, we need to deploy a team with shared values which allows working together with a shared sense of purpose.

Where values are in tension, there will be a difference of professional opinion and conflict ensues.

Understanding the values of your team is critical. As a team leader. we must be able to identify our own values and that of others to ensure that we achieve our aims and objectives.

As a leader, we must role model the values we have identified as important.

Your values not only describe your character but reflect your uniqueness. They will showcase your strengths, your motivation and your purpose. Working to your values will provide energy to be happy and resilient.

So to create a team we must:

• Understand what our purpose is as this will ensure we all are travelling in a similar direction.
• Understand who in our team can create positive energy and harness their motivation but also understand those that challenge the status quo and understand their perspective as this enables development of strategies to avoid negative outcomes.
• Use values to motivate and understand complexity

Once you have thought about your wicked problem, you have brainstormed and explored the topic and spoken to lots of people to create a diversity of perspective, you are ready for next steps.

You will have analysing the data, considered possibilities and can create a purpose statement. By identifying your vision or creating a mission statement, a shared purpose can be identified.

Even a quality improvement project, needs a purpose.

The purpose tends to guide a direction of travel rather than be a specific goal which will give you the ability to flex and bend to achieve success.

If you are struggling, consider the following possibilities:

• Achievers: Do you want to be the biggest or the best at something.
• Explorers: Do you want to know the most about a subject or create new knowledge. This can also be inventing or developing something new.
• Connectors: Do you want to create a community and influence change.
• Self Expression: Do you want to empower others to achieve something specific.

Once this has been identified – you can pull together the right team to succeed.

What are the next steps when you have an idea for a quality improvement project, a business case or an entrepreneurial opportunity? We can all be that person who changes things for the good.

I love this video that shows if children can come up with great ideas: we can too!

Many of us feel that we are not able to identify new solutions or turn an idea into action.

Every idea and project needs to consider who are the individuals and groups that are intrinsic to the solution. We need to consider how we can connect and enable everyone to be heard.

Our role as leader is to understand how we can hear wider viewpoints. This is really important and often forgotten.

 We need to explore and understand the problem (market research).

Being able to use your senses and talk to others to explore the problem. You need to dissect the problem from all angles – see it, feel it, move it around, touch it and listen.

When looking at the problem, consider it free from the system it exists within.

Ensure you are listening to all the voices and be aware of the power people and systems hold.

By creating neutral safe spaces, we can hear peoples truths and limit interpretation through our own lens of experience. Then we will ensure that we identify all the data that can inform our solution.

Finally, be kind with the time frame!

We should always give ourselves longer than we anticipate.

My personal experience is that although local improvements can be delivered in a few months, every project has to embed and if we are not careful your new idea will rapidly return to the previous status quo.

The need to embed and champion the change often takes two or three years of constant reinforcement to ensure that your great idea becomes part of the fabric of our service.