by Marcus Powell
The NHS Confederation conference last week was a busy affair; quieter, I’m told, than previous years but nonetheless a meeting place for reconnection, sharing and networking.
For me the most impact was made by the personal story told by a truly extraordinary lady: Kate Allatt. Her story touched me, stuck with me and points the way towards a new and powerful relationship between patients and the services they receive. It also points the way to a new and important leadership model for every aspect of health care and its delivery.
If you don’t know Kate’s story then I can recommend looking her up.
Kate’s speech at the NHSConfed2016 is here.
Kate was diagnosed with locked-in syndrome, after a severe brainstem stroke left her unable to move or communicate. Her story is one of a determined individual who defied all odds and, against the predictions of the medical community, managed to make her dream of regaining control and reconnecting with her passions in life – her family, friends and her love of running – a reality.
Initially, the medical team gave Kate a poor prognosis and privately warned those around her not to raise their expectations too high. But this underestimated Kate’s indomitable spirit and self-belief; she and the people that loved her responded by advising the medical team, ‘Don’t lower Kate’s expectations, raise yours’. The human spirit finds its own way and when it’s unleashed the most amazing stories of regeneration and hope can emerge.
It so easy to say that health care professionals and organisations should find new and innovative ways of hearing the experiences of the people they serve. The NHS five year forward view talks about the need to ‘engage with communities and citizens in new ways, involving them directly in decisions about the future of health and care services’. Of course this should be the case and I’m sure no one would really disagree.
However, for me, Kate’s story points to a fundamental challenge to the notion of ‘expertise’ and the need to co-create solutions that are truly relevant for the patient as an individual. If the health system is to change to become more patient-centred and relevant to their needs, relational leadership has to be at its centre.
Old leadership models point to a relationship where the power lies with the hierarchy: command and control. Those that lead expect to be followed by virtue of their position. However, in a complex world such a paradigm is no longer either true or helpful. In a digital world, where information and knowledge are freely accessible to everyone, we can challenge the traditional notion of leadership and power. Everyone can potentially become a leader and everyone becomes powerful. This is a challenge to the elite leadership model of the past but, if embraced, does offer the opportunity for shared decision-making with the hope of new and novel outcomes.
It also brings into sharp relief that in this new digital world people have a choice. A choice to follow or not. The followers are just as powerful as the leaders. You can’t lead unless those around you choose to follow. This is true for patients as well as people that work within health.
I firmly believe that those within health need to rethink the traditional relationship with patients. Patients’ voices, experiences and insights need to be listened to and be central to a new and exciting relationship.
Margaret Wheatley has written extensively about leaders and leadership in a complex world and I’ll leave you with her words:
Our great human capacities of generosity, caring and creativity are ignored or denied. And people themselves don’t remember their own capacities as they withdraw into fear, aggression and self-protection in response to this frightening time. Too many leaders grasp for control and self-interest, making short-term decisions that destroy both human potential and the future.
- Read more about Marcus Powell’s perspective on leadership in the NHS.