Webinar | Leveraging Emotional Intelligence for Sustained Continuous Improvement

Virginia Mason Institute

Join healthcare leaders from Virginia Mason Institute and NHS providers as they discuss the importance of emotional intelligence for sustained improvement in healthcare. They emphasize the significance of prioritizing staff engagement, promoting civility and addressing unconscious biases to create a positive work culture. Watch now for more insight on emotional intelligence in healthcare.


00:07 Good afternoon and welcome to our webinar on leveraging emotional intelligence for sustained continuous improvement. My name is Wendy Korthius-Smith. I’m the executive director at Virginia Mason Institute, a nonprofit organization specializing in healthcare transformation. We’ve been on our own 20-plus year journey developing and sustaining a patient-centric, really a people-centric, leadership and management system. I am delighted and honored to be joined by three incredible executives today. Our senior panelists, I want to please welcome Sir Julian Hartley, the chief executive for NHS Providers, Anthony May, our chief executive officer from Nottingham University Hospitals Trust within the NHS, and Professor Mary Day, who’s our chief executive officer for St. James Hospital in Dublin, Ireland. So let’s start by having each of them share a bit about who they are and their background, perhaps in a minute or two. And if you can add, what’s the number one issue, challenge, or opportunity you’re facing today. And so I’m thinking we’ll start with Julian, then Anthony, and Mary, and we can advance to the next slide, please.

01:30 Great, thanks very much, Wendy. It’s great to be joined by Anthony and Mary, and hello, everyone. Really good to, in inverted commas, see you, although webinars are always a bit strange because we can’t see everyone’s faces. But I know we’ve got lots of colleagues on this, so it’s great to have you join us. So I’m Chief Exec of NHS Providers. As you said, Wendy, I’ve been doing this job for over a year now, previously a chief exec in the NHS for many years, most recently at Leeds Teaching Hospitals over the last decade. And I think for me right now, it feels like the NHS has never had greater pressure in terms of the operational challenges it is facing. We’ve been through and lived through the biggest public health crisis in its history during the pandemic, and we’re still feeling the shockwaves of that. And I think perhaps one of the biggest challenges in my job, because my job is different now to the one I was doing, is how to make sure we speak truth to power about the felt reality of what is happening in the NHS at the moment, particularly in relation to those operational challenges. And also just the scale of the financial challenge that the NHS is being asked to deliver. And I don’t think in the context of improvement, you can really separate out the financial challenge from the operational quality, safety, or workforce challenge. And this is where leaders are really having to think hard about how they tackle this, because in terms of today’s topic around emotional intelligence, when the pressure is on, and it really is on, it tends to affect behaviors, sometimes in a negative way. Sometimes the kind of pressure that acts on teams can lead to suboptimal conversations and hence, outcomes. And we know that the evidence is really clear about all of this, that the more engaged staff are, the better the outcomes for patients, the importance of civility in discussions, particularly amongst, you know, colleagues at the frontline, at the sharp end. So for me at the moment, in a crucial year when we are likely to see an election and a change in, or at least a new, government, it’s vital that we are thinking about what the NHS needs and wants in the context of a sort of medium to longer-term plan. And that despite the challenges around the operational and financial issues, which are very, very current and short term, we can’t afford not to be thinking about the medium to longer term. And in that way, thinking about how we deliver improvement for our patients, our populations, and our staff. So I’ll stop there. I think that’s two minutes. Thank you.

04:39 Thank you. All right, Anthony.

04:42 Thank you very much, Wendy. And thanks, colleagues, for the invite to this. So I’ve worked in the NHS now for just coming up to 20 months, and for me, it’s a second career. Prior to working at Nottingham, I worked for 40 years in local government in a variety of roles. My last role was as the chief executive of the Nottinghamshire County Council. Prior to that, I’d been the director of children’s services. So working in the NHS is, although new to me, in some senses familiar because of my background. Our challenges here at Nottingham are all around managing the complexity that Julian has set out. And particularly here at Nottingham, we have a lot of things going on simultaneously. So we are the subject of an independent maternity review being led by Donna Ockenden. There’s a police investigation running in parallel to that. Our recent track record, we’ve been in intervention for a number of years, has dented public confidence in our services. And yet, we’re still engaged in recovering from COVID, managing financial challenges, and trying to make sure that we balance operational pressures amongst all of that. And as Julian said, that relentless look outwards and manage our stakeholder environment and try to influence the environment around us, rather than being a victim to all of those complex factors that are apparent here in the organization. So a lot of my time is spent balancing those three things: trying to manage the day-to-day and the complexity of all that scrutiny, trying to make sure we keep the shield around managing stakeholders and trying to regain public confidence. Lots of times, I’m in meetings with MPs and chairs of health scrutiny committees, and our NHS colleagues. We get a lot of attention regionally or nationally from NHS colleagues who have been very supportive in trying to help us improve. And then, as Julian said, relentlessly trying to find time to plan for the future; otherwise, we’ll just be a victim of the future rather than trying to shape it. So those are the things that I’m grappling with every day here, Wendy.

07:05 Thank you for that, Anthony. What a list, and I see some definite themes and similarities between Julian and yourself. Mary, how about in Dublin, Ireland? Perhaps you can provide your intro and share.

07:20 Yeah, thanks very much, Wendy. And again, delighted to be part of this panel this afternoon. So I’ve been in health all of my career. I started off in the NHS as a nurse, working through an oncology career pathway. I’ve been a chief exec for over 10 years, in just two large teaching organizations in the Marsh north side. And we recently came to St. James’s in 2020, just as part of the US pandemic was unfolding. So I’ve just completed as well an 18-month stint in the national office as director of acute hospitals. So a lot of experience in relation to healthcare and healthcare administration in the Irish context, I suppose in relation to where we’re coming from, very similar to my colleagues. And then hey, just very much. You know, we’re talking, I suppose, coming through a high demand relation to delivering on that demand, albeit restrained in relation to the financial challenges that we’re burdening. In addition to that, because the Irish health system is going through a change, positional change moment moving into regions, who will be six regions, overseeing the health delivery system, and I suppose then local closer to home here on St. James’s campus, we’re delighted to be sharing the campus with the new Children’s Hospital that will be opened in the very near future. So that’s a quite a, I suppose significant infrastructural project that is being delivered. And I suppose this campus is quite exciting, because, you know, it’s sharing it with you know, we were already partnered with Trinity College Dublin, we have the Children’s Hospital, we have the Irish Blood Transfusion Service, we have a number of research facilities. So it was our ambition here in Dublin, on St. James’s campus to evolve that into an academic health science center. So it was really what our strategic opportunities and I suppose the strategic direction, we have the operational today, delivery in relation to meeting the demands of both our scheduled care and our unscheduled care of our cancer services, and high-end services. So it’s very similar to my colleagues in relation to the current climate of constraint at the moment.

09:50 Thank you for that, Mary, and thank you to all of you for that. Setting the context in terms of the challenges that we are all facing and as I said earlier, definitely some similarities. I also want to thank all the colleagues and attendees today. Joining us. It looks like we’re going to have a rich and robust discussion with lots of representation across organizations and individuals. So the format for today’s session is really going to be first about framing the conversation, kind of refresh. What is emotional intelligence for those who need that refresh? Why care about it? Why is it important? And then we want to deconstruct it just a bit to talk about some of the elements so that we can have that more deep, robust conversations, perhaps more pointed. After that, we’re going to open it up for some questions that we’ve designed for the panelists to get their experience, their insights and their ideas, and really spark your thinking as audience participants around this topic. And so most importantly, we want this to be interactive. And so we’re going to ask you to put your questions in the chat box as earlier described. And we’re gonna be looking at those as we go through, saving definitely some time at the end. One last note, before we dive into the topic is kind of why we pose this as a topic in itself. And if we go to the next slide, I would just say, perhaps the three executives said it best when we’re talking about significant challenges today, around attracting and retaining our talent, engaging our workforce, the pressure of our systems, unmet needs, public satisfaction being at an all-time low, and staff shortages. I was reminded of the BMJ cover last week, I think, where it talks about the NHS workforce and built to survive with a question mark. Very striking. So while we all know about some of the significant challenges globally, as well as the complexity that we have in healthcare, in our organizations itself, our ability to solve the problems of today, and of those of tomorrow, really require us to work together effectively. And so thinking about a culture of trust and psychological safety, well-being, compassionate leadership, accountability in a respectful way, and foundational to this is emotional intelligence, that catalyst, that linchpin perhaps, where the stakes are high and the lives of our patients are really depending on us. So the next slide highlights a bit about what we mean around emotional intelligence. I’m assuming most people know, but again, just to refresh, I’m with it. Over 30 years ago, the word was first coined by some researchers, and then popularized by Daniel Goleman, a psychologist with a book of over 5 million copies sold, continues to be sold today. You’ll see some definitions there. I’m going to highlight that third one, which is around the ability to monitor one’s own and others’ feelings and emotions, to discriminate among them, and to use this information to guide one’s thinking and actions. So thinking about understanding and managing our emotions, recognizing and influencing the emotions of others, and the key to this is to not be controlled by them. We often think of that primal brain. And so how do we bring our higher levels of brain to the conversation with this work? The next slide talks a bit about why it’s important. And I think we’ve heard some reasons why it’s important today from our speakers, specifically, when we recognize that our greatest asset really is our people. And it’s about developing and fostering relationships and engaging their hearts and minds. And so this is a sketch of just a few to again, spark the thinking around some of the ways this can be important for individuals, teams, organizations, and systems. If you look at that left-hand side, first, you’ll see the deliver impact, increasing those quality interactions and decision making. It’s about higher productivity and a multiplier effect on outputs and outcomes. The second one below that notes preventing biases, particularly around unconscious bias. And I think they’re like the Johari window where we have the four panes and one of the panes is unconscious incompetence, not knowing we don’t know. And so emotional intelligence helping us recognize to be open to be curious and continue to learn. And then the last one on that left side, increasing understanding, strengthening our ability to be empathetic and managing conflict. And so key elements there, recognize that empathy is so needed today. And that conflict can be a good thing when it’s managed appropriately. And we have a divergence of thought that then can converge into action. We’ll go to the right-hand side, it talks about securing commitment, setting tone, setting the climate and the culture. And this is where I’m leading change and transitioning. And that conveying the vision in ways that inspire and allow people to go up that commitment curve. I’m going to skip to the bottom one around encouraging innovation, where we’re talking about that flexible, adaptable mindset and that growth mindset for creativity and change. And then go back to that leader, one, develop and align leader behavior. Here, we really set that climate and culture and create leaders who are self-aware, that value and foster trusting relationships, understand, and regulate emotion in positive ways, and that are inclusive and respectful and compassionate, so important in our world today. So I’ve got one last slide before I’m going to turn this over to the panelists. And this is diving in a little bit deeper on emotional intelligence. And so this framework comes from Goleman, but it’s also been reconstructed with leadership and organization that we work with around this area, we dive in deeper, you’ll see competencies and capabilities in two levels. There’s the personal and there’s the social level. And there’s also the awareness and the regulation if we go down horizontally on this.

And so let’s start with that left-hand side where we’re talking about the personal or the self lens. And you’ll see self-awareness there, which is really about how do we manage self-important areas around emotional self-awareness, reading our own emotions, and recognizing their impact, looking at accurate self-assessment, knowing our strengths or limitations, and self-confidence, a sense of one’s worth and capabilities. And then as we go lower, it’s about how we manage now that we know and we’re aware, how do we manage those. And so things like achievement around standards of excellence, self-control, disrupting the emotions that might rise when triggered and impulses under control, being transparent, where we have honesty, integrity, and trustworthiness, flexibility, adaptability, initiative, and optimism, all part of that. We look over on the right-hand side, that’s the more social elements of emotional intelligence. And there is how we manage our relationships with our teams, with our organizations, with our community, politicians, perhaps. And so thinking around the upper quadrants around social awareness, empathy, being a really key element, understanding or sensing others’ perspectives, taking active interest, listening for their concerns. The awareness piece is about the current decision networks and politics at play, and service as well recognizing client and consumer needs. And then going below again, how do we manage those if we’re aware, and so elements around developing others with feedback and guidance, motivating and compelling visions for inspiration and influence, that Change Catalyst around leading in new directions, helping resolve disagreements, building bonds, and teamwork and collaboration. So the great news about this is that this is not fixed in each of us, it can evolve and improve. And so if we go to the next slide, let’s pause here for a minute and engage our panelists. And we want to see what thoughts are in their mind. And so we’re going to go to a few questions to start. And I’m thinking for this portion, perhaps we can stop the slide share, and just bring up the faces of Julian and Anthony and Mary, and others as we start this discussion. Okay, so we’re gonna start with the first question here around Goleman. He states, the most effective leaders are alike in crucial ways. They all have a high degree of emotional intelligence, not that IQ and technical skills are irrelevant, they’re entry-level requirements for leaders and executives, but emotional intelligence is what makes a great leader. So my question to you, what have you found as your greatest strength related to emotional intelligence and how did you cultivate it? And if you’d be so vulnerable to share, on the flip side, where’s an opportunity for you in emotional intelligence? Happy to repeat the question, but who would like to dive in first? I see Julian’s chuckling, so does that assign you?

20:11 Um, I’m happy to have a go at it, Wendy. So, yeah, I think that it’s interesting. If I look back over the course of working in the NHS, I think that there’s something definitely for me about the sort of expectations that are often placed on you as a manager or as a leader. And actually, understanding that sometimes those expectations aren’t actually the ones that are the most appropriate or effective in terms of doing the job. So let me try and give you an example. When we embarked on the work in Leeds with Virginia Mason, back in 2015, this was all about implementing an improvement approach. And we’ve done a lot of work on culture and a lot of work on engagement. I think what started to really feel really, really important was the role of leaders in listening. And when we worked with you guys, one of the fundamental mantras going all the way back to Taiichi Ohno, the founder of Toyota, and there’s a funny little sort of picture of this, which is big eyes, big ears, small mouth. And that sort of stayed with me and reinforced how I consciously tried to do more of that because, particularly in the NHS, leaders are often in transmit mode. And it’s very easy to occupy the air time. And it’s very easy in the power dynamics of bigger organizations, in roles like the ones that we’ve got, that Mary and Anthony particularly do right now, is that, you know, the CEOs are often looked to for the answer and so on. But actually, a lot of the answers come from those teams that are doing the work.

22:43 Did Julian freeze? I think the rest of us are still on. I wasn’t sure if it was me. Or okay. Okay. Well, he’s going to do that dramatic pause. Anthony, sounds like he has his hand up.

22:59 Yeah. Yeah, thank you. So I’m sorry, Julian’s frozen down, I’m happy to pick up the thread. So when you read the four quadrants of the elements in emotional intelligence, it’s really difficult to argue about any of them, like arguing with requests for world peace. They’re all things that work in and of themselves. But I always think about these things as how you might apply them. Because things like research or the sorts of attributes in that quadrangle are really only good if you’ve got a method of applying them. Julian talked about the methods that you promote through Virginia Mason, and they’re all also very effective, but sort of boil it down into a number of things that are trying to live by. So first of all, it’s about being curious. That quote from Peter Drucker about health organizations being really complex, as somebody who’s relatively new to the health service, is very stark to me, because there’s no way any chief executive of any large trust in the health service can be an expert in every domain that we’re accountable for. It just simply isn’t possible. But if you can be curious about every domain, and listen in the way that Julian said, so that you genuinely want to understand what it’s like to work here. When I came here, we did a piece of work. We call people first, trying to answer three questions. What’s it like to work here? What’s it like to receive care here? What’s it like to be one of our partners? You can’t answer those questions if all you do is talk. You have to listen, but listen in a way which is curious and humble, and try and avoid the sometimes overplaying of status or omnipotence that comes with senior roles. People do expect you to have all the answers and I find it’s best if you set out from the outset that you don’t have all the answers. Otherwise, you’ll end up trying to guess things and make it up. But if you listen to people with genuine curiosity, and you’re humble enough to learn from that, then you can weave it into behaviors and actions, whether you call it standard work, or whether it’s things that are just genuinely good practice, like visiting people in their workplace, listening to their experiences, trying to behave in a way that you think is suitable for the office that you hold, which is genuinely a privilege, and genuinely one of stewardship, because there was someone before me, and there’ll be somebody after me. I’m only really here to steward the role as long as I’m privileged to hold it. And then try and impart some of those behaviors in the way that you communicate with people. So queue up in a coffee bar, have a chat with people, get to know people, so you say hello to them in the corridor, encourage people to lift their heads up from their smartphones, and greet you, when they see you as someone that’s their colleague, not someone to hold in reverence, just because you’ve got a nameplate on your door, and try and remove some of those barriers that can stop genuine engagement with people. Drucker also said that strategy, culture eats strategy for breakfast. And culture is super important in an organization. But the other thing that I rely on here, which is why we did the work on people first, which became the trust strategy, is a framework. Culture in and of itself, emotional intelligence, in and of itself is only good if everyone shares a common purpose and a strategy. And in our case, five priorities that everyone understands, and they can see themselves in, then we’re all rowing in the same direction. And then when I have a chat with someone in the coffee bar, I can talk to them about what’s going on in their lives, not just at work, but I’ve got some hooks to have a conversation based on what they contribute to the people first strategy. So there’s kind of more to it than just wanting to be emotionally intelligent. Everyone wants to be emotionally intelligent. It’s for what purpose? What tools or techniques, what behaviors does it drive in senior managers, and how can you use it to generate common purpose and implement strategy?

27:36 You know, very well said, I so appreciate those comments, Anthony. And I think, as we go through the questions, I want to hear more about it being kind of innate or learned along the way, because you certainly model those as well as Julian. With that, before I turn it over to Mary, Julian, you had a very dramatic pause. In your information you were sharing, did you freeze? Sorry,

28:02 I, sorry, Wendy, I lost view, and I thought I’d lost internet connection. Oh, goodness. So that that that was why, but I was just making the point. Hopefully, you got that you asked about owning up to stuff. And I was going to say, under a lot of pressure, my tendency is to move into that more transmit mode. And that’s something I constantly have to keep a bit of a check on. Because, exactly when listening to Anthony talk, you need to express that curiosity and that sense that you don’t have all of the answers.

28:46 Yeah, no, I love that. That’s fabulous. Thank you. Mary, what would you add?

28:52 Yeah, so I suppose really would agree with the last two contributions. For me, as I was looking at these questions and reflecting on them, I think the one that stands out to me, and I think it speaks to listening and building strong relationships, is that whole relationship-building piece of yours, with different catalysts for change as you go about that role. So just from my own experience, being involved in improvement in different guises, you know, there’s always been a catalyst for doing it, which sometimes can be a disadvantage as well. For one reason, we were moving into a brand new build and looking at the processes and how we design our processes, but sometimes that actually can be a disadvantage because it’s not inherent in the organization to move in this direction. So in another role I was in, which worked much better, was by bringing a group of hospitals together. In that respect, we were using this to enable us to do that work. So what I’m trying to get at is that relationship-building and understanding where people are in their journey is really important. Sometimes, we can misinterpret that. I was thinking this work has been done to you, it’s not really successful. Top-down doesn’t really work with improvement; it really has to be bottom-up and understanding where the culture of the organization is. So I do like Anthony’s way in relation to testing the temperature and doing that awareness piece for us. But sometimes, I feel there’s an awful lot of foundational work that we don’t necessarily put in at the beginning to get the right outcome, to ensure that we have intelligence both from leaders and from our interactions to get the right impact.

So in sharing one area that I feel I probably need to work on is self-awareness. When I came here to James’s, having undertaken improvement for about six or seven years and brought an organization or organizations along a pathway, I found that the hospital wasn’t ready at that time to embark on the improvement journey that I was really enthusiastic about and probably overdue to go after. I think it was really a learning experience for me in relation to being aware and listening. Going back to that listening and understanding and investment in that foundational piece is really important. There are times we get overenthusiastic and want to get straight into it. Emotional intelligence can be hugely beneficial in that foundation, setting the organization on a pathway for improvement.

32:00 Wonderful, love those comments as well. I know we have a couple of questions in the chat. Lesley has asked about knowing how people share, create, and share their definition of emotional intelligence in the workforce? And then how is the workforce supported to build their belief and skills in this area, recognizing that it might not be “Oh, today we’re going to talk about emotional intelligence,” for example. It might be something more subtle. I know in our organization, for example, it’s part of our equity work and psychological safety. Do each of you have ways that you try to weave this into your circle of influence or organization? Is it more subtle? Is it more pronounced? And do you help others build their skills in this area? Who would share any elements on that?

33:04 I can start with us. Okay, Wendy?

33:05 Yeah, Mary? Thank you, Cindy,

33:08 I suppose where we are coming from in Ireland, and a lot of the organizations in this work, I think, definitely be very subtle in relation to how we build and how we build a team. I think a lot of it is probably working through modeling behaviors and how we model each other’s behavior. So we do spend a lot of time and work and investment in relation to leadership behaviors, not necessarily transactional, but very much around how do we, you know, how do we want, how do we prepare leaders? How do we prepare staff to, you know, move into those roles? So I suppose it’s really, you know, there’s not a big tactic way of how we do it, but I think it’s very much around an understanding and unified behavior, and also understanding where it needs to be called out as well, where it’s, you know, where there has been a war, it’s not been undertaken or it needs to be challenged in some respect. So, yeah, I think, to be honest with you, I think it’s an area we probably do need to place more emphasis on. It’s an area that I think we, we know, like the research is there, we understand that it can contribute hugely to our improvement journey, what we’re trying to do, and also, I think when you work in a high pressurized environment, as any chief executive does, in relation to, I suppose how we model our behavior as much as more dealing with the political system with our founders, you know, which are commissioners. You know, I think when you’re getting caught up in that environment, I think in relation to emotional intelligence, it’s something that isn’t innately in your sphere, but it’s an area that I believe needs to be. And I think sometimes we get caught up in the external factors, like Leslie mentioned, what we need to do internally around it.

35:14 Right? Yeah, a lot of the noise from the external environment prevents that. Yeah. Julian or Anthony, anything you’d like to add?

35:25 I think maybe just to say it, I think in terms of the way we frame this, Wendy, it’s sort of not talking about with staff, the sort of emotional intelligence, per se, but demonstrating it through your values, behaviors, and also just building it into processes like appraisals, where it’s not just what have you achieved, but how have you achieved it in the context of how it’s felt for your team and how you’ve exhibited the values of the organization that you’ve agreed on. And I strongly agree with Mary’s point about that foundational element, really understanding where you start from and what you do. We know the work we did on the evaluation of the VM trusts that Warwick Business School did, that the cultural readiness was a really key part of this before you embark on an improvement journey. With that comes a lot of insight, understanding, and questions that go back to the broader point about emotional intelligence.

36:43 Now, it’s very good, very relevant. Anthony, anything you want to add? I know you mentioned that comment about having a system to help ensure these kinds of things happen. So you might have kind of described it already, but anything that you would add,

37:02 I do think it’s important that we weave our approach to this into things that already exist. Because trying to invent new things when people are really busy and under pressure is largely futile. So I answered one of the questions in the chat. One of the things that I’ve done in previous organizations, and we’re looking at here, is to create a coaching culture and a coaching program. The best way to build emotional intelligence into the organization is to have an element in everyone’s supervision and appraisal that goes something like this: How are you feeling about your work? How are you feeling about our relationship? Is there any way that we can help each other to achieve our own professional goals and the goals of the organization that employs us? And if we can build those conversations—and frankly, most mature adults in a professional setting are capable of having that conversation—you don’t need to go on a course to do that. That’s just human interaction at a basic level. That genuinely trickles down into the organization and then encourages water cooler and corridor conversations, which are similarly based around what is it like rather than just ticking jobs off the list? In a very technical and bureaucratic organization like the health services, it’s easy to get sucked into that and distill everything to a three-letter acronym. What we’re dealing with fundamentally is people; it’s a people business, and we’re accountable to the taxpayer as well. What would they think about an organization that didn’t have an open culture where we ask each other, how are we today? Are there things we can do better? Are there things we can do for each other to make us more comfortable at work? I think that has an impact in a whole host of areas, including reducing the incidence of bullying, harassment, and racism—all the things that often make headlines either locally or nationally, which, in truth, shouldn’t be in a modern 21st-century workplace. They just shouldn’t be there. But if we don’t talk about them openly in that curious way where we genuinely try to understand why these things happen, we won’t open the culture and we won’t find solutions.

39:38 Yeah, thank you. I love that. And I think, as I hear from each of you, leadership is so key in terms of setting the tone as the keeper of the culture, as we describe it. I do want to go back to that question about, for each of you, is this something innate in you? Did you have to learn this? Did you learn it from someone role modeling it? Tell us about your experience in this; maybe it’s a combination of multiple things. But the way you describe it today is so impactful and so important. So how do other people who are wanting to get there, get there? What was your experience like?

40:30 Perhaps Wendy, you go?

40:33 Oh, God, you go first.

40:34 Okay. All right. All right. All right. So at the most fundamental level, Wendy, we are all working in the people business, aren’t we? This is all about understanding our hopes, fears, dreams, and motivations. Understanding how teams work best together, and get the best out of one another. There are lots and lots of textbooks and lots and lots of advice, and so on. But ultimately, leadership and management are all about, you know, it’s very much a team sport. And it’s all about doing it for real, not just kind of reading about it. It is very much about getting involved and having a go. And of course, you make mistakes. One of the important things, again from the work we did with VM, is that fail stands for First Attempt In Learning. So embracing failure for learning purposes is important, you know, and trying, because sometimes in the NHS, we’re not great at handling that. That’s where you get blame cultures, and where you get toxic behaviors. So, I think for me, it’s been a journey, like for all of us, of learning and trying to get better at managing and working with and empowering groups. I cringe when I look back on some of the things I’ve done in the past, which I thought management and leadership were about, you know, issuing emails or letters without any prior conversation about important things—just clumsy handling. And I think as I’ve progressed, I’ve understood better the importance of how you genuinely try and create a sense of ownership and engagement. Incidentally, Wendy, it’s great to see in the questions, there’s one from Ruby, who’s a former colleague of mine at Leeds. Hi, Ruby, can’t see you, but thanks for the question. And her point about emotional intelligence with accountability is interesting because I think there’s part of how leaders should feel accountable to those colleagues that are in their teams. That is a reciprocal thing. It’s based on trust and relationships. It’s not just about position power. And that is a vital part, I think, for all of us in our work, but that does mean an investment of time, effort, and energy into those relationships and into creating the conditions for teamwork and engagement to flourish.

43:35 Fabulous, and thank you for sharing some of the great comments that we’re getting from participants as well. They’re kind of rolling in. Anthony and Mary, anything that you might add in that innate learned? What shaped you?

43:51 Could you go next, Wendy? There are three things for me. There’s learning from failure. What I mean by that is quite a lot of people lead or do their jobs motivated by the fear of failing, but then when they do fail, they don’t learn from the experiences and a lot of sort of self-loathing and blame goes on. I’m happy to admit, I’ve presided over some fairly catastrophic mistakes and failures in a very long career. And I’ve tried to learn from them. That point that Julian made about, and was in the chat from Ruby, the link between failure and accountability—in the end, it’s on your watch, you have to own it, and then you have to go into learning mode. How did it happen? How can we learn from it without blaming people for what has happened? There’s nothing like listening to people’s examination of your leadership when you’ve failed to make you humble and think about how you can manage and do better in the future. The second factor in my leadership journey has been having a very wide network of stakeholders and doing things that are out of my comfort zone. When I was a director of children’s services, I was pretty sure I didn’t want to be the chief executive of the council because I was worried about dealing with the politicians. Politicians don’t adhere to the same professional codes because the officers are not their colleagues. Their constituents—the people that elect them—are the people they need to influence and who they are accountable to. So, it’s a very different relationship, and learning how to manage in that sometimes ambiguous and complex set of relationships and still find a way to solve a problem, and respect the fact that people have different political beliefs, but in the end, you’ve got to try and find a way forward, is a great learning opportunity around how to use your emotional intelligence. Equally, I did work on regional and national economic development, and led some pieces of work at a national level through COVID. Those things were probably well outside my comfort zone, but they give you a lot of exposure to people who think differently. That work is so useful if you can listen to the contrary view. If you can listen to the antithesis, as well as the hypothesis, eventually, hopefully, what you’ll find is synthesis, but only if you open your ears to the contrary view. For me, it’s just practicing every day, managing my emotions, because every day there are highs and lows. Every day I’m bringing something from home or from my private life, and trying to modulate that can be like an amplitude, so that the highs aren’t too high, and the lows aren’t too low. Practicing as much as you can somewhere in the middle, so that people genuinely—not always, but you know, 95% of the time when they come into contact with you—they know what to expect. You’re going to respond in a similar empathetic and logical way pretty much every time unless the roof is caving in. And then, of course, you have to engage management. But that level of consistency at work should not be underestimated. You only get to that if you learn the tools and techniques of managing your own emotions.

47:25 I love that, and I think both Julian and you describing kind of missteps, as well as some potential failures and learning through those along the way, is so valuable. Modulating that, maybe it’s like the inverted U curve from the 60s where they talk about stress and performance. How do you make sure you don’t have that tipping point? I hear a bit in your description about managing that on a day-to-day basis. Mary, how about you?

47:57 Yeah, so nothing too different, I suppose. The only added thing, like, I think everybody learns through experience and when you’re at this level, especially, you know, you do learn from your mistakes and learn from failures. I think, interesting for me, the last 18 months have been spent at the national level. That was really an interesting learning opportunity. Like Anthony said, I think, you know, it exposed me to areas I wouldn’t have been exposed to before in relation to dealing more widely with the politicians, the department, going into health committees. Also, I think it led me to see how the system looks after their leaders. It’s very much how we look after ourselves and how we look after our staff. It’s like a tiered, supportive piece from the bedside to the board table in relation to how we provide and nurture and support that emotional intelligence. But I think it’s interesting—how do you manage upwards? How does the wider system manage upwards? I’ve been exposed to that for the last 18 months. It’s definitely a huge learning curve. It did give you insights as well in relation to our roles, how we’re valued, and sometimes there dare I say it. What impact can that have? Because that does have an impact when you’re battling for resources, battling for services, and battling to get your voice heard in a competitive market. What impact does that have then in relation to how you deal back at base within your trust, within your hospital, within your campus? So that’s just interesting learning, looking at it in that direction, looking at how you manage upwards and how that, on the upward level, impacts how you manage your business or how you manage your health system back at base.

49:57 That makes sense. Yes, now that’s very, very helpful. Thank you. I’m looking at some of these comments or questions and I appreciate Lesley’s. On the back of the WBS civil evaluation, it looks like she’s going to help us find some really interesting things around interpersonal development and emotional intelligence. That sounds like there’s going to be some great work coming there. One of the question areas we wanted to kind of focus on was unconscious bias, perhaps some things that either you do as a leader to help promote and expose and address or explore—explore is a better word, perhaps—around that work. I’m looking at a comment from, it’s an anonymous one, but it notes that emotional intelligence is also something impacted by learning difficulties or mental health, and ensuring we’re mindful and respectful of our neurodivergent colleagues. We also had another comment from Paul around good gender balance on this debate, but it might be good to see some other minority perspectives as well. That could have a different context, but maybe just a comment or two around unconscious bias as it relates to emotional intelligence and work you do either with your teams or yourself to kind of help address that issue. I know you’ve broached it in some instances already, but I want to just directly hit that again.

51:30 Wendy, can I just jump in on that? Because you mentioned neurodivergent colleagues, and also mental health. Just to say, a lot of my job is getting around and seeing the great things that are going on across the NHS in England. One of the things I think that we’ve seen, really, in a number of mental health organizations, and indeed other sectors of the NHS, is impressive work on enlisting experts by experience, patient voices, and the importance of doing so in the context of helping staff really gain greater insights into the felt experience of many patients and service users. Many of whom, in mental health settings, are absolute experts given their experience, and able to offer a lot into the co-production and design of services. I’ve seen that learning. I think that requires a leadership approach, which again goes back to a lot of the themes of this conversation about appreciative inquiry, about curiosity, about not knowing that you’ve got the answers. Given the pressures that are acting on mental health at the moment, and the number of high-profile inquiries that are happening, this is another important time to make sure we emphasize that side of things, as well as the governance and accountability piece. I’ve seen some great work, and we want to encourage and support that.

53:34 Great to share. Thank you for that, Julian. I would also just add that I know for my organization, one simple example we use is around the inequity wheel. So, in the middle of a meeting, in the middle of the day, at any point in time, kind of looking at what we are doing that’s either silencing perspectives. Is there power and privilege happening in the moment? What assumptions are we making? Is there any mistrust or underrepresentation? I was thinking some of these questions relate as well to that. So having those structural pieces to help support that. Anthony, Mary, anything the two of you would add?

54:15 I think what you’ve just said is going to be very important, Wendy, when we all go through periods of financial constraints. I’ve lived through austerity for a number of years in local government. It’s so important to understand the impact of change on everyone. That can be quite difficult, especially if leadership teams or individuals carry unconscious bias with them. So for me, these things are on a spectrum. Julian said quite rightly, it’s got to be set in some kind of strategic framework. If we know these things are happening to 90,000 people working in our organizations, by definition, a diverse organization, but we can’t all be the eyes and ears of the organization. So there’s got to be some kind of strategy that guides our approach to inclusion. We’ve just published our workforce inclusion strategy. And it’s deliberately broad, which looks at every aspect of protected characteristics and beyond in the hope that we can have a framework and methodology through which to tackle these things. On the other end of the spectrum, when I came here, we had a reputation, particularly for bullying and racist bullying. It seems to me, we’ve lost the art of just asking people simple questions: What’s it like to be bullied at work? What’s it like to be subjected to racism at work? What’s it like to be discriminated against on the basis of your sexuality or your faith? All of which are examples that come across in the work here. I’ve made a point of asking people, what’s it feel like without intervening in the processes, and I’m encouraging more people to just ask those questions. Because if we don’t know what it’s like to feel marginalized, we will continue to carry bias with us. Without that level of curiosity, even the best strategy in the world is likely to fail because it’s written by people who don’t understand the issues. So there’s something for me that ties all of this together in the sense that if you understand what’s going on in your organization, then you can apply a framework and a strategy to deal with it. I do agree very much with Julian that you can bring in experts to help you co-produce it, but you have to produce it with people that experience it every day. And the truth is, you don’t.

56:42 Wonderful, thank you for that. I see that we are getting notes that we need to wrap this up. I feel like we could go on and on and talk about this topic. It’s so important. So I’m just going to summarize by saying, you know, we’ve talked about the intricate tapestry of healthcare, right? And that emotional intelligence is such a critical thread weaving through the fabric of trust, collaboration, and innovation—a cornerstone for what we’ve been talking about around Compassionate Leadership, high-quality care. Emotional intelligence is so important to round our overall effectiveness and the humanity of our healthcare ecosystem. So I want to say a special thank you to our executive panel, Julian, Anthony, Mary, thank you so much. Again, I could have this conversation all day with you. I’m going to wrap it up with a quote. One of my favorites is that the three of you embody this: When we come to the table willing to learn and transform beginning with ourselves, the result is truly remarkable. So I want to thank you. I want to thank everybody for joining today, for interacting, for being curious, and for what you do each and every day. Have a great rest of the day. Take care. Thank you.

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