Which City?

Thursday, 5 December 2013

Feeling Blown About and Battered? By the High Winds or the Autumn Statement?

Well done George Osborne, you've brought me back to my blog! And yes, it's the pension headline that everybody is talking about, so I thought I'd join in. I might just warn that there are a couple of other topics coming, so if you're not into pensions, stay with me for food banks and depression...

With auto-enrollment spreading are we looking at the death of the state pension? Retirement is a relative concept, and without employment, it becomes a bit of a nonsense. The Fabians are on this tack, so go have a look there when you've done here, but not before.

It saddens me to be able to see the beginning and end of the Welfare State in this country. My parents, born in the 1920s had the benefit of it as adults, as parents themselves and into late middle age as they fell ill and out of work. My father didn't live to draw his pension at 65, he died aged 60 on invalidity benefit as it then was. My mother benefited from a widow's pension for 18 months, which is just as well because she 'didn't pay full stamp' so wouldn't have had much of a pension of her own. My grandparents had no state pension - if they lived into old age (a few survived beyond 70, a very few) they lived off continuing earnings if that was possible, or shared income from sons and daughters sharing their home, or from charity or the parish. In my family history research I have found none of my direct relatives named as workhouse residents, but I have seen them named on the 19th century Census returns as 'pauper' and 'destitute'

I've said it before, the Welfare State has made me what I am - a hard working relatively prosperous member of society who has paid in and will (absence of further crashes willing) be paid out with a company pension at 60 and a state pension at 66. My husband has a modest private pension coming from a long career in private and public sectors at an average  income level. Our personal pensions, which we can access whilst we still earn money from our business, mean that we can manage well for the next few years, hopefully, although if the next three years are as tough as the last three, we will be managing rather than thriving. But yes, we are the lucky ones.

My son, in his first job after graduating, is also lucky to have one which is interesting, stimulating and appropriately paid - so many graduates continue to fill our shops and cafes waiting to do what they really want to do, and so many young people without a degree wonder what the future holds for them. Going through the consultation on auto enrollment with his employer, my son feels sufficiently well paid to go with the enhanced company scheme. I have been surprised at the low take up of pensions in the sectors I am involved in as a Board member - housing, social care and universities, even though we pay a so called Living Wage. It isn't surprising if you're young and low paid that you prioritise the here and now. How worrying if you're older and low paid. 

So, no state pension until 70? Why bother? Indeed, if you have a job it makes more sense to provide for yourself through a contributory scheme. But what if you haven't got a job, or you're in and out of work, or low paid all your life - this is the reality for millions of people. It feels to me like the last half of the 20th century was some kind of dream where we had a belief in the social provision of welfare support but now we've woken up to find that we're going back to a 19th century kind of world where the poor are  villified, offered little support or 'support' in the form of punishment.

Bringing me neatly to food banks. It is not the done thing to say you hate food banks - it sounds mean at the very least. But I do hate them because they symbolise a willingness to accept that we live in a country where large numbers of people are unable to feed themselves and their families properly. The large numbers might include people who (some of us think) have got their priorities wrong, but the truth is that many many people using food banks are doing their best, living without food themselves to feed their kids, working their socks off and still not able to put food on the table. What an absolutely exhausting nightmare that must be. We cannot let food banks cloud our vision and think they are a solution, they are not, they are a sop, and we have to have a system which provides a proper safety net for individuals and families, and which helps people to thrive in the long term. 

I don't sign many petitions or contribute to Kickstarter projects but this week I have supported #jackspetition and a book about Incredible Edible local food campaigns. This is better than just fretting about food banks, let's take a bit of control!

I do want to say something about the wonderful step John Woodcock MP took yesterday in talking about his depression, but I think there is so much to say that I will save it for another blog, not in four months, but maybe more like four hours, or four days time. I hope so, writing this has been good, I'm glad to be back!

And in York, where 74 mph winds this morning have taken the felt off our shed roof, the air is calmer and the sun is peeping through - let's hope that in itself is a sign of better things to come.

Sunday, 4 August 2013

Life Stories: Three Single Men Get a Place of Their Own

This week I have talked to three single men who have had experience of care services over a long period of time. Their stories are different in many ways but the issues raised by their circumstances are worth some reflection. One of the men is my brother, I will leave him to last.

On Friday I had a day with colleagues looking at some of Metropolitan's sheltered housing schemes in Derby and Nottingham. We found many good things -  buildings, staff and services - but we also found room for improvement particularly in relation to the physical and social standards which people rightly expect. Our rule of thumb was - would I live here, would I want my relative to live here? Unless we can answer yes to these questions, we can't be confident we are offering the best we can manage in housing, care and support services.

As we walked round we met several people, including two single men who I won't name here but will call John and David. John had Multiple Sclerosis and David Prader-Willi syndrome; both men were in their late fifties and had lived in sheltered housing for some time. They had both lived with their parents until they died, and clearly needed some kind of support to live on their own.

John told us that he had lived in a nursing home for 17 years after his mother died. He expressed real gratitude that eventually somebody questioned whether he could live independently and helped him to move to sheltered housing. In these relative terms John's experience is remarkable and truly positive - we had met him on his way back from the bank where he went on his motorised scooter. 

But things could be better for John - we asked him whether he used the communal lounge or joined in activities. He told us that bingo and coffee mornings weren't of much interest - he liked music, rock music and would have appreciated something a bit more lively. John is a baby boomer, born in 1954 hitting 60 next year - he may be physically frail, but his mind certainly isn't. And he is a generation apart from the 80+ year olds who are his neighbours. Sheltered housing can be a practical option for younger people with physical disabilities but their social needs are likely to be very different from  their older neighbours. We need to think about how the management of sheltered housing can encourage flexible use of facilities in order to benefit a wider range of tastes and needs.

At another scheme we met David, who told us he had Prader-Willi syndrome, a chromosone disorder which affects people in a variety of ways, but which includes a learning disability. David moved to sheltered housing after his parents died, and he manages a busy life of volunteering and fundraising. For David, one of the real benefits of living in sheltered housing was having personal contact every day with the Scheme Manager, but unfortunatley, this level of support has been cut by the Council, and this daily human contact has been lost. This might be part of the reason why David kept us talking for so long, enjoying some interested company.

As we looked at the different sheltered housing schemes and talked to residents, we began to ask ourselves what it was for? Enabling and re-abling people to help them to become or remain independent seemed to be core to its purpose. Our aim might be to support people to live well with a disability or into older age, and sheltered housing could not only be a permanent home for people, but also a place of transition to and from independent living. In order to fulfil this purpose we need to get better at co-ordination and integration with health and care services, working more effectively to match people and properties.

We saw some empty flats - an increasingly common occurance in older sheltered housing schemes - and could see how we might improve their presentation to make them more attractive. For some adapted flats with specialist features, it might be necessary to talk to social services or health partners about specific individuals rather than expect a choice based letting service to identify them.

And talking of specific individuals, there is my brother. Another single man finding himself adrift and vulnerable after a life at sea with everything provided including plenty of alcohol. As his life catches up on him he has spent 12 months of the last 24 flipping between hospital and nursing home, trying to establish a stable home and routine back in the UK after years living abroad.

This week he is hospital again, recovering from a bout of severe confusion caused by vitamin B deficiency. Today he was lucid enough to talk about what was happening to him, to commit to a healthier lifestyle and to discuss his living arrangements. I imagine he might fare well in sheltered housing, where he can be independent but with some kind of safety net of support if needed. I am thinking of John and David, it works for them, to an extent.

My brother, however, is not keen. He likes it where he is, living in a small room in a shared house, hoarding biscuits in his bedroom and endless packets of cuppa soup in a deep drawer in the kitchen. It seems odd him living like this, it's as if he is a 62 year old well-worn student. But to him, it's sheltered housing - his own private space, a communal lounge, help on hand in an emergency.

Seeing John, David and my brother this week has made me think deeply about independence, support , choice and the interface of housing, care and health services. We all need a place where we can be who we want to be, and we might be prepared to compromise other things to achieve that.

Sunday, 14 July 2013

Four Cornerstones - a model for friendly communities for us all?

This week Doncaster community partners from across health, local authority, voluntary and private sectors will agree an action plan for creating a Dementia Friendly Community. Over the last six months they have considered how Doncaster supports people with dementia and their carers and families and how the Borough could do even better. Through an Accelerated Learning Programme devised and led by AESOP Consortium and The Open Channel, around 20 community leaders have committed to making Doncaster more Dementia Friendly.

Doncaster will be the first place to use the Four Cornerstones model to develop its action plan for a Dementia Friendly Community. Developed  from concepts originally explored with Innovations in Dementia for work for the LGA's Ageing Well Progamme, the model was an integral part of our research for the Joseph Rowntree Foundation 'Creating a Dementia Friendly York' 

So what are the Four Cornerstones?

First is The Place. In this cornerstone we explore issues about the physical environment and infrastructure and ask how they help or hinder poeople with dementia and their carers. So for example:

What is the Scale of the Place, and what happens at each level?

City, Town, Village, Suburb, Street, Home

How Welcoming is it?

Human scale, Environmental Quality, Clean, Calm

What level of Clarityexists?

Buildings which look like what they are, Streetscape, Signage, Access, Transport

How Familiar is it?

Distinctive Elements, Landmarks, Features, Historic Resonance
In The People Cornerstone we consider how those closest to people with dementia - including carers and families, but also regualar carers and people in the community - support, react and respond. We ask:

What Awareness do people have of Dementia and what it means?

Do people and the community judge, stigmatise or patronise?

Are people understanding and empathetic?

Do they support, facilitates  the abilities of people with dementia, encourage the retention of skills and the aquisition of new skills and interests?
We call the third cornerstone Resources to signal that is about more than 'services', and consider:

What Natural, Physical, Cultural, and Personal resources does the community have - everything from rivers to evening classes.

How can care and support draw on the wider resources of the Community?

What role can Personalised Budgets play?

What Specialised Support exists?

The fourth cornerstone - Networks - is as much about how everything is wired together, through joint working and collaboration. We assess whether the networks are

Effective in sharing understanding

Practical in helping to solve problems

Inclusive in crossing boundaries

Discreet in respecting confidentiality

Strategic and Personal

In Doncaster the model has proved useful in helping partners to identify priorities for action. We do not suggest that any community can be fully dementia friendly, but anywhere can progress and become more so.

In developing and using the model, we have become convinced that it has wider applicability - we have looked in some detail at a number of age-friendly initiatives and feel that the model certainly applies in thinking about how to support older people. But why stop there? We all, whatever our age, condition or situation, are more likely to thrive in a community which is relatively 'friendly' - we need quality and support in terms of place, people, resources and networks, and we know that when one of these is missing or dysfunctional, problems occur. 

For community leaders, it is not enough to focus on one dimension in order to progress - we know that communities which work offer a multiple of benefits such as good environment, housing, culture, jobs, education, healthcare. We believe that the Four Cornerstones model has the potential to help community leaders to work together to identify how they need to improve and commit to action to create friendly communities for us all. 

Sunday, 23 June 2013

Regulation and Assurance: Doing the Right Thing

This week the controversy surrounding the CQC will have caused many of us working in regulated areas and sitting on Boards to think deeply about our roles and our behaviour.

We cannot and should not expect Boards or regulators to take the place of management and know what is going on at a detailed operational level on a day to day basis. Indeed, executive managers are skilled at making sure that Boards do not get involved in day to day management, and regulators are by their nature in less than regular contact. 

What this means is that our expectation should be that executive managers will run their organisations well, understanding how to maintain safe, good quality and consistent practice and to assure themselves that this is happening. Boards and regulators will then 'dip in' to test this on a regular or occaisional basis.

When things go wrong, Boards and regulators can support and oversee improvement plans, and retest practice and outcomes to assure progress. This process relies on the truth being told in terms of information and analysis produced and what people say in face to face interviews.

Triangulation of patient, customer, public and stakeholder views is important in challenging data and narrative about what is going on - at Winterbourne View, Mid Staffs and Morecambe Bay, people said things were wrong, but they were ignored and suppressed until it was too late, and irreparable damage was done.

It has been shocking to hear the suggestion this week that the regulator itself had been willing to engage in cover ups - if they are afraid of the truth, who can the public trust?

Public services - and particularly those which are literally about our lives and deaths - are based on trust, and if this breaks, catastrophe can appear in the cracks.

At every level of our public services, and especially those which care for us at our most vulnerable, we must have people who recognise the importance of safety, quality and consistency and who are prepared to challenge within their own organisations to ensure the highest standards and the effective management of risk. They must also be prepared to recognise when things have gone wrong and to put them right - to fear the consequences of poor practice rather than the embarrassment of bad PR.

We should know what it is to do the right thing, and if we don't we should work it out together. 

The CQC has been forced to take a long hard look at itself - public confidence is very low. But they should not be alone in this. Regulated services cannot rely on their regulators to tell them when they are going wrong - it may already be too late. The primary focus and responsibility for safety, quality and consistency must be held by those who directly serve the public. 

Other players are also in the frame - the government, civil service, legislature, commissioners. They must recognise and be open to pushback about the impact of their demands on services. The push for earned autonomy through mechanisms like Foundation status can clearly distort the views of hospital trusts trying to respond to pressure from the Department of Health/NHS and Monitor But it is literally fatal to ignore or even hide service failures in the interest of passing the 'exam'.

Whilst we understand the drive from commissioners to try to get more for their money as demand for health and social care outstrips the resources we can make available in our society, this has to be done in safe ways which assure quality. There is a proper concern about the impact of downward cost pressure on pay and staff quality which seemed apparent in Winterbourne View.

These examples of failure are dreadful, but they are not universal, thankfully. What this suggests to me is that the system, if it is distorted and not properly managed, can fail us, but crucially we need to rely on people to do the right thing. In a system where poor and excellent practice can sit side by side, it is the intentions, commitment and energy of good people making the right choices day in day out underpin our best public services.

Find our more about our work with regulated public services and Boards at The Open Channel

Sunday, 26 May 2013

The Merry Month of May

I love May, most of us do. This year we have had to be patient waiting for the blossom and the fresh green of spring, but it is here today (although of course, as we have come to expect it may rain tomorrow).

This May I seem to have been busier than usual, so the poor weather has not distressed me so much, as I would have had little time to enjoy a glorious spring. We did enjoy quite good weather for the early May bank holiday, and spent a few days at Arnside birdwatching around beautiful Morecambe Bay. But that all seems so far away now...

I have been in London a lot this month with all my Boards meeting and all Metropolitan subsidiary and Committee Meetings falling in the same month as the Board. I've done five days and four overnights in London in the last three weeks, and almost felt like an interim again. My hectic schedule has included Sheffield Hallam and Compass Boards as well as all the Metropolitan meetings, being interviewed for a contract, interviewing candidates for Director roles,  being a participant in a workshop on different approaches to management, joining in a presentation on equalities and fairness, giving a presentation about housing for older people and people with dementia, helping to facilitate an intergenerational action learning set, visiting a drug and alcohol service, as well as catching up with colleagues to support them through change and share ideas for the future, and with friends for food, wine and laughter. I also spent some time in beautiful Rosedale researching my family history, and a wonderful day in Mortlake writing poems with people I had never met before, but hope to see again. And if I didn't see my family every day, I certainly spoke to them.

I have been tired and footsore this month, probably not very profitable, but I  have been fulfilled, stimulated and very very blessed. As I sit down to write this week, of all of the many things that have happened this month, what is likely to stay with me, what have I reflected on most, what have I learned and what would be good to share? I've chosen just two quite contrasting things, one philosophical, one more political which reflect the breadth of my work and the  issues that interest us at The Open Channel

Get out of your comfort zone occasionally, but ask yourself what is it that makes you most comfortable - when are you truly yourself?

Stretching  and extending yourself is a way to grow and develop your skills. Some of the things I do are well within my comfort zone, many are a stretch, although an easy enough stretch, some are a harder stretch, and occasionally some are downright scary. Interviews for jobs or contracts are always scary, not just because you might make a fool of yourself on the day, but because the fear of rejection is inherent within them. This month I have been on both sides of the recruitment table, and tried in both cases to make the experience as pleasant and constructive as possible. Whatever the outcome, there is scope for learning - about how you might do better next time, of course, but also for reflecting on the skills you have displayed, where you were best able to express yourself, which parts of your background and experience made you feel most confident, and how this recollection can help you to target what you go for next time, or how you demonstrate your strengths. 

In our intergenerational Action Learning Set this month, a graduate trainee and a recent graduate talked about their career aspirations. They were able to identify already the types of work and sectors which interested and attracted them and where they felt motivated, but there was sometimes a gap between what they wanted to do and what they felt was expected of them, or where they had found themselves. Being true to yourself, having the confidence and courage to pursue your dreams is hard in early career, but also in later stages when the need to generate an income that others might depend on is pressing. What seems important is to find your own balance - you may be prepared to forgo a dream for a while or even permanently if the consequences of pursuing it are too hard to bear (having no money, being away from family for instance), but if you find that you have worked for a time and been unfulfilled, ask yourself how long you could tolerate this, and why you would want to. Enjoying your work, being fortunate enough to express yourself through it and be yourself is a great privilege - make it one of your goals.

The North South divide is important, but inequality exists in the North and South, and is stark in London.

As a Northerner living in the North, I am passionate about the need to rebalance the economy and find ways of redistributing some of the wealth in London and the South East. I am not convinced that HS2 is the answer (for which I may be heavily rebuked by some colleagues) - it is too far away in timescale, just as likely to benefit the South as the Midlands/North, not as important as investment in technology, and I think it would do more good to find a way to make train travel more consistently cheap now than faster in the future. Anyway, back off my hobby horse, my interest is in understanding how the economy of the North can prosper and bring benefits to local people, but also how we can balance the national economy for the benefit of all.

The overheated economy in the South isn't a brilliant thing for everybody - in fact, the poor in London and the South East are in a worse position than the poor in the North, as prices of everything but most critically housing are much higher and have a disproportionate effect on incomes which are not relatively higher in London and the South. How people in London manage to pay for housing is a great concern - this week Shelter published a map showing how far some London Boroughs are placing homeless people in bed and breakfast with expensive Boroughs using places in cheaper Boroughs who in turn are having to send people as far as Birmingham or even Devon to find cheaper accommodation. And you don't have to be poor by any definition to find it a struggle to buy - in fact the threshold for eligibility for Shared Ownership is an income of £60,000. In the North, somebody earning that sort of salary could buy a house without difficulty, but the majority of people in the North don't earn that sort of money - and neither do the majority of people in London. Last year's ONS Earnings Survey reported here by the Guardian shows the median earnings in outer London were £31500.

My visits to London this month revealed the stark inequalities between rich and poor, not only in terms of income wealth, but also in term so environmental quality. At Clapham Park, Metropolitan is transforming the environment of this large Lambeth estate through a programme of refurbishment and new build development. The investment in people's homes represents an investment in their lives and it is important to co-ordinate the physical regeneration with access to training and jobs for local people.

It may have been because I had spent some time in the affluent environs of Kensington High Street that I was distressed to see the impoverishment of Harrow an outer London Borough where I lived in 1977. At that time, I would say that Harrow, whilst not South Kensington, was certainly a desirable place to live. I lived in a flat converted from a beautiful Edwardian terraced house - unfortunately my road is now a dual carriageway and the centre of Harrow is  dominated by mixed (some quite poor) quality development and people-disatrous road layouts and underpasses. This looked to me like poor planning and absent political stewardship - investing poorly in places lets people down.

I admit to some degree of sentimentality here, but actually I am sure that what I saw was not what Harrow or anywhere else deserved. Many of our town centres - not only in the North - are in crisis, not just because of the challenge of online shopping or the proliferation of bars and betting shops - but because of the incoherent nature of development, the unthinking destruction of good quality historic buildings and the faddy and undistinctive investment in jazzy cladded blocks by people who take their profit and run. Local councils are critical in this process and communities need to be empowered and encouraged to use Neighbourhood Planning to get the best for their places.

It was raining when I went to Harrow - perhaps if the sun had shone, lighting up the spring blossom, I may have felt less discouraged, but the way the cars whizzed off the roundabout to park under a Morrisons with no access to the shop from street level was evidence enough that people were way down the list in somebody's mind when this development was planned.

Rant over - feedback welcome

Visit us at The Open Channel and at DKP

Sunday, 12 May 2013

How do Trustees and NEDs balance duty and passion?

Many thanks to my colleague at The Open Channel Christina Heaton for inspiring this blog. As a Probation Trust Board member she has had a challenging week, with Chris Graylings announcement about the future shape of Probation Services.

It is so important for our society and for themselves that offenders have the opportunity and are appropriately challenged to take a different path and choose not to reoffend. Good Probation Services are the key to that, so there is a lot at stake in the Government's experiments with different providers and the fragmentation of the service.

The issue I want to address in this blog, though, isn't particular to Probation Services, it's a wider issue for Trustees and Non-Executive Directors. What is the responsibility and focus of Trustees and NEDs when policy changes affect their organisation? How do they balance a duty to steer change, with their passion for the service for which they are accountable?

Change from within, owned and understood, is often preferable to facilitate a smooth ride and sustainable difference. Change from the top can be ideological, but impractical, visionary but unrealistic. Being in charge of delivering change works best, doing it to yourself on behalf of somebody else can be very hard. Even if you believe it, you haven't conceived it, you may not understand it fully, it's being thrust upon you, it's hard.

For Chief Executives and their teams, their role in organisational change is clear, no matter whether they are driving it from within, or it is being driven by elected members, politicians or legislation - they have to get on and make it happen. They must articulate the need for change, celebrate the best of what has been, and create the future in open collaboration with their colleagues across the organisation.

How is the role of Trustees and NEDs different? Well, non-execs are of but not in the organisation, their role is not to do, but to be assured that the right things have been done. They also have a corporate responsibility to lead, to set a strategic course, to monitor performance and to support and promote the organisation to the outside world. Critically though, they are the champions, not just of the organisation itself, but of what it does - their role is to see that the purposes of the organisation are fulfilled by delivering the benefits to customers, service users or patients which are promised.

If non-execs are unconvinced about the need for change, or the prescription for change, what should they do? If individuals feel a genuine conflict in their position, they can and do resign in these circumstances, but it is not practical for all non-execs to stand down every time a shareholder or funder or political master wants to change course.

Big changes can often leave non-execs feeling unconvinced and uncomfortable though. Many non-execs, including me, were put into the position of overseeing their own demise as a result of NHS reform. Most of us knew our duty - even if we were not convinced of the need or design for change - to oversee a safe transition to the new commissioning structures. It is hard to be passionate about a future which is not yours, but you can be professional, thorough, supportive and encouraging to staff caught up in the maelstrom of change and to the new leadership.

With the benefit of an arms length perspective, it can be possible for non-execs to take a cool-headed view of change, which can be helpful, but might also contain some risks. Non-execs can sometimes fail to understand the scale and depth of disruption that  change can create, and to underestimate the effect on staff and service users. On the other hand, non-execs can over do it, to want to help and get too involved in trying to manage the process of change, feeling that they can see the solutions and are able to fix things quickly.

At times of  change and disruption, it is important for non-execs to be at their best, balancing their duty and passion in equal measure. They need to remain clear about maintaining their focus on their primary purpose for as long as required, to be clear and efficient about implementing change, to let go when the change comes, and to embrace the new in its place, creating optimism and confidnece in the future.

At The Open Channel our personal and professional experienc as non-execs mean that we understand deeply the challenges that Trustees and NEDs face, and can help colleagues develop their own ideas about how to deal with them.

Sunday, 28 April 2013

Do you set goals or ask questions?

In the past week or so, I have had the benefit of some good quality ideas and challenges to my thinking, which I want to share with you. 

At The Open Channel we take a positive approach to the work we do with individuals and organisations, building on their strengths, so recent workshops by Action for Happiness and Quakers and Business have chimed well with our style.

I'm going to start in reverse chronological order with a workshop given by Vanessa King of Action for Happiness on the Great Dream - Ten Keys to Happier Living. I don't know how many of you will have come across this, but I recommend you have a look.

You'll find that the Great Dream is a mnemonic for the Ten Keys which are:

Giving Relating Exercising Appreciating Trying Out
Direction Resilience Emotion Acceptance Meaning

There isn't anything new in each of the words, but putting them together and looking at ourselves in the round can be very powerful. The first five keys are actions which we do externally to others, and which reward us with satisfaction and progress inwardly. The second five are things we do inwardly which have the potential for positive impact on others.

A couple of simple examples:

Giving - there is a well known business epithet 'Givers Gain' which is based on the experiential view that if you give a business lead or referral you're more likely to get one back. The key of 'Giving' in Action for Happiness' scheme is based on the belief that other people matter, and is underpinned by psychological research (which you don't have to believe if you don't want to) that giving lights up reward centres in our brain. This is parallelled in other business focused research on the success of Givers, Matchers (who only give in relation to what they get) and Takers which seems to demonstrate that Givers are the most successful group. 

So, giving may be good for our well-being and good for business. And the giving doesn't have to be massive - a small kindness or just being pleasant tends to have at least three degrees of separation. If you're nice to your partner in the morning, and they are smiling when they buy a paper, the news vendor is more likely to give a smile to the next customer. Other research suggests that five small acts of kindness in one day can have a positive impact which lasts up to eight weeks.

Direction - this is about having goals to look forward to. Action for Happiness says this is how happiness happens, through the power of small wins and the sense of progress which goals produce. I like this approach, it is of human scale.

Sometimes we can get caught up in developing long term strategies with lofty goals that are ambitious but probably never achievable. There is no doubt that these kind of goals can inspire and energise people, but probably only for a short time. They need to be broken down into steps and personal goals which people can recognise as something they can personally achieve within a visible time line.

I have a goal to write a novel (I might as well say to climb a mountain, its seems as daunting). But I can make steps toward this goal. I can practise writing in my comfort zone by producing another poem or two. I could send these to a competition or to magazines or put them on my writing blog to see if anybody has any feedback for me. I could try writing some prose, I could aim for 2000 words a week. With these smaller steps I can build up confidence and practise my skills.

Within organisations, goals are often articulated at both the visionary and practical levels and people need to feel a sense of progress by identifying with the part of the goal or steps that they can achieve. Appreciative Inquiry is a technique which involves people in producing a vision of the future together and designing the steps which need to be taken to deliver the vision. This co-production of goals works at a strategic level, but also at the personal level, for instance in setting goals with individuals making progress on a care path or towards a health improvement. At The Open Channel we have experience of using these techniques in a range of contexts. We are also experts at using Action Learning and Coaching techniques to help teams and individuals to find ways to overcome the barriers which make their goals difficult to achieve.

So yes, I am sold on goals both personally and for organisations, but I am conscious of the risks. I have plenty of personal and professional goals which I have not achieved and it is important to be aware of the negative impact that failure can have on people and organisations.

Which brings me to my second recent experience of hearing wise words from people who know things. Last weekend I went to a Quaker and Business Coaching Skills workshop where people from the excellent Sheffield Hallam University (I declare my interest I am a governor there and was trained in coaching by SHU) led an interactive morning where we learned and practised simple coaching skills. We were a mixed bunch of practising coaches and people who wanted to learn about coaching and how to use it at work or in a group they belonged to. We used the GROW model and the Three Stage Process as models to play with, but the general value was in learning how to use open questions powerfully. 

In the afternoon, we had the privilege of a discussion led by David Megginson, Emeritus Professor and world-renowned coach. His use of poems and quotations to illustrate his points was delightful, but it was his insight into the use of goals which has stayed with me. David and his colleagues are publishing a new book on goals in the autumn, so look out for it. 

For now, consider this. What would happen if, instead of setting yourself a goal, you didn't, but asked yourself the question, will I do that? It might be writing a novel, climbing a mountain, or in David Megginson's case a more simple and immediate goal of taking a run on a Saturday morning. What is the effect of changing I will go for a run, into Will I go for a run?

Well, it gives you the choice, to say no, I won't, I'll choose to stay at home and read the papers or do the garden or get the shopping done. And it means you cannot fail. If you make a choice not to do something, that's as positive as a choice to do something else. You don't fail if you have a choice. So you don't  have to burden yourself with a sense of something not done, a lack of achievement.

Is it worth a try? Shouldn't a goal always be a matter of choice anyway? Try framing your goals as questions, as choices and let me know how you get on.

Monday, 15 April 2013

Just to be different, my blog is not about Margaret Thatcher...well, not all of it.

Since my last blog, a fortnight ago, Margaret Thatcher has died. I can't imagine how many millions of words have been written about her, and there will be yet more, so I don't need to add to that volume. Looking back at my last blog, however, I realised that if you want to know what I thought of Margaret Thatcher, it would be pretty clear, so I refer you there.

One of the reasons why my views of Thatcher are clearly to one side, is because of my heritage. I am a coalminer's daughter. And over the last fortnight I have been obsessively researching my family history, triggered by a feeling that there is nobody left now in the generation above me and I need to leave some legacy to my children, who knew little of their grandparents.

I discovered that I am a coalminer's daughter, and grand-daughter and great-grandaughter back to the ninth generation when coal was commerically mined in Staffordshire. It is fascinating to find the details of people who have carried my DNA to where it is now, but the greater fascination is in tracing through the stories of real people the economic and social history of the last five hundred years, since amazingly I have found some relatives born in the early 16th century.

After an initial breathtaking but false start when I thought I was part of a line that stretched back through earls created by Henry V, to knights slain at Flodden and even pre-Conquest back to Charlemagne, I had to concede that I was probably fantasising but the likely false link has yet to be definitively disproved. Still, it is more likely that one of my ancestors was known as 'Big Charley' rather than Charlemagne!

The truth of my heritage is that on one side it is almost exclusively North Yorkshire, in a line from the outskirts of York to a village near Saltburn which is now in Redcar and Cleveland. These families illustrate clearly the impact of industrialisation on the rural poor as increasingly young men moved alone or with their families from labouring on farms to crawling down mines - initially ironstone mines in Rosedale and after 1926 to coalmines in South and West Yorkshire. 

And here they met families of Staffordshire miners going back generations who had moved for more work to Doncaster, Rotherham and Barnsley, as well as Irish migrants who built roads and railways and then mined for coal. These families initially farmed the lands of the gentry, and later mined to create power for factories and wealth for mine owners. They created wealth, but their share was only ever just enough.

It is striking how much they moved around for work, how much they squeezed into one another's tiny cottages to keep a roof over their heads, how few of their children survived to old age, how some of them declared themselves (especially a women living alone with three young sons, or an old man or woman) as paupers, and how some of these people after the Poor Law did find some awful kind of safety net in the workhouse. Pickering workhouse records for the end of the 19th century are full of surnames which appear in my family tree.

Some branches of my family enjoyed a little more prosperity, with small farms and skilled work appearing now and again, but generally I am clearly from working class stock.

Interesting developments appear in my grandparents' generation, where my grandfather's move from Rosedale to Doncaster is supported by housing provided by the local council. Having returned from the First World War alive, he was indeed a worthy beneficiary of these Homes for Heroes, but the solid brick family homes had an economic benefit in enabling men with the right skills to generate wealth in the local mine.

For my parents, born in 1920, early lives of austerity if not poverty in the 20s and 30s were followed by a married life after the war of relative security, comfort and aspiration. Things began to change for them, and were different for me because they had the benefit of social housing (initially the prefab in which I was born ) within five years of their marriage in 1946. 

My father, a bright man, was prevented by a test of his families means from going to grammar school - they could not afford his uniform or equipment. I passed the eleven plus and my brother and I benefitted from state education which set us up for working lives outside of mining or factory work for women. We enjoyed good health as children with free vitamins, vaccinations, eye tests and dentistry and developed aspirations to do something with our lives. 

Our parents, their parents, and all the generations before them clearly had  worked hard, moved around for work, used every spare inch of space in their homes to good purpose, and always hoped for better. All this they did on their own, with little help from anybody. 

With the help of collective contributions into welfare services and state provision of health, education and housing, I have prospered, which was the intention. I have had a career which has meant I have paid back into the system at a fairly high level, my children hopefully will do the same. But they are already seeing the state narrowing for them - they have no expectation of social housing, they will pay back the loans for their student fees, they will pay for the dentistry, the vitamins, possibly some of their healthcare, their care in old age.

We seem to have the view that the Welfare State makes us weak. It has made me strong. It has been the platform from which I broke out of generations of poverty and despair. I was lifted up by collective kindness and collaborative effort. By being the best we could be collectively, I have been the best I can be, I hope.

I have seen through the eyes of my family that people will move for work, live in overcrowded conditions, share their resources in order to survive, but I have also seen that some of them will die in infancy, of starvation, of addiction, of early ageing because without some kind of support.

I have worked in public service all my adult life. My commitment to it is personal and professional. I think it is good for individuals and society that we contribute collectively to support those who need our help. We all recognise that in charitable giving, (and in the modern idiom, in crowdfunding), but we don't seem to apply that kind of positive logic to taxation and the state.
State support in itself does not disempower, in fact it can do the reverse, it can make us strong. After just one generation of the welfare state 'experiment' we have just pulled out some of the vital bricks of support which may see the most vulnerable suffer real hardship. It is harsh and not economically sensible to frighten people into work without good access to jobs and housing in the places where jobs exist.

Margaret Thatcher is dead in the flesh, but clearly not in the spirit.

Sunday, 31 March 2013

At the end of Winter, is there hope for Spring?

We are still waiting for Spring, when new beginnings give us hope for the future. The persistent cold weather in the UK is almost a metaphor for the long dark winter of austerity which many are feeling, and which for some will deepen tomorrow when the first wave of benefits cuts bites.

On Easter day I woke with a sense that we are all in this life together, dependent through the cycle of birth and death on one another for our existence and our survival. Yet the system of monetary exchange which we use to make the world go round seems increasingly to divide us - the rich get richer, the poor never do.

After a Quaker Meeting which I attended in York today, I queued for coffee with a lovely Geordie  who I hadn't seen for a while. He told me he had been struggling and had been out of circulation for a bit, trying to prepare for the reduction in his income which would mean that from tomorrow he would treat 'every pound like ten pounds'. I don't know by how much the gap between Geordie's income and outgoings will grow as a result of bedroom tax, loss of specific benefit or requirement to pay Council tax, but it's enough to worry him deeply.

This week I went to my last meeting as an NHS Non-Executive Director 
and felt positive about how hard staff had worked in the most uncertain of circumstances to make sure that the handover to a plethora of new organisations goes smoothly. I am hopeful that the Clinical Commissioning Groups will work positively with provider NHS Trusts to form the backbone of excellent NHS services, but I am less sure that the commissioning landscape overall has any more clarity or stands a better chance of joining up effectively with social care and other vital public services. I asked the Director of the new Local Area Team of the NHS Commissioning Board (renamed NHS England as I spoke) what the process would be if somebody wanted to complain about their GP, and he was honest enough to admit that he wasn't sure. Patient access is a key requisite of a responsive NHS and a good companion of patient safety. 

I spent Wednesday morning in Doncaster with health, social care and voluntary sector partners talking about how to create a Dementia Friendly Community. This work, which is a joint venture by AESOP Consortium and The Open Channel is based on our work for Joseph Rowntree Foundation published last year as Creating a Dementia Friendly York. We heard from a woman who is caring for her husband who has Parkinson's and dementia with Lewy Bodies. They are a well-off, educated couple who need no financial support from anybody, but who are frustrated by the lack of consistent information and moral support which good coherent health and community services should provide to them as tax and community tax payers. It is not the money that's important, it's the understanding, fellowship and humanity that people need in their darkest moments, and rich and poor are no different in this respect. We all wondered how people living alone or with fewer personal resources were coping, and we realised that this is why too many people with dementia are in hospital or nursing care when they don't need to be, because there is not enough support in the community. We must turn this situation round before the NHS and local authorities are swamped - will CCGs be able to commission this change?

On Thursday I chaired a meeting of a national drug and alcohol treatment charity where I am a non-executive trustee. We reviewed the caseload of serious untoward incidents affecting people using our services over the past year. This included about 12 deaths. Almost invariably these were deaths, not always accidental, of heavy drug or alcohol users who risk their lives by their lifestyle. But they are also the sons and daughters, husbands, wives, mothers and fathers, sisters and brothers of many of us, and they have been unlucky enough to encounter addiction, whereas we have not. Some of these people would have led difficult, impoverished lives with or without addiction, but some could have lived well, happily, productively if things had turned out differently. 

This weekend I spent with friends in my hometown. Ironically, I went to a beer festival in a pub which I used to frequent as a teenager in the 1970s. My brother and I both drank there - I escaped addiction, he did not. We heard stories of our friends and their families which illustrate that alcohol is blighting the lives of people with good jobs and incomes, outwardly respectable and happy but suffering under a burden of habit and aggression. We are not all as we seem to be.

This weekend a group of Churches in the UK spoke out against the government for perpetuating myths about poor people -   that they are lazy; that they are addicted to drink or drugs; that they are not really poor; that they cheat the system; that they have an easy life; and that they caused the deficit.

How important it is that we speak truth to power, that we stand against the stereoptyping and blaming of vulnerable people, that we recognise addiction to be a curse and not an indulgence, that we understand how all of us can fall victim to the seductive draw of money, but that the rich have much more scope for exploiting others that the poor will ever have.

We are all in this together - isn't that what the Prime Minister would have us believe? Then yes, let us support one another, recognise or interdependency. Don't set us against one another, making us ever more distant and afraid. We will thrive through joint endeavour, mutual support and understanding but if we continue to punish the poor we waste their potential and impoverish our human spirit.

Sunday, 17 March 2013

How Do Boards Really Know What's Going On?

Corporate failure continues to be in the spotlight, whether in private or public sectors. How do Non-Executives, Independent Directors and Governors really know what's going on? Are Unitary Boards best, or can they become too managerial? How do Boards set a good cultural tone by finding the right balance of challenge and support? How do Board members 'test' the information they are given to assure themselves of its accuracy?

I hold four board roles - one, as Chair of a drug and alcohol treatment charity, is wholly concerned with the delivery of public sector contracts and has a board with private, public and third sector experience. We seem to face in all directions at once, responding to and affected by public sector commissioning and payment by results, concerned about our charitable objects, and needing to create an operating margin to secure a sustainable financial future. 

When I joined the organisation I was soon conscious that senior staff and Board members portrayed the charity in different ways, emphasing various strengths and weaknesses and holding different views of how we might manage the future. It was important for me to  establish quickly a position where there was a shared understanding about the basic 'facts' - our financial standing, what we were delivering, how our customers and commissioners saw us, and our position in the current and future markets. This has stood us in good stead. It has enabled us to take some difficult but necessary decisions. We may still hold different views and have a range of ideas about the future, but at least we are able to identify our differences from a common starting point.

For me as Chair, this experience in the first six months, has been very hands on and not what I might have expected of the role. The culture of the Board is managerial with non-executive trustees who are very experienced and intellectually able and who are very challenging and highly supportive at the same time. We are a unitary board, with a third executive membership and this is a relatively recent evolution which may not be fully embedded. Executives tend to contribute in their areas of expertise, rather than in general on any matter. As we develop the board over the coming months we will think very carefully not only about our constitution but also about our behaviour, and how our structure affects the way we act .

In the NHS Unitary Boards are the norm in hospital and community trusts and have been in the shortly to disappear commissioning bodies, the Strategic Health Authorities and Primary Care Trusts. Having been a Non-Executive Director on both and SHA and a PCT over the last six years, I reflected on how things might change in the new NHS in a Guardian Public Leaders Forum at the end of last year. The new Clinical Commissiong Groups generally have two lay members to eight GP members with other professional members from local authorities or other sectors. If the lay members represent the only source of independent challenge, they are going to be a small voice. I noticed this week my local Commissioning Support Unit - the arms length structure set up to provide back office services to CCGs- advertising for a Lay Adviser. Positive that outside expertise is being sought, but interesting that it is clearly not a decision-making role.

Governance is so much in my mind this week for two reasons - the first is having the opportunity to participate in a Leadership Foundation event on the role of Universities in the current economic climate. This thought-provoking conference allowed us all to think about the purpose of universities and how independent governors in particular might encourage a more outward facing approach. Our creative thinking was balanced by very focused sessions on the very complex regulatory framework and on Key Financial Indicators. 

What this brought home to me was that, whilst I had been recruited as a university governor for my expertise, knowledge and connections in particular areas, my obligations as a governor require me to understand the business  well and to be able to ask the kind of questions which our regulators, funders and students would be asking. Talking to staff and students, taking the temperature of the organisation is a valid way to hear whether the information in board papers rings true. Comparing performance with other univerisities or similar sized organisations in different sectors is important in evidencing how progress is being made and what your organisation is choosing to do and why. You can be an outlier, but with good and conscious reason.

Also this week I spent 24 hours with the Board and senior officers of a large social housing provider whose Board I joined last year. Like the university,  we are a large organisation with charitable objects operating in an increasingly commercial context with reducing public funding. We are a refreshed board with a majority of new members and a new execuitive team, so building relationships and finding out about one another is important. The organisation is in a state of rapid transformation and the context is also changing with Welfare Reform and a challenging housing market being  twin peaks of concern. How can the Board, meeting six times a year, keep a focus on what matters and oversee the development of strategy and the management of risk at a volatile time. At the moment, our approach is to involve as many members as possible in the business through role on subsidiary boards and Committees. This is all very well, and engages us in the detail, but it also generates a lot of governance business which distracts from delivery and results in information being reproduced and processed by the same people in different groups. 

We are conscious of our responsibility for good governance, so we are prepared at the moment to have more detail rather than less. But data and information are not the same as knowledge - we have to understand and know what the numbers mean whether they are about finance or activity. So again, seeing how the organisation runs, what our homes and estates look like, listening to residents where they live and around the Board table are essential parts of testing the reports we receive.

Boards are not there to do Management's job - what many Chief Executives fear- but we can't govern well without understanding what Management's job is and how well they are doing it. Governance is about assurance, assurance is provided through evidence, evidence is multi-dimensional . Boards need to understand the dimensions of the organisations they govern in order to do their job well.

At The Open Channel our support for Board Development and Leadership reflects many of these experiences. Let us know how they reflect your.

Sunday, 3 March 2013

Organisations Need Excellent Leaders But Not Just at the Top

Leaders are always in the spotlight, whether they are in charge of the country, the banks or the NHS. The people at the top of organisations are rightly held to account for the performance, productivity or profit of the public services or corporations they run.

The ongoing debate about leadership in the NHS following the publication of the Francis report last month, highlights how patients and the general public assume that the ‘top person’ determines what happens in an organisation. 

The Daily Mail continues to bay for the blood of Sir David Nicholson, responding to the understandable need expressed by relatives of patients so badly treated at Mid-Staffs for some kind of retribution. The more balanced and specialist press, as well as senior managers in the NHS find themselves uncomfortable in wanting to defend Nicholson without appearing to challenge the righteous indignation expressed by the relatives.

As someone coming to the end of a six year tenure as a Non Executive Director in the NHS my perception is that the NHS itself has subscribed to an autocratic style of management which can only ever be partially successful. The perception and reality of political interference in the day to day running of the NHS has led to its separation from the Department of Health in the new reforms, with Nicholson at its head. This both clarifies and intensifies the ‘chain of command’ felt by all senior management within Sir David’s sight line. For many of us who serve as Non-Executives who are not from within the NHS, his personal influence is overwhelming, and it doesn’t feel that healthy.

There is no doubt that a top down performance driven culture can achieve results. It is true that many people have been better treated, more quickly, for less cost in recent years as a result of the ‘grip’ on the ‘system’ which is the everyday parlance of NHS management. As someone who is very keen to see people enjoying better health and experience excellent services, this evidence is welcome. But it often feels hard won, and difficult to hang on to.

The NHS is an extremely complicated business, demand is growing as the population ages and technology offers more possibility for treatment and cure. We expect more, faster and we don’t really want to pay for it. The pressure is intense, and it is felt every day in every hospital, clinic and GP surgery. Strong management is only one aspect of the kind of leadership needed to deliver an excellent NHS, and on its own is not only insufficient, but as Francis has demonstrated it is very, very risky.

As in all organisations, the NHS needs good leadership to run through everything it does, like 'Blackpool' through a stick of rock. Strong management is not the same as good leadership. Strong management can be prescriptive, telling people what to do, encouraging them to wait for orders. Good leadership is empowering,  encourages people to generate ideas and to respond appropriately to changing situations.

In a National Health Service we are looking for consistency, fairness and access for all, so there have to be national policies, guidance and sometimes rules. But health varies from person to person and from community to community, influenced by lifestyle, economic and social circumstances and genetic inheritance. A public service needs to respond to what it finds at the point that people ask for it, and our NHS needs to enable the doctors and nurses that we train so well to practice their clinical and caring skills in a wise and sensitive way. 

I am disappointed that the NHS reforms seem to have resulted in more managerial and bureaucratic layers than they were designed to replace, but I hope that there will be more opportunity at a local level to determine excellent quality services within a national health context. I hope that leadership at the top of the NHS will recognise that it is a service, not a system and will empower those locally to serve people well. 

At The Open Channel our commitment to building on the strengths in people and organisations recognises that leadership exists at every level and in public service we fulfil our purpose if we support one another to achieve our best. We are all accountable. And we have the power to succeed, if we share that power.