The blindingly obvious

I came across an opinion piece in the Health Service Journal recently. Well written, to the point and with a clear call to action. It’s been bothering me ever since.

The piece, written by speechwriter Simon Lancaster, described the damaging affects of the car metaphors we use in the NHS. He pointed out words like drive, toolkit, dashboard, accelerate and phrases such as ‘step up a gear’ and ‘patients in the driving seat’.

Simon’s argument was that the language is demotivating, emotionally detached and jars with the very idea of change. The killer point is that this has a direct impact on our behaviours and culture.

I might not use all of these words and phrases but I definitely have drive and dashboard in my lexicon. Or should I say, did. If my job is help make the NHS less about corporate speak, less management jargon and more about being connected to people – to patients, families and staff – then I have let them down.

I consider myself pretty self aware, tuned in to plain language and customer insight and yet I have been blind to these metaphors. Sure, I can pick up an acronym at 40 paces, spot the latest management buzz word or question the meaning of a gobbledygook sentence. But the subtle power of the clunky, mechanical and detached car metaphors? They were under my radar.

I am indebted to Simon. He opened my eyes to something right in front of me, allowing me to see the blindingly obvious. As we approach the publication of the Francis report, such fresh perspectives on our behaviours will be crucial.

This blog was originally written for the NHS Top Leaders programme website.


I’m not budging

Remember Dolly?

She’s my dog. The one that plays inside outside.

Time to mention one of the other traits she has. The ‘I’m not budging’ trait. It goes like this. We’re walking along, I’m admiring the sunrise, enjoying the solitude that comes with walking her before work and she’s trotting along at my side. It’s a perfectly normal dog walk; one that you see on any street in any town or village throughout the country.

Until Dolly stops. She’s not stopped to sniff anything, eat anything or because she’s tired. She’s just decided to stop. A bit of coaxing from me. “Come on Dolly, good girl.” Nothing. A bit of tugging on the lead from me. It’s met with resistance, the brakes are definitely on. More cajoling from me, this time with excited intonation (it’s what the dog trainers say, right?). “Good girl, let’s go! Come on!”

Still nothing. She’s sat down, big brown eyes staring right at me. Her neck rigidly set waiting for me to pull at her lead again. My pre-work schedule doesn’t have time for her shenanigans. I’ll be late if she doesn’t budge soon. So I raise my voice and pull on her lead. “Dolly, come ON.”

Still nothing. Just her will to stay put.I feel frustration welling, my temper and anxiety levels rising. I DO NOT HAVE TIME FOR THIS. We’ve gone from pleasant stroll, where I’m feeling great to be alive to this ridiculous impasse – in a matter of minutes.

The answer – as I’ve learned – is to wait for Dolly to get up and walk on, by herself. It doesn’t take that long either. Once I’ve stopped pleading and yelling and pulling, she decides quite quickly. We’re already on a course and she knows where we’re heading. My role is to enjoy the moment, breathe in the clean countryside air, admire what’s around me and use the precious time to think about what I can do next to get the best out the day ahead.

I’ve found it’s a useful lesson in communications too.


Let’s face it, falling isn’t pretty. And when it’s from a great height it can have some devastating consequences:

  • First, there’s the obvious. Bruises, broken bones, and if you’re really unlucky, maybe even some internal damage
  • Second, should you actually be able to stand up and walk away, there’s the aftershock. Did that really just happen to me? Did anyone see it?
  • Third, should you still be alive, there’s a protracted recovery period.

And that recovery period depends on two things: how hard the impact was (physical) and how many people witnessed it (psychological).

This week, we’ve seen two massive falls. Jimmy Savile and Lance Armstrong. One a once popular DJ, TV presenter and charity activist; the other a man who defeated all the odds to become one of the greatest cyclists of our era, a paragon of what ‘fighter’ looks like. Or so we thought.

They were household names just a few weeks ago, held in affection or awe. They are now being talked about in very different tones. And whatever our own personal thoughts, the general accepted view of these men was one of reverence. Personal brands that were, forgive my prose, untouchable.

While I’m hearing people say they’re not so surprised, I still think there’s an element of shock that the revelations have been so, well, on such an industrial scale. In both cases.  Why do we, passive viewers mostly, feel a bit stupefied? It’s simple. We believed them. We thought they were authentic. I know this feels uncomfortable – but we (mostly) trusted them.

Brands are built entirely on behaviours and actions following a promise. The difference between personal and corporate brands is human behaviour. We, as humans, can relate to people. Of course, we still want to relate to ‘things’ (and boy, do those corporate women and men try to help us!) but it’s just not in our human nature to connect on an emotional level with a product. This is what makes the personal brand fall even harder. It’s why the column inches, the broadcast air time, the social media conversations are even bigger.

While each must yet be properly judged, I fear the damage is done. How do you recover from such a monumental impact. For Jimmy Savile, we might argue that it doesn’t even matter.  He’s dead. So what? Well, indeed. But there is the question of his family and how they feel about his legacy. As for Lance Armstrong? I’m interested in what the legal rebuttal hopes to achieve. Short term, it’s about saving his reputation but long term? Experience tells me that you can’t argue with facts – and reputation management must take this into account. The risk of not doing so ends in far greater toxicity.

And sometimes, if it’s appropriate, it’s about saying sorry. Why? Because we’re human beings. Because we talk to each other, because we can reason and because we can feel. Because we can assimilate evidence and reach logical conclusions from it.

Generations that inspire

One way or another, we’re all inspired by past leaders. I don’t mean Winston Churchill here. Nor Mahatma Ghandi, Martin Luther King or Aung San Suu Kyi.

I mean leaders we’ve personally known; such as, for me, Mrs Greensitt. In the comprehensive system of the 1970s, she was both my French teacher and the school’s librarian. She insisted on punctuality, neatness and discipline. She’s the reason I enjoyed French so much and she can take full credit for inspiring my passion for words.

Or how about my news editor, Mike? Nothing, but nothing phased him. He approached every news assignment calmly, quickly cutting to the facts and setting the context for the story. He also instilled in me the golden rule of deadline.

Then there’s Bob, one of my PR bosses. His handling of journalists was outstanding, his ability to navigate a strategic course for a client exemplary. He taught me the importance of building and maintaining relationships and why communications was never about the short term fix but the longer game.

And in the NHS? Well, I’ve learned from some amazing people. From the staff who can see a better way to do things and make it happen, to the board directors who can motivate and lead a whole workforce.

I am part Mrs Greensitt, part Mike, part Bob, part others. And just as they inspired me, I am acutely aware that I too am a role model for those who work with me today. I love our Olympic strapline – inspire a generation. But for me, there’s also something about generations that inspire.

We have a responsibility as today’s leaders.

Why comms teams need to measure their work

Being measured on how well we’re doing, as individuals, organisations or across the whole public sector – is now commonplace. In fact, we expect it. People want to know where public money goes and they have a view about whether it’s a wise or ill-advised spend. Long gone are the days when the only probing questions were from a journalist with a good lead.

Thankfully, there’s lots of great work going on to address this, and while some of it’s prompted by policy or nudged by law, I don’t think there are many who would disagree that greater transparency is absolutely the right thing to do. Take a look at any NHS website, there’s reams of stuff – from board papers, to annual reports, quality accounts and lists of payments (though all of these aren’t always easy to find). Personally, I love what Chelsea and Westminster Hospital NHS Foundation Trust has done – they’re totally up front about openness.

Now here’s the irony. While communications professionals are usually the ones advising on how best to make data accessible, we haven’t traditionally been great at measuring our own effectiveness. Up until recently, the main industry method was crude – we worked out how many column inches our proactive work produced and then translated it into its advertising value equivalent (known as AVE). It only ever really worked with positive coverage and even then, was pretty blunt.

So it’s great that NHS communications is starting to get to grips with how we demonstrate value – aided significantly by technological advances that simply weren’t there 15 years ago. It’s not easy to find evidence but Leeds Teaching Hospitals is doing it and so are we.

And we’re doing it for a range of reasons – it helps us measure ongoing work and campaigns, it helps us plan and prioritise and it gives our work credibility in the boardroom. Most importantly, it helps us to work out the return on investment, so we can discover if the campaign was worth doing in the first place.

In the last six months, my team has been working on a comms dashboard, which is helping us to do all of the above.


It’s still embryonic but as an ambitious team of three, it’s our starting point and way of showing the value our work brings to the public purse. Every month, we split down our activity into print, broadcast and social media, internal and external communications – matching input against outcome measures. It’s not easy but we’re learning and improving it month on month – based on feedback and benchmarking.

I’d love to hear your views.

Common purpose

I’ve just counted how many people who I don’t line manage who helped me last week. It was 26.

That’s 26 people who had no obligation to put my request before their own work priorities. The list includes an emergency department consultant, a lead nurse, two midwives, a physiotherapist, a facilities manager, dietitian, matron and several directors.

Without their support, the hospital couldn’t have passed its Information Standard (IS) assessment or hosted national BBC news for 12 hours on the doctors’ action day. Both of these activities were time consuming, hard work and certainly not imperative.

So why did they help? Was it personal gain (thinking of their own CV)? Maybe some of them wanted the glory of being on telly (really? This was a tricky subject matter with stardom extremely unlikely)? Or perhaps they wanted some distraction from the routine?

You know, I don’t think it was any of these.  I think it’s the old favourite – coming together to deliver a shared goal. In both instances I needed staff from different disciplines to respond urgently and in some cases, asking them to drop what they were doing (with the exception of patient care) to respond to assessors or news crews.

There’s something about being able to influence here (more on this another time) but I also think they did it because we all share the same goal of wanting patients to have confidence in what we do and how we do it. Going the extra mile without hesitation and with passion is easy when the end point is so obvious.

We already know from anecdotal evidence that local people were impressed by what they saw of their hospital on the BBC coverage and now that we’re able to use the IS kitemark on our patient leaflets, well that means they can trust the information we give them too.

And that’s all thanks to 26 people who had other things to do.

An Olympic challenge

There are two camps of Brits out there right now: those who are loving the Olympic Games build up and those who are thoroughly hating the hype.

So if you’re in the latter, stop reading this now. It is likely to provoke symptoms of agitation and possible exasperation. But if you’re an out and proud Olympics fan, then read on – this story could make your heart swell.

I work in a district general hospital where the staff turnover is low (below the national average) and long service awards are a-plenty. It’s both a positive (strong relationships in and across teams) and a negative (team morale can disproportionately suffer in challenging times).

So as we step up our communication and engagement efforts to encourage transformational change, it felt timely to measure that morale. And so, using the NHS Institute for Innovation and Improvement “energy” test, we asked the hospital’s top 100 employees (nurses, doctors and other healthcare professions) to tell us. My hunch – that our energy state would major on ’resigned inertia’ – was right. We’ve got a lot of downbeat staff out there.

Then just the other week, I saw quite the opposite. I watched off duty staff from one of our wards compete in their own mini Olympics fundraiser at the front of the hospital. They did it in lousy weather, with far fewer spectators than the official ones around the corner. And as I stood watching them in the freezing cold, as they ran up and down the obstacle courses, I couldn’t help but ask what was motivating them? They’d gone to a lot of effort. Equipment had been loaned from a school, a bouncy castle had been borrowed, they’d sat down to plan and manage the event and, above all, staff had bothered to come in on their day off. These people were neither inert nor resigned.

Here’s why I think they did it. They have a great leader in their lead nurse. She connects with people across the hospital and outside it, she’s a great communicator, her energy levels are off the scale and she’s keen to try new ideas. She is inspirational and her team adore her. They can see her vision (absolutely amazing care for elderly and dementia patients), they can feel her passion and they want a piece of it. It’s that simple.

So while our overall energy levels need some tlc, there are pockets where it’s hugely productive and positive. What we need to do next is understand the measurable success factors in those teams and benchmark against them. If we do that, while continuing to frame our organisational challenge as a positive one, we might just have ourselves a winning team.