I am probably not alone in my ‘dghealth blog thing’ reading habits. I usually take a very quick look at the blog on my phone while walking down the corridor and sometimes I can read a bit more in a gap in a clinic. Occasionally a multi-disciplinary clinic has finished ahead of time, the sessions have gone well, all my admin is up- to-date, and I get to read the full blog at a leisurely pace and discuss some of the issues raised with colleagues over a cup of coffee. That last one has never actually happened, but I live in hope.
To accommodate varying time constraints, this blog is available in four sizes; one sentence, short (basic facts), medium (takes a bit longer to read, but puts it into more of a context), and big. Perhaps think of it like the ripples moving outward from where a stone hits the water. Feel free to read some or all of it.
The One sentence version:
Listen to your Values and Do what matters.
The Short Version:
NHS D&G have developed a list of shared values. That is, principles we agree are a central part of our organisation and should guide our behaviour. They are both ‘core’, as in essential, and ‘CORE’ as an acronym. These were developed during 2013 through a partnership process and agreed and adopted by the Board in May 2014.
Our CORE values are;
So what would these values look like in the real world? The good news is that there are already lots of examples of ongoing work which is consistent with CORE values (What Matters to Me?; VOICES; Values Based Reflective Practice; Emotional touch Points, Appreciative Enquiry etc to name but a few). Several of these have featured in previous blogs. At a recent meeting we started to chart what was already being done and it became clear that there are many ways move towards these values.
The next stage is about ‘spreading the word’, so that everyone is aware of the CORE values (if you are reading this, congratulations, you are aware!) and then trying to ensure that they become part of everyday practise. Discussions are ongoing as to how CORE can become part of our everyday work through various possible ways ranging from conversations, PDP’s, Staff Inductions to posters and letterheads.
So far, so good. No doubt we will all become much more aware of ‘Our CORE Values’. People with far more artistic flair than me (thankfully!) will hopefully develop some sort of logo that would be recognisable and remind us of Our CORE values.…
The Medium-Sized Version:
You may be wondering why it is now felt necessary to state our ‘CORE Values’? Isn’t that what we already do? Is this just the latest ‘top-down’ noise/nonsense/way to keep people with not enough to do busy/busy people busier etc? You may have noticed that NHS organisations across the UK over the past year are also busy promoting their own, strikingly similar, versions of the ‘CORE Values’. How comes?
Does this stuff matter? Really?
The Francis Enquiry (2013) took place into the causes of the failings of care which occurred within the Mid Staffordshire NHS Foundation Trust between 2005 and 2009. The report outlined ‘widespread unethical behaviour …. toxic work environments where bullying and intimidation are not uncommon’. In short, it warns that if we do not want repeated scandals due to poor, neglectful or abusive care, inadequate governance, interdisciplinary conflict and poor staff morale, then we need to do something different. This year, Robert Francis said: ‘A repeat of the Stafford Hospital scandal is still possible and it is “dangerous” for NHS staff to think otherwise’.
As tempting as it is to think that a few ‘rotten apples’ are to blame, research from social psychology illustrates that the way we behave could best be understood as part of a much wider social framework, (for example, how and why ‘good’ people do ‘bad’ things and how some groups are devalued in societies). There is also the impact of ‘power-relations’ and authority. Some people in some situations are more powerful than others.
So yes, it would appear that it does matter.
Francis made 290 recommendations, including openness, transparency and candour throughout the healthcare system, together with calls for improved support for compassionate caring, committed caregiving and stronger leadership in healthcare. The key issues here are all interconnected – patient safety, leadership, governance and staff well-being. Diagnosis of a problem and prescription may sometimes be relatively easy, but delivering effective solutions in complex healthcare systems is very hard to achieve.
‘Our CORE Values’ is one way to try to find solutions to these issues. The words that make up CORE need to become consistent patterns of behaviour. We need to first understand what these words actually mean and then what they would like in practise. This is no small task. But if we really agree with CORE, then worth it.
Oh yeah, the ‘big version’ of this blog? My hope is that ‘the big version’ will be the conversations about Our CORE Values and whether we are acting on them.
Jim Lemon is a Consultant Clinical Psychologist working in Medical Paediatrics for NHS Dumfries and Galloway