Making Meetings Better

iurI’m not a great meetings person. I just generally find them tedious. I lose concentration easily, I get distracted, I end up thinking about a whole lot of things that maybe I shouldn’t be thinking about or eat far too many biscuits and then feel bloated and guilty at the same time! Meetings and me don’t really mix….but I have to go to a lot of them, in fact, I now have to chair many of them and so I’ve been on a bit of a journey about how meetings can be made better.

 

My main beef with them, it turns out as I’ve reflected on why I dislike them quite so much,iu-6 is not that they don’t achieve anything. Nor is it that I’m involved in conversations I don’t care about – actually I don’t go to any meetings in which I don’t deeply care about the things being discussed. So what is my problem? My problem is that meetings, and I don’t think this is unique to the NHS (but this is where most of my meetings take place), are so often devoid of any real human connection. They lack care for those attending the meetings. It’s so easy to get so focussed on the stuff, the business, the discussions, the problems, that we forget that there are other human beings in the room, each of whom arrive in the room (or virtual space) with many different emotions, stories, dreams and realities that may be really important, but we don’t know because we don’t give space to those things.

 

So, as I believe culture change has to start with me and the teams I work with, I am trying, somewhat awkwardly at times, to have different kinds of meetings! When I chair, I refuse to let us get on with ‘business’, until we have taken time to connect with each other. Using iura simple technique from the ‘art of hosting’ I give space for a ‘check-in’. A check in is really simple, it’s just what it says on the tin. There are usually 2 questions and they can vary from meeting to meeting. Often, I just ask: How are you? And what do you love about your job? It is so important to know how each other is doing, so we can create teams that care for each other. People don’t have to be honest, but when they choose to be vulnerable, it opens up a space that is incredible and invites the entire team to go a bit deeper. And giving space for people to focus on the positive aspects of their work automatically changes the dynamic of any meeting from the start. Another of my favourite questions is: What do you love about working with the person on your left? (And if there’s time another round of ‘And what else do you love about working with the person on your left?). It is so healthy for a team to learn to appreciate one another but more than that, to actually tell each other that they are valued. You can get to know one another over a period of just a few weeks so much more and you end up actually caring about one another’s lives and wellbeing.

 

Secondly, I learnt a trick from a great friend of mine, who recently finished an MSc at theShoulderStretch University of East London. In the department of positive psychology there, a bell goes every 25 minutes of a lecture and everybody stands up and has a stretch. Research clearly shows, we don’t concentrate for any more than 25 minutes. And so now, in my meetings, every 25 minutes, my alarm goes off and we all stand up and stretch and get the blood flowing round our bodies. We’ve become so conditioned, like Pavlov’s dogs, that if anyone’s phone goes we all start to stand and stretch! Plus, it is great for low back pain!

 

The other thing, I have introduced is 2 minutes of meditation/mindfulness at the start or CeOnPGFWEAA48hjin the middle of a meeting. Using a very simple technique, I encourage everyone to find a comfortable sitting position. We then breathe in through our noses for the count of 4, deliberately breathing a sense of hope, peace, love and gratitude. We then hold this and hold our breath for the count of 8 (people count at their own pace) and then breathe out to through our mouths for the count of 8. When we breathe out, we deliberately breathe out stress, bitterness, anger, distraction, or anything that stops us being able to connect. And then we continue. The first few times I tried this, we had some giggling (mainly from me), photos being posted on twitter (!) and general weird feelings…..but we have pushed through and it’s amazing how good it feels to just stop and be and let the busyness just wash over us for a couple of minutes.

 

I can hardly say the above is a revolution, but I can say that I genuinely enjoy the meetings now. I know my teams better, I am more connected to those I work with and I am more able to focus. Connecting, stretching and some time to be still……it’s exactly the medicine that NHS teams need right now, and probably a whole bunch of other organisations also!

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5 Ways to Wellbeing 2) BE ACTIVE (Changing the culture of the NHS)

In my last vlog, I started looking at how we might use the 5 Ways to Well-being  to help build resilience and promote health, particularly for those who work within the NHS (though it can apply to anyone). This second vlog takes a look at the being active and how it can improve health and well-being.

 

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Better Care Together – Hope for the Future

iu-4My last post, “Time to Face The Music” was deliberately provocative. We cannot simply keep on doing what we’ve always done or nostalgically hold onto the ‘good old days’. As previously stated, it simply isn’t sustainable and we’re only deceiving ourselves if we think it is.

 

We find ourselves in a a different (post flood) landscape, a terrain that requires a new way of being together. And we are fast learning, here in Morecambe Bay, that it’s not just enough to break down the traditional barriers between Hospitals, GPs, Mental Health, Community Nursing, the Emergency Services and Social Services. No, we have to go much wider and deeper than that if we’re going to develop a radically new way of working that is sustainable. We need to develop a Wellness Service that is of high quality, able to continually improve and offer compassionate, excellent, affordable, safe and accessible health and social care to everyone in our community. In order to do so, we need every person in every community to partner with us. We need partnerships with education, business, sport, justice, housing and the voluntary sector to name just a few. Old silos must be broken down and centrally driven targets must be re-examined to give communities the ability to creatively flourish together.

 

We need big conversations across the sectors of society about what it really means for us to be well and how we can take better responsibility for ourselves and each other. It is so much more than just physical and mental health. It must include a wider understanding of social and systemic health also (see earlier posts on this).

 

And this is exactly what our team in Morecambe Bay is trying to do.images We’re not always getting it right and we’re learning some really tough lessons along the way, especially that our old habits of trying to fix things die hard! Real engagement takes time, but in the process of doing so, we are seeing 3 core principles emerging out of our focused work in Carnforth that we believe to be important keys to unlock this process in every community.

 

As we listen and engage with local people and communities, firstly we are seeing community leaders naturally rise up to make a difference and help increase the well-being of their area. We have many varied examples of amazing initiatives beginning. Secondly, we are seeing clinical leadership that is evidenced based and responsible, but empowers others to make a change. Thirdly we are seeing culture change beginning to emerge, with a more effective coaching culture and a focus on the wellness of those who deliver the care within our communities.

 

iuConversations really matter and carry within them the dynamic potential to make significant and lasting change, as we learn not only to talk differently, but to act differently as well. In the NHS, we have some expertise, but the true experts of their own lives and communities are the citizens we serve. We must change to be much more in conversation with them rather and lose the role of ‘grandma knows best’!

 

 

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New Year’s Resolution

imagesI’ve been thinking about making a New Year’s Resolution. So, this year, taking my role as lead for health and well-being seriously, my resolution is simple. In 2016 I want to improve my well-being and encourage others to do the same.

 

The New Economics Foundation have done some amazing work on how we can improve our well-being. “NEF is the UK’s leading think tank promoting social, economic and environmental justice. Their aim is to imgrestransform the economy so that it works for people and the planet. The UK and most of the world’s economies are increasingly unsustainable, unfair and unstable. It is not even making us any happier – many of the richest countries in the world do not have the highest well-being.” Have a read about their incredible work (www.neweconomics.org).

 

NEF have come up with 5 simple ways to improve well-being and my New Year’s resolution is to use their 5 steps and blog about the effects I experience personally as a result. I hope that this will be replicated in my work as our team engages with communities. So, here are the steps:

 

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1) CONNECT – this year I am going to be more present. I have found that ridding myself of my

imagespersonal twitter account and spending less time on social media has already helped this. I am going to listen with attention and speak with intention. I am going to listen with attention to my wife, my children, my friends, my family and my patients (rather than assuming what they will say) and I am going to behold them, dig for the treasure in them and be grateful for them. I am also more well when I connect with God, who is love. For me, more than anything this means taking time to be still. Being part of a community, rather than moping around in self-isolation (a tendency of mine at times – surprising for an extreme extrovert!) is also key.

2) BE ACTIVE – This year we are launching a really exciting sports initiative in our local schools to imagesencourage our kids to have better health long into the future. I am going to continue running and swimming, but I will increase this to ensure I am being active on a daily basis.

imgres3) TAKE NOTICE – I have a painting on the wall in my consulting room (done by an amazing local artist) that has these words on it: “Take time to do what makes your soul happy.” I am going to feed my soul good things this year by noticing what is around me. I live in a world, surrounded by beauty – from tiny rare orchids to vast mountains, the sea and the night sky. I am going to notice this beauty more.

4) KEEP LEARNING – I already have some things booked in. I’m going on a refresher skiing course,images
before we take to the mountains in February. I am widening my culinary skills with some cooking lessons. I am re-learning how to arrange some pieces for our local choir. I am continuing to work with a life coach and the NHS leadership program. This will be a year in which I learn a lot! I love learning.

5) GIVE – At the beginning of every year, my wife and I review our finances and make sure that we are giving enough money away. We try to ensure that we give at least 15-20% of what we earn to various friends or charities. Money can have such a hold and I find as I earn more, it is easier to get sucked into an unhealthy imgresview of it. Money is just money. I am determined to have a relationship with it that is joyful and giving rather and anxious and hoarding. I love the phrase – “Live Generously”. I want to live in a way that gives of my time, skills, energy and resources without burning out in the process! My life coach has taught me well about boundaries – very empowering, as long as the motivation is to be able to give. It’s amazing how much a sense of giving/contributing to community and the world really improves our sense of well-being. It’s not an easy path. It’s all too easy to get one’s sense of self-esteem and self-worth by how much one gives, so I will try and remain honest about this.

So, if you want 2016 to be a year in which your well-being increases, why not try the 5 ways above? And if you fall over, get back up and keep walking!

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Christmas

In my last blog post, I talked about the concept of meta-narratives and how they effect our health and wellbeing. For me the Christmas story is the ultimate meta-narrative (the big story with which I align my life). It changes the idea forever that God is a far off hierarchical, imperial, power-hungry megalomaniac. It eradicates the notion that we must go to him where he is in some special sacred space and will only find him if we clean up our act and start behaving in certain ways. No. He comes to us. This story (as JRD Kirk says) is not one of God changing his mind about humanity, but about humanity changing its mind about who God is.

iuHe comes to be with us and changes himself in the process. He becomes utterly human, not some weird, ready-break glowing child, but deeply human and in so doing destroys the stories we have told ourselves about what he is like. He comes to us. He comes right to our very situations, our joys, or triumphs, our brokenness and our shame and says, I AM with you.  And if you run away, I’m there with you. And if you turn away, I’m there with you. And if you hide away, I’m there with you. And if you fail, I’m there with you. And if you don’t believe, I’m there with you in your unbelief.  Because contrary to the caricature of Dawkins, I am love itself. A love that will pour itself out time and again.  A love that is stronger than bitterness, hate and division. A love that is willing to be misunderstood, misinterpreted and misrepresented. This is not the story of a God who slaughters his enemies in order to protect himself and those he holds close (a narrative upon which the nation state is built and uses to predicate the violence it does to others – and if you don’t believe me, then you haven’t read enough history). No, this is a story about a love that will lay its own life down for its enemies and enables us to do the same.

As Steve Chalk says, Jesus never came to start a religion. He came to start a political, social, economic and spiritual revolution. God with us – wherever we are. The God who prioritises the poor, the refugee/marginalised/outcast, the sick, the prisoner, the woman, the child, the environment. The powers have never and will never understand Light in Darkness-02or overcome this light. The promise of the light is peace. Peace on earth. If we embrace the way of love, anything is possible. Even in the midst of all the turmoil in our world this Christmas, I find great hope in the idea of God, who is love, with us in it all. I believe that when we embrace this light and this love as our meta-narrative, as our raison d’être, we find healing for ourselves individually and corporately.

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How Well Are You?

I have the joy of leading some health and well-being retreats with a good friend of mine, who is a life coach. The retreats look at the idea of alignment. Human beings are unique and beautiful, incredibly intricate and are made up of layers, like an onion. Some of those layers are individual and some are corporate, because no person is an island. At the core of who you are is your spirit, your unique self. Then there is your soul – that sweet mixture of emotions, thoughts, ideas, hopes, longings, memories, hurts, resentments, desires, etc. All of that is encased in a physical body, with all the complexities that the intertwining systems entail. And these 3 parts of you are constantly interacting and affecting one anoiuther. For example, physical pain caused to you by another person, may cause you to feel emotionally hurt also (soul pain) and crush your spirit. Or indeed, as I see many times in my work, emotional pain leads to a resentment, which causes a bitterness which manifests itself in a physical pain and so too your spirit is negatively affected.

But you do not just float around in a bubble. You exist in a corporate body, in a family, group of friends and community. You live in an environment of some sort, and your surroundings have an incredible amount of ability to affect your health and well-being. This is evidenced in the effect of air pollution on respiratory disease or the effect of isolation or indeed bullying on mental health. We are all aware of the sights, sounds, smells and stressors in our physical geographies. Added to this corporate body is our corporate soul. And in the corporate soul we find corporate memories, ideas and beliefs, fears and dreams, things we have been taught, world views that shape us and all of this feeds into our meta-narratives, the stories with which we align our lives, that give us some sort of meaning. Surrounding all of this? The corporate spirit. Love. God is Love, not fear, or hatred or violence or bigotry or judgment, but Love. We find time and again in our own lives and in the lives of those who come on retreat the misalignment/disalignment/nonalignment that happens so easily, not necessarily through anyone’s fault, but because life is so complex.

 

It’s not as simple as tweaking one thing and then everything falls into place. Many of us still have to live with chronic and enduring illness of various sorts, be that mental or physical and achieving images“perfect health” may not be possible. But alignment is possible and it is this that gives us a sense of well-being. So, how well are you? Do you know how much you are influenced by the corporate body and soul? What are your meta-narratives? How aligned are you? There are things we cannot change, but we can chose how we respond to them and the choices we make within them. I want to unpack this a bit more in subsequent posts, but this might just kick off some musings.

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Love – It’s a Two Way Street

There is a lie that has been told, to clinicians in particular, that it is wrong to get too close to patients. One is told to keep a healthyimgres separation, perhaps to make the tragedy we often deal with somewhat more bearable. We have shaped medical ethics around the four core principles of beneficence (do good), non-maleficence (don’t do harm), autonomy (respect a person’s own wishes) and justice (treat everyone the same). But as the black eyed peas would ask us (!), imagewhere is the love? Where is the love and compassion that makes us human and deeply connects us to the ‘other’ and even the ‘other, other’ (someone so different to us that we find it almost impossible to connect to them)?

 

I was involved in a conversation recently with Phil Cass, a psychologist and CEO of a healthcare company, from Ohio, about this very subject. He told me some very stark facts. In the USA, the highest suicide rate is now amongst physicians and 67% of medics suffer with depression. Studies found that although these people were motivated by love, they found it very hard to receive love back from those they were giving love to.

 

imgresWe have made the clinician-patient relationship a one way system, and we shut down the reciprocity of the love we give in the name of ethics and professionalism. But this is to our great detriment. Patients love and trust their doctors, nurses and therapists and this love could be a huge source of resilience, courage, support and hope. We must let down our guard and receive back the gift that we give in order toimgres become more healed ourselves. It will allow us to enjoy our work more, reconnect with the core motivation inside us and encourage us, because when we give and receive love it spurs us on to keep going when the system feel like it is against us.

 

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Compassionate Communities

I hope that Lancaster, the city in which I live may become the first official compassionate city in the UK. I don’t mind if it isn’t, but I do hope that many cities choose to take on this mantle.

Here is a beautiful and moving animation of what becoming a compassionate community is about.

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Integration and Collaboration

In my opinion there are two main systemic barriers to providing great health care on the NHS, currently (there are other ones also but in terms of the system itself – these are the two biggest). The answer to overcoming them btw is not privatisation via the TTIP. I like to look for solutions to problems, rather than focus on the negative….

So, firstly (and it really isn’t that hard to do, it just requires some funding, which in the medium/long term would be money seriously well spent):

 

iuAmalgamate patient electronic records and share them across the system. There is so much time/money wasted and clinical errors made because of this very easy to solve issue. I’m sure there are reasons why citizens may feel concerned and I really do understand them, but given the great work already going on in Tameside at the hands of the excellent, Dr Amir Hannan, and the positive feedback from patients, this needs to rolled out as far and wide as possible.

It helps patients feel more able to manage their own health conditions and ensures notes are always available at each consultation. It means medication changes are managed more safely and effectively and information is shared between professionals in a timely way.

 

And secondly:

iuBreak down the silo mentality and reality of the various care organisations. Breaking down the walls that prevent effective team working and amalgamating the budgets of health and social care will be a huge breakthrough for care. We are already seeing this with the establishment of Integrated Care Teams within general practice. The teams comprise of: GPs, Community Matrons, District Nurses, Community Therapists, Midwives, Health Visitors, Mental Health Teams, Social Workers, the Police, the Fire brigade, and a Care Co-ordinator to pull it all together. If you also throw into the mix third sector organisations aligned with practices and patient volunteers, you have an amazing force for good!

 

There are some warnings to put in place. Manchester, which is the first place to really try this under ‘Devo Manc’ is having a huge overall budget cut (20%) as it launches into it. The hope is that by working more collaboratively and in an integrated way, savings will be made. But the ‘Save our NHS’ group have some major misgivings.

 

 

If you wanted to know more about the details of DevoManc and the health impacts of that. You can find the Memorandum of Understanding here: http://www.nhshistory.net/mou%20(1).pdf and the Five Year Forward View here: http://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf
Innovative collaboration and integration of our health and social services does not have to mean the privatisation of them. But if the TTIP comes into effect, despite huge public opposition, then the NHS as we have known it will be over. IMO the TTIP deserves a full referendum by the people of Europe. If you don’t know about the TTIP, you need to, and you should seriously think about writing to your MEP to tell them why this deal needs to be stopped.

[1] Independent: What is TTIP? And six reasons why it should scare you:
http://www.independent.co.uk/voices/comment/what-is-ttip-and-six-reasons-why-the-answer-should-scare-you-9779688.html
Huffington Post: Corporate Courts — A Big Red Flag on ‘Trade’ Agreements:
http://www.huffingtonpost.com/dave-johnson/corporate-courts—-a-big_b_5826490.html
[2] MEPs will be voting on a resolution on TTIP in Strasbourg on June 10th. It’s not a legally binding vote, but what MEPs decide will send a strong message back to the European Commission about where we all stand on TTIP. If there’s enough opposition, especially to the worst parts of TTIP, it could damage the deal for good:
Euractiv: What will Parliamentarians vote on TTIP?
http://www.euractiv.com/sections/trade-society/what-will-eu-parliamentarians-vote-ttip-313845
[3] You can find out more about the European Citizens Initiative and who’s involved here:
https://stop-ttip.org/

 

If you want to, you can sign a petition here:

https://secure.38degrees.org.uk/page/s/eu-ttip-petition#petition

 

We need to continue with the kind of healthcare we actually believe in, improving it where this needs to happen, without it being stolen from those who need it most because of greedy trade deals.

 

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Healing our Corporate Soul

In my video blog about ‘Reimagining Health’, I talked about the fact that our well being is not and cannot be an isolated, individualistic experience. The truth is that we are part of a Corporate Body (that is a community of people with a physical environment in which we live) with a Corporate Soul (a set of beliefs/mindsets/worldview) and a connection to the Corporate Spirit (which in my view is either the spirit of love aka God or the spirit of fear). These corporate experiences have a massive impact on our individual sense of health and wellbeing, and actually, as we are part of the corporate, our individual wellbeing has an impact on others around us also.

Our Corporate Soul is the issue I want to concentrate on in this post. It is complex and something to which I believe we pay little attention. However, it’s effect on our individual and corporate wellbeing is vast. Take a moment to think about the subliminal messages that come through our various forms of news and multimedia everyday.

“Your life isn’t as good as your ‘friends’ on Facebook”

“You need to be on Facebook or you are missing out on so much”

“Unemployment is being caused by Immigrants – be wary of them”

“Be afraid – people hate our country and are trying to kill us for the ‘values’ we uphold”

“The way our country does things is right and just and those who die for ‘our country’ are never to be forgotten”

“Pollution is rising – we are heading for natural disasters”

“Buy the new car – you need it, don’t worry about the pollution – live for the now”

“The chocolate industry is built on the slave trade”

“You can’t change anything, so keep on eating all the chocolate you want”

“Banks are to blame for the financial crisis”

“We have bailed out the banks with taxpayers’ money, because we need them so much.”

“Really the reason for our national debt is the poor, who claim too many benefits – we should blame them because they are lazy – we won’t bail them out”

“We all need to live longer”

“We can live however we want – our healthcare is free”

“Our children aren’t doing as well as some other children around the world when we measure them against a set of very narrow targets – therefore we need more targets and more testing”

“The only way to keep our nation really safe is to keep the nuclear deterrent – in the end, this is what makes us safe”

“Our armed forces protect us by using violent force to topple regimes which do not suit our national interest. Power vacuums are now left in those nations with untold turmoil and the rise of significant extremism of which we should be even more afraid and need to silence. We will do this with more force. The use of violence make us feel safe”

 

No wonder we are so messed up. We have some very damaging and also conflicting messages coming at us, especially through the (social) media 24/7. When do we stop to ask ourselves how healthy our worldview/beliefs/mindsets are? How much of our life is driven by fear? A fear of want? A fear of lack? A fear of the ‘other’? A fear of loss? A fear of debt? A fear of attack? And how much of this feeds our individual(istic) souls of self-protectionism?

How badly we need some conversations together that enable us to challenge some of our current core beliefs. We will not find a place of health and well-being, happiness or wholeness until we do. We have aligned our lives with the Spirit of Fear and our Corporate Soul is entirely broken as a result. We must realign ourselves with the story of Love. There is so much goodness out there. Can you see it? Only love can drive out fear. Only love can heal and awaken our souls to another holistic way of being.

 

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