No.

On a bus in 1955 in Montgomery, Alabama a bus driver ordered a black woman to stand up and give her seat to a white passenger. This was the rule of bus segregation introduced in 1900. The woman, a seamstress called Rosa Parks, looked at the driver and said 'No'. As a result she was arrested and the civil rights movement in the United States developed to a new level. It resulted into a bus boycott that lasted a year. Rosa explained her word, 'I had given up my seat before, but this day, I was especially tired. Tired from my work as a seamstress, and tired from the ache in my heart.' She also said, 'All I was doing was trying to get home from work'.

Rosa's 'No' changed the world. It played a pivotal role in the movement led by Martin Luther King for racial equality and respect. Today where she boarded the bus there is a plaque to Rosa. Her statue is in the US Capitol Building in Washington DC. She received countless awards, met American presidents and had streets named after her. What Rosa symbolises is an ordinary person doing an extraordinary thing. Here was a black woman who said 'No' because her conscience wouldn't allow her to go along any longer with a system that discriminated against people on the basis of their skin colour. Rosa is a call to integrity. Her name is a byword for having principles and holding them when the going gets tough.

Principles and values are what make us what we are. They shape and hold us. There is a saying that says, 'To betray oneself in order not to betray another is the greatest betrayal of all’. This is a very insightful comment. It tells us that there has to be some space or line written within us that is inviolable. This line says that we may compromise on some or even many things but not on this. We all need this line. Without it we have no deep identity. The word integrity comes from the word integer meaning whole or complete. Without integrity we cannot have completeness or wholeness. Without a core set of values or principles we cannot have what we all seek in so many different ways- that sense of oneness, wholeness and completion.

At work and life we can be challenged to go along with things that may conflict with our centre. There is a point when we have to make a stand for what we are. There is a time to say 'No.' Without this possibility we are not really free. We are not of course advocating that people fight everyone and everything. What we do assert is that principles are key and without them and standing for them we find something fundamentally missing in our life and what we can bring to work.

So how do we keep our principles? Rosa's life and words gives us some clues. She didn't go looking for trouble or fights with authority. 'All I was doing was trying to get home from work.'  She had given up her seat before but now knew she couldn't to be true to herself and her values of justice and fairness if she did. A moment may come for us all when we have to make a stand or lose our integrity. Rosa was filled with a sense of what was right. 'You must never be fearful about what you are doing when it is right',   She also said,  'I have learned over the years that when one's mind is made up, this diminishes fear; knowing what must be done does away with fear.' This to us adds us to the following. We need to have our core values and know them deeply - not just on an intellectual level but on a intuitional one also. There is nothing wrong with avoiding trouble and confrontation. However if we are faced with a situation where we need to make a stand then we need to do that  - trying to have sensitivity,grace and dignity. There is a moment when the issue that faces us is a values question and our answer is about whether we are true to ourselves or not.

This article is all about Rosa but it's also about you and us. It's about the sort of people we will choose to be. And the sort of people we decide to be is the sort of world we will create for ourselves and others.We started with Rosa and we will finish with Rosa. In doing so we dedicate this piece of writing to her and all the other Rosa's who say 'No' to whatever is wrong in our world. They are the real heroes and heroines. Rosa expresses this better then we ever can. 'Stand for something or you will fall for anything. Today's mighty oak is yesterday's nut that held its ground.'

Lisa Falkingham, Service Improvement Team, Leeds Community Healthcare

John Walsh, York Street Health Practice, Leeds Community Healthcare

Meet our staff - Rehan Majid

The trust has a wide variety of services and employs over 3,500  people, many of which carry out different roles. Through these blog posts, we aim to offer a snapshot of some of these roles by talking to people that either care, treatment and support.

Rehan speaking to a client at York Street Health Practice

Rehan Majid, a Client Support Worker at York Street Health Practice, has kindly shared with us an insight in to his role. 

Tell us what your role as a Client Support Worker involves...

The CSW role is very varied and diverse. I work with and across all client groups here at YSHP, helping, supporting, signposting and advocating in whichever support matter is raised with me, with the exception of Immigration. In this role, it is vital to be able to think and work on my feet and be able to be very resourceful and to be able to work under pressure.

Working with various clients across the practice is wonderfully diverse, and brings the best out of me as I have to be able to switch from one set of issues to another often in a very short space of time. In my professional opinion, it is imperative to have a basic understanding of various systems whether health, welfare or the Asylum Process.

Moreover, the role entails being able to go out and deliver presentations on issues that I care about very passionately and share information with whichever audience I have been requested to speak to. The teaching aspect is for me is equally wonderfully satisfying for me, as I am able to utilise and demonstrate skills that lay dormant within me.  

                                                                                                                                                                  

Why did you want to do this role?  

I wanted to do this role for several reasons – primarily to try and help make a difference to people’s lives, to do my best to be a strong advocate as possible for the most vulnerable client groups in today’s society. To be able to care for people and support as much as feasibly possible the most vulnerable client groups in our society. I already had some previous experience within the voluntary sector and prior to that in a College of Further Education as a Street Life Support Worker. Having being grounded and brought up with a very strong sense of social justice, it was a natural step in a sense to be able to contribute in a positive sense, and be able to put back into the local community after having fulfilled my academic responsibilities. To be able to care for and work with the various clients groups is an ultimate privilege and an honour, and is a very humbling experience.

  

What is the best bit about doing your job?

The best bit about doing my job is being able to help our service users, even if it just means being there to listen, as often clients are in crisis, immense distress and feeling very alone. Hence, being able to listen to and support, providing empathy and a listening ear is often very powerful and can give people the lifeline that is required. 

Being able to help in the process of change is a critical aspect and most rewarding aspect, particularly when I am able to witness at first hand the progress of a client is a tremendously profound feeling, as there is some sense of achievement in those particular scenarios.

Have you seen York Street change during your time in role?

I have been very honoured and privileged to be able to witness the journey of the York Street Health Practice since its inception four years ago. York Street has gone from strength to strength, working exceptionally hard to try and meet the needs of our most vulnerable service users. Recently, the practise achieved the GOLD LEVEL of Involvement Standards, as well as being praised by local, regional and national agencies and above all by Dr Stephen Field from NHS England.

There are many changes that occur on a very frequent basis; however one critical aspect is that the levels of high quality care are not affected. YSHP prides itself on very high levels of quality holistic care, a welcoming and non threatening atmosphere. 

Do you have a particular highlight from your career to date?

Working at York Street has been a pleasure and a privilege, there have been some very touching and heart warming moments where some of our clients have been able to say thank you in very profound expressions, to listen just for a few seconds and hear what it means to have someone to sit, listen and care for that individual at that time.

If someone was thinking of joining the trust in a similar role, what advice would you give them?

I would encourage that particular person to be non judgemental, caring and compassionate, and to be ready to be open minded for the journey of a lifetime ahead. Moreover, it is important to have an understanding and empathy and be able to demonstrate plenty of compassion. It takes a special kind of person to be able to undertake a role of this nature, and to have very strong interpersonal skills and high levels of cultural awareness.

Thanks to Rehan for taking the time to share this.  

A vision of care

Representatives from CaSH ( Contraception and Sexual Health service ) and York Street Health Practice met over coffee to talk and listen. Both are Leeds Community Healthcare NHS Trust services. CaSH  provides effective, accessible and non-discriminatory contraception and sexual health services to improve the sexual health and wellbeing of both young people and those who are vulnerable in Leeds. CaSH includes a consultant, doctors, nurses, clinical support workers and a youth worker. York Street is the medical team for people who are homeless, vulnerably housed and in the asylum system in the Leeds area. Both teams operate across the city.

The meeting had three great outcomes. The first was a commitment to find new ways to work together and support the Leeds Health and Wellbeing Board vision for the poor and vulnerable in our city. We recognised the potency that our services together working for best health outcomes and care offers. Two are better than one and the specialisms of both services working alongside each other offers much. The second thing is that both services have the quality mark for working in domestic violence. We discussed how we can work together to obtain level two of this quality mark. The third aspect of the discussion was what we might call 'the deep stuff' - how we work and support not just good housing, medication and services but how we help support people find identity, focus and purpose.

In this last aspect we touched on three elements - responsibility, respect and relationships. These '3 R's' offer a possibility of what can happen. The first was responsibility. This is the moment when we really make that commitment to be adult and act as adults. To stop blaming and undermining others. To accept ourselves and life as it is and work from there for the best. It's amazing how we as adults can act as children. The call to be an adult and responsibly act is rarely a once and for all reality. It must be something we do and renew each day and week - sometimes against great stress and challenges. To move away from behaviour that is not adult and responsible to be honest and authentic people is a journey. Our good friend, Anne Cooper, the Lead Nurse for Informatics for NHS England, wrote a very powerful blog about this road to being authentic.  Anne ends it with these wonderful words, 'So authentic leadership is, I believe critical; the ability to be myself and be human, not to be a robotic corporate being, to help others to understand the whole me, flawed as I am.' To be responsible is to own ourselves and take responsibility for one's self. It's actually to love ourselves just as we are but also to love ourselves enough to want to change and develop too.

Respect. What does respect look like? Perhaps it can be defined by what it does, not look like. The subject of domestic violence and abuse we discussed offers a contrary opposite picture of what respect isn't. Those words, attitudes, actions, undermining, bullying, nastiness and hate are what we find at the heart of domestic violence and abuse. The opposite of these may be deemed acceptance, developing, affirming, kindness, love, gentleness and goodness. This to us is respect and whenever humans find these values they usually start to warm up themselves and open up like new flowers to the sun. These things - kindness, respect, gentleness - are infectious and can change so much.

What about relationships? Any one who has worked in care for a while and who has really been listening and learning knows that relationships are the heart of all that good care work is all about. We can do the work it's true but we can't do work that connects and changes people without positive therapeutic relationships. At York Street one of the theoretical images of the work we use is that of the circle. The circumference is the doctor giving the prescription, the nurse bandaging the wound and the support worker filling in the form. Yet the centre of the circle is and has to the rapport, the connectivity, the relationship. All good health work has to focus on creating and sustaining this relationship. It's the relationship that makes the difference. After the tragedy of Mid Staffs we have a real call to ensure person centred dominate all our work.

So how do we become conduits for responsibility, respect and positive relationships? There are a number of ways. In fact each of us receive dozens of opportunities every day for this to happen. A story might help here. Last year at a conference outside Leeds one of the authors was approached by a student studying health asking to visit their service. A few weeks later the student arrived and had a tour and talk about the service. After this the young student started to talk about an issue she was facing in her placement. She saw a clash between what she was learning in her classes and what she saw in her present health placement. We were able to say two things. The first is that what she saw in her placement was culture. She mustn't think the great things she learnt in class - the patient centred approach, great team work, vision and values - were just ideas that couldn't work in the real world. What she was looking at in the placement was culture and that culture had been made by human beings. And it could be unmade or remade by human beings too. The second thing was that in the NHS that there is an army of us - thousands and thousands working for better cultures and care. She was part of this movement and she could be - indeed was - the change needed. The call was to light a candle rather than curse the darkness. That young student - with no power and authority - went back to her placement and course to be that difference. That's not good leadership - that's really great leadership. What we see in this young woman is how to be a transmitter of the responsibility, respect and relational approach that we are talking about in this blog. Great leadership isn't about where we are - it's about what we are. We can be people who own their own being and potency to serve and care for others. If we can do this we don't have many worries that the '3 R's' - responsibility, respect and empowering relationships - will quickly start to appear. 

Dr Farah Haider, CaSH,

John Walsh, York Street Health Practice

Day at the Opera

On Monday 7 July we attended the annual NHS Organisational Development conference - DoOD. This saw 200 staff from the NHS gather to look at the issues and direction of organisational development (OD). It was a great event, which featured Professor Michael West and Dr Pat Oakley as keynote speakers. It was good to meet or re-meet colleagues such as Paul Taylor from NHS Employers, Karen Dumain from the NHS Leadership Academy and Dr Maxine Craig from Sunderland University. We were happy that colleagues from our own organisation, LCH could also join the conference.

We were to present the after lunch session on 'Finding Our Voice'. We did this work with Tracey Gray, Head of Head of Education at Doncaster and Bassetlaw Hospitals and her daughter, Victoria. Tracey shared her personal and professional story of vulnerability, growth and finding her voice. She then introduced her daughter as her inspiration and 'rock'. Victoria emerged from the back of the room and started to sing from 'Carmen'. Victoria is an opera singer and went through the audience singing. She then, from the stage, shared her story of vulnerability and finding her voice. The audience were then invited to find their voice and Victoria led us in singing the chorus from the opera, 'Carmen' by Bizet.

We spoke to the audience about how we can create the cultures to find our voices and support staff to grow. We started to outline what good OD work looked like. There were three things OD practitioners could do and were doing. The first was visibility. To go out into the highways and byways of the service and talk and engage with staff. To be a presence that offered options, hope and possibilities. The greatest thing we can offer another is our own self and an OD practice that doesn't offer this has both missed the opportunity and lost the heart of the work. The second was vision. The call was to let a vision inspire us and then let others hear our passion and catch the fire. Movements for deep cultural and organisational change will not emerge from weighty documents but where individuals and groups see a vision and ignite it in others. The third was making the space for the voice of the staff. OD practitioners had to be able to create a positive circle and invite others into it for the OD dialogue to start and spread. This work created the ever increasing circles, like a rock thrown into a pond, drawing in more hearts and minds into making compassionate OD a reality. We then spoke of how we can create the cultures where OD can flourish and grow. 

The basic message was that culture doesn't fall ready made from the heavens. It is constructed and made by all of us and therefore we all hold in our hands an awesome power. We can create the best or worst cultures. Every time we open our mouth we create culture. Every time we act we create culture. The challenge was to be the best people and staff we can be. We might sometimes miss the mark but our work for best practice and best culture would bear fruit and make these things start to happen. 

It came down to - if we want the most inclusive and supportive cultures we need to be truly inclusive and supportive. We need to make the difference every day for the better. We ended by asking the audience to talk with people on their tables about what conversations they should have 'to make the difference for the better' in their practice and services.

We ended by offering the acronym OPERA as a sign of great OD work.


   O - Open to Possibilities

   P - Persistence

   E - Emotion and Passion

   R - Receiving and Giving Feedback

   A - Awareness of Self and impact on others

When we think of the conference this was what resonated in the speeches and also in many of the private discussions too. OPERA is an OD charter. It calls us to be what we are and can be. To be flexible to options and opportunities. To not see organisational life as a static fixed entity. To see, as Hegel the philosopher would, reality and organisations as in movement and development. To see life and where we work as dynamic realities which we can work in and direct. We can only be open if we are humble and create a space for the richness of others. We need to be a people of patience and persistence. Rome was not built in a day and cultures will not be changed by next Tuesday. We need to be a people of passion and commitment working for a cause greater than ourselves. The feedback and awareness are really key here. We are not called to be lone ranger figures riding into town to sort out the bad guys. We need a deep awareness of our own weak points. This is about 'us' not 'them'. This can demand radical honesty, deep and authentic self-reflection and the courage to start to change oneself. Big stuff really but then the best OD is transformation not tinkering.

The presentation had a quote from the great Dr Viktor Frankl - 'When we are no longer able to change the situation - we are challenged to change ourselves'. This is an interesting enigmatic statement. Maybe Dr Frankl was pointing to a secret but not stating it. The secret is - if we change ourselves the world will change and we will find that either the situation has resolved or we are able to deal with it in new and better ways. The conference was for us all about the power, potency and possibility we all hold in our hands. One person tweeted that she had realised she was holding power, potency and possibility as a result of her learning at the conference. That's the message and the means. We hope - we really hope - we can use these incredible energies wisely and kindly for this service that means so much to us. A big thank you to all who made this conference possible.

Steve Keyes, Head of Organisational Development, Leeds Community Healthcare

John Walsh, York Street Health Practice, Leeds Community Healthcare  

Work lessons from Oz - Doorways of hope and possibility

Einstein once said, 'If you want your children to be intelligent, read them fairy tales. If you want them to be very intelligent, read them more fairy tales.' Stories are part of our human way to articulate lessons and meaning. They allow us to connect and express our deepest wishes and dreams. They raise us up and open up doorways of hope and possibility. It is probably a sure sign that a civilization is losing its soul and its way when it can longer tell stories in a meaningful way.
 

The Wizard of Oz ( or to give the book its proper title 'The Wonderful Wizard of Oz' ) is something many of us remember from childhood when the film was always shown at Christmas. This story, told in a meaningful way, has many significant lessons for the workplace and office and  here we explore just a few . The ones we choose will hopefully have a relevance to the ongoing discussions in the NHS about how we produce the best cultures for staff and the best services for our clients. 

The Three Companions 

The story is that a young girl from Kansas journeys to a mysterious and wondrous land called Oz. It's very different from home. She tells her dog ( who makes the journey too ), 'I've got a feeling we're not in Kansas anymore' and she needs to get home. She meets three companions on the way who become friends. They all seemingly lack something. The scarecrow a brain, the tin man a heart and the lion courage. In the 1939 film they all sing the same song bemoaning what they don't have. The scarecrow sings 'If only I had a brain'. The tin man sings 'If only I had a heart' and the lion 'If only I had the nerve'. The plan is to go to the Emerald City to see the great Wizard of Oz who they hope will solve everything for them. So off they set along the Yellow Brick road with their dreams and wishes. Does this resonate with our work  and life ? We have hopes, wishes, passion and dreams and we go looking for something, some place or someone to make them come true. 

When working with people and teams in the NHS  we often hear a difficult story. It is that people are waiting for someone else to make life better.

They seek a ' hero' who may  come along, make the difficult  stuff stop and allow the good times begin. Working with people and teams teach us that we all have to own our own contribution to the present situation. It may be small or major. This is a critical first step to improving any difficult situation. Self discovery and owning ones ' whole self' are critical skills.

The three companions in our story make an amazing discovery. They see at the end of their journey that  they already have what they went searching for. For them courage, brains and a heart. But what about for the rest of us? Seeking what we desire, want, and feel we need is most definitely a journey. It is a painful process for teams to  consider what a 'great' team looks and feels like and then benchmark their own current situation against this finding how near or far away from this they are. It is also, and always an enlightening process. To do this work in our teams is challenging and needs courage. If we want our NHS and social care to be a great work place and as a result deliver excellent services we must look at ourselves in the mirror each day. We  need the courage, capability and the ability to create a kind and caring work environment. We learn, from our characters in Oz that  it starts from within. 

And just like the characters from Oz, teams realise it takes the event and experience to see this. The traveller to Oz discovers what they need is what they have in and through each other. This is an important lesson. We all have great gits and qualities. Yet we only see, own and release these through our journey. We also experience the manifestation of these with and in others. There is a friendship and social aspect to our becoming what we wish to be and how we choose to live our work lives. We can be kind and supportive to each other or unfairly competitive and harsh. The choice lies in our hands. We 'become' through and for others. We spend many hours with our colleagues at work - let us seek to build supportive communities in our workplaces  that value and include. Happily the three companions find what they are looking for. The three things they found - courage, a heart - compassion and intelligence are things we all need too.

What sustains them on their journey is a growing friendship, mutual support and hope. We would suggest this is the same  in our teams. 

The Wizard 

When our travellers  get to the Emerald City they enter into the awesome habitation of the Wizard. In the film in his room they see no one except a face that keeps appearing and disappearing. There is smoke, fire, a booming voice and an authoritarian presence. They discover a shocking secret.

These are all tricks - mere smoke and mirrors. The Wizard is actually a man behind a curtain working levers to create the atmosphere. The 'great and powerful Oz' is a little man working a machine. Dorothy accuses him of being a very bad man. The Wizard replies, 'Oh, no, my dear; I'm really a very good man, but I'm a very bad Wizard, I must admit.' This is the lesson here. We actually think the Wizard was very wrong. He was saying he was a good man but had no magic, no power. The truth is that we all can choose to be good and we all have power. The problem is one of three things:

.       We don't see that we have power.

.       Or we don't really own that we have power.

.       Or that we don't find the ways for the power to flow and function.

The fact is if we don't see we can't own and if we don't own we can't have the power. It is a great error to think we don't or can't have power in our lives. 

Again a feature of teams facing difficulty is that they often describe feelings as powerless and being over powered. It always strikes us that having no power is such a disabling state. Yet as we explore the issues of power and becoming disempowered we discover an interesting fact. When the going gets tough we often defer to those above us ( just like we did when we were children ). We ask those above us to make difficult decisions then we complain about the decisions they have made and we distance ourselves from those decisions. We often wonder about this dynamic;  do we fear being part of the decision making process so much we would rather act as a victim to the decision of others?  Within this dance we have given away our power.

 We have also seen the opposite - the liberating picture of staff finding their power and voice. In Oz, Dorothy finds that when she confronts the Wizard, he is a little man, another human being just like her. And so it is our world. We are all human, trying to do the best we can with what we have. We may get it wrong. We will make mistakes. The people above us are not bad people. Just human beings doing their best often in difficult circumstances. We work in one of the most politicised health systems in the world ( in our humble opinion ) and a key commodity we all have is our personal power. We should never play games with it or give it up. We should guard it with our lives.

It is what gives us identity, stability and hope to work for change . Our patients and clients should expect no less from us. They deserve a staff force which holds its power and uses it positively and effectively. 

The End 

Finally Dorothy discovers what it's all about. At the end of the story Dorothy can't get home to Kansas. She is understandably upset. In the film the good witch tells Dorothy, 'You don't need to be helped any longer. You've always had the power to go back to Kansas.' The  scarecrow asks if this is so, why didn't the witch tell Dorothy. The good witch says, 'Because she wouldn't have believed me. She had to learn it for herself.'

Again we find here the need for Dorothy to find her own answers and power.

The Wizard couldn't give her this. It was her own inner wizard she needed to find - her will, energy and gifts. If the good witch had told her this she wouldn't have seen or believed it. Dorothy needed the journey of self discovery just like her three friends. The story of Oz calls to how we must learn from work and life, it asks us to consider how these journeys can support our growth, how the  friendships and relationships we make on the way co-develop us. And finally we are asked to consider our inner most ability and the  treasure that lies hidden within each one of us. The North East of England and Yorkshire may be a long long way from Oz - certainly a rainbow away. Yet the lessons are the same and we commend them to you

John Walsh, York Street Health Practice

Dr Maxine Craig, Head of Organisation Development at South Tees NHS Trust and visiting Professor at Sunderland University.           

What happens at an NHS AGM?

On Thursday 18 September, we will be hosting our Annual General Meeting (AGM) as well as a Health Fair and Achievement Awards. This is a chance for us to reflect on the past year, highlight the work our services have done whilst looking to the future for the trust.

For those who have never attended an NHS AGM, we thought we would give you a rundown of what to expect on the day.

The event, which is taking place at Elland Road, home of the mighty Leeds United, welcomes everyone to attend. There will be a mix of people that work for the NHS or third sector organisations alongside members and the general public.

Opening at 4.30pm, the official AGM will start at 5.30pm and run until 6pm. During this time, Chief Executive, Bryan Machin, will provide a summary of the past year and then the financial accounts will be delivered by Cherrine Hawkins, Interim Executive Director of Finance and Resources. Guests will then be invited to ask the Board of Directors questions, these may touch on changes we’re making to our services or how money is spent across the trust.

Throughout the event, there will be lots of stalls for people to visit as part of the Health Fair. Many of our services will be there to showcase the care, support and treatment they provide to the people of Leeds and beyond. From 7pm to 8pm, we shall be celebrating achievements over the past year. Starting in July, staff began nominating their colleagues, teams and volunteers, for the awards, of which there are ten categories. Prior to the awards the nominations applications were narrowed down by a panel of judges. Dr Dawn Harper of Embarrassing Bodies on Channel 4 will be on hand to present our winners with their awards.     

We look forward to seeing you on the 18^th but if you can’t make it, we’ll be live tweeting from @LCHNHSTrust and posting updates to our Facebook page – Leeds Community Healthcare NHS Trust to keep you in the loop.

If you have any questions, please get in touch, email us at lch.comms@nhs.net or call 0113 220 8512.

Sarah Elwell, Communications team

Losing the mask

History has some intriguing examples of people pretending to be someone else. Some of the most famous were the women who claimed to be the daughter of Czar Nicholas 11 of Russia. The Czar and his family were killed in 1918 by the Bolsheviks. Rumours persisted that one of the daughters, Anastasia, had somehow survived and got away. Several women claimed to be Anastasia. There is a film about one of the most famous of these claimants. The actress, Ingrid Bergmann, played the main role and won an Oscar for her performance. People have pretended to be other historical figures including Nero and the daughters and sons of European kings. These historical episodes are pretty rare and those making the claims were never ( in my understanding ) ever accepted.

There is another form of pretending. This is where we wear a mask - where we pretend to be what we are not. Why do people do this? I think there are a few reasons. People may not know who they really are. They may not like who they are and therefore 'create' another self. They may also feel an insecurity that leads to the making of a self worn as a mask for protection. I am not not talking about where we put on a better disposition or decide to be positive or negative about a situation. The issue here is different. It's where we are living an identity that we feel to be inauthentic. A mask rather than our true face. Scared to be our real self. The problem with all this is that we are not being honest. It's living in old fears of not being good enough to be liked and also negating our true self. This fear of letting our true self out of the bottle seems to be the major issue here. Yet when we are able to be ourselves that's when the long walk to freedom starts.

How can we let this process of freedom from masks begin? I can offer two steps that aid the walk. They also build and nurture us in so many other ways. The first is to not just follow the crowd. To sometimes make a stand for what we believe  - even if we have to stand alone. To speak and say what we feel is right. We have to do this wisely and sensitively. This starts to overcome what counsellor, Deborah Day Poor calls 'Peace at Any Price' and 'the Please Disease'. Here we can start to mark out ourselves not as echoes of others but real people with their own take on things. This might not be easy at first but it is place to start. We may feel many pressures to be someone else and go along with the crowd. If we allow the demands of others to shape us we surrender our identity. They, and not us, become our life force. Ralph Waldo Emerson, the American poet, wrote that 'To be yourself in a world that is constantly trying to make you something else is the greatest accomplishment.'  Wise words and something that can support the emergence of us facing the world just as we are.

The second practice is to find peace. Mask wearing is often linked with a sense of feeling unsettled. People who have found a sense of peace tend more often to be OK with themselves and others. Deborah Day Poor in her book 'Peace at Any Price' says, 'Our most important relationship is the one we have with ourselves'. This is not meant to be a call for ego-mania or to be self- obsessed. The opposite actually. It's a call to be at peace with ourselves. When we find this peace we usually feel more at ease with who we are and with the world the way it is. We feel it easy to be ourselves and the pressure to be something else loses it's mesmeric force. So how do we find and keep this peace? That's the million dollar question. Yet we find the start of an answer given again and again free of charge. We all have our portals to peace. Walking, painting, listening to music, meditation, pottery - the list goes on and on. Each of us will have our own ways to enter peace. I think most of us know our path to peace. Our biggest problem is making sure we get time to walk in it. So peace is key to letting the mask fall and discovering with joy that we are fine as we are.

 

The Dalai Lama said in a lecture the following, 'Inner peace is the key: if you have inner peace, the external problems do not affect your deep sense of peace and tranquility...without this inner peace, no matter how comfortable your life is materially, you may still be worried, disturbed, or unhappy because of circumstances.' Very few of us would probably claim this sort of peace all the time. Yet if we can start to find its sometimes  it can grow. What starts as a seed can become a mighty tree. With peace comes strength and from peace and strength the masks and pretending start to become redundant. We don't need them anymore. We now have a face we are fine to face our world with.  

John Walsh, York Street Practice

Changing Our Minds To Change our Lives

Recently I met with Gill who is the director of Phoenix Health andWellbeing. We were brought together by Jon Woolmore, Chief Executive of Community Links,  who suggested a connection between the work York Street Practice and Phoenix do. Phoenix is a charity that specialises in offering 'high quality relaxing or remedial complementary therapies' which is based in Leeds. Their website explains their ethos and work: 'We are a charity supporting people with mental or physical health issues. We offer counselling and body work therapies to a range of people who are referred to us by medical professionals, mental health support workers or associated charities. These referred clients can have a range of complex needs but many experience low self-esteem, anxiety and social isolation. This can be reflected in their perceptions of themselves, their sense of isolation and level of self-care. The use of counselling and physical treatments provide  real contact with another person in a safe environment enabling the client to experience care and to feel genuinely valued as an individual. By coming along for one of our therapy sessions you are supporting our charitable work'.

We sat in a coffee shop near York Street and talked about what our respective services did and, as always, with these conversations we moved to how we can be part of the work to build best cultures and services in Leeds. Part of this call is to create best conversations. We cannot have best cultures and services if we don't have best conversations. Conversations of listening, learning and birthing new ideas and actions. It's a great sign that these conversations and actions are occurring all over our city. You can't see these networks and movements from a high office window. But they are there. It takes a different sort of seeing to note these and be aware of their power and potency.

We discussed the issues of wellbeing, work stress in life and at work and the necessity of positive spaces in our hectic lives. In this a story was shared. The story was of a trainer who worked with business people. The trainer led a group of business folk into a simple relaxing exercise lasting a few minutes. The aim was to let go, relax and just enjoy the moment. After the exercise a woman in the group said 'This is no use to me. I don't have 5 minutes a day to do this!' This frankly is an amazing statement. It says that we are too busy to relax, chill and give ourselves a few moments of letting go. It reflects how work demands can make us feel we don't even have time to make an instant coffee. We make no judgement on the lady who said this. We do say that if we don't make time for change then change won't ever come. If we wish to find some positive space and peace in our lives the chance is that we will have to make the time and space to do this. It just won't just happen. This has been recognised for a long time. One 16th century spiritual writer, Francisco de Osuna, advised meditating because it provided a refuge when faced with stressful situations. We have to withdraw to go forward.

Maybe one reason we don't change in the ways we wish is that we don't give the change the energy and time required for that change to appear and become stabilised. So is there any hope when we know we need to change but think there's no way we can make the time? We think there is. We need to change our thinking. We need to draw a good inner picture to ourselves of why we want this change, of the benefits and how much better life will be when the changes start coming through. We need to create a vision. A vision that moves us and connects with us. Finding what one writer called 'visional power' is what can start us off wanting the change and wishing to make it happen. This is not something we can just do once then forget. It's something we need to repeat daily so the vision of what we can be starts to grow and conversely we start to grow into that vision. The most powerful cases we have seen of people breaking the addiction to alcohol have not been those who have stopped drinking but rather those who have found a state of sobriety, a positive state of living without drink. This story holds to us the challenge of living in a busy world with so much stress. It also holds to us that we have 'visional power', the power to dream that we can act and live differently and seek the steps for that to happen. The work that Phoenix and York Street do are on the surface quite different  - different client groups, different sectors and different specialisms. Yet in the depths - where it really matters - the work for hope, wellbeing and people feeling better about themselves - it's just the same.

John Walsh, York Street Health Practice
Gill Trevor, Director, Phoenix Health and Wellbeing

The space to be vulnerable

Sean had a problem. He knew he was drinking too much. As a result his work, marriage and life were in trouble. What had started as a 'weekend relaxer' was now a weekday, sometimes daily, activity. Sean had made all the just excuses...

'Work is very stressful at the moment. I'll cut back when things get calmer'.
'I don't have a problem. It just helps me relax.'
'I probably drink too much but I can stop anytime.' 

Yet Sean did have a problem and a recent conflict with his family and time off work due to the alcohol had confronted him with his need for help. He was now on his way to his first meeting of AA ( Alcoholics Anonymous ). Sean arrived at the meeting and sat down with a few minutes to spare before the meeting opened. His mind reeled with a flurry of thoughts and a strong wish to bolt and get away through the door. Things got even worse when people stated to share with the famous words 'Hi. My name is X and I'm an alcoholic.' Sean was confronted by the vulnerability and deep honesty of those there. This struck him and confronted him. Sean got though the meeting and came back for more. Today he is many months sober.

Sensing our vulnerability is both a great challenge and a great possibility of growth. We often, like Sean, don't want to admit our vulnerability to ourselves or any one else. It's no accident that the 12 step movements such as AA start with this radical self honesty. The person admits to themselves and others that they have a problem and are there to learn how to deal with it. We do not need to have a gambling or alcohol problem to be vulnerable. Many things can make us feel this way. The news, work issues, relationships and people can bring to the surface the sense of not being OK - of feeling shaky and at our weakest point. This is a natural thing. It's human to feel vulnerable.

One thing some people find very helpful is to have the space to be vulnerable somewhere in their lives. This is where they meet with a person they trust. There is the positive centre where they can talk about how they feel and seek the path forward. These spaces where it is safe to be vulnerable we would contend are vital for good mental and emotional health and wellbeing. They can only exist where there is a positive connection, real trust and a non- judgemental framework. They are not spaces or place to beat oneself up or be ultra negative or throw accusations at others. More than anything they are places of affirmation and reality checking. They can exist in workplaces and in other life environments. They have three core elements which make them work - context, connection and consciousness. They offer a context where we see things in a larger way. We see our weakness but also our strengths and lights. This allows us to see our struggles in convergence with our qualities and this meeting offers possibilities of resolution, hope and coping. They offer connection. Firstly to another person and through this other to the wider human experience. It's easy to believe when we have a problem that we are on our own. These spaces, in a sense, bring us back to the human family. Through context and connection the third element can take place.  Our consciousness can change. Our views of ourselves and the issues can start to alter and new ideas and visions can start to grow. These spaces then can be truly transformative, albeit, in a gentle and quiet way.

These spaces allow us to be our authentic self. The real us is a mixed bag of things wonderful and things not so great. That's the same for all us. The challenge is how we learn to accept this and work to make the good better and either make the less good what it should be or learn to accept it. This work of inner integration leads to what might be called wholeness, completeness or true self acceptance. Dr Brene Brown, a research professor at the University of Houston Graduate College of Social Work, wrote a book with a fascinating title,  'The Gifts of Imperfection: Let Go of Who You Think You're Supposed to be and Embrace Who You are'. If we let others define who we really are we will lose our real self. In these spaces the real us can start to live and breathe.

Sean had to touch his own vulnerability to see who he really was. Yet the vulnerability was not the final destination but a road to discover a new life and self. In work we can help create these spaces to be vulnerable but only if we become people of care and trust. An interesting paradox really - it's when we start to be what we really are that we can help others find themselves. There's  an old Latin phrase and legal rule - 'Nemodat quod non habet'. It means 'No one gives what he doesn't have'. We cannot give what we haven't got. It's only when we start to become what we want to see in others that we can be truly forces of transformation. Ultimately its transformed people who transform others and its only inspirational visionary people who give vision and inspiration to others. The great news is that we can all do this. We can all in very different ways and shapes be people of inspiration, vision and catalysts of change and recovery. The reason is simple. Just as we all have  vulnerabilities, we all have tremendous potential and gifts. It's the tapping and release of these that can change our world. 

Denis Jackson, Mental Health Chaplain, South West Yorkshire Partnership NHS Foundation Trust

John Walsh, York Street Health Practice

The Power of Listening

Wouldn't it be great to be a really good listener?
 
Someone  once described Sigmund Freud, the 'Father of psychoanalysis', as such, "He struck me so forcibly that I shall never forget him. His eyes were mild and genial. His voice was low and kind. His gestures were few. But the attention he gave me, his appreciation of what I said, even when I said it badly, was extraordinary. You've no idea what it meant to be listened to like that." Wow! What an incredible listener and power of listening.

Most of us think we are good listeners but are we? We probably often go into situations with minds full of ideas, hearts full of emotions and actions full of agendas and what we want from the meeting. Doesn't this block real deep listening? Is it is possible to deeply listen if we are full of all this stuff? Perhaps it's when we put to one side all our drives and wants and really become present to the other or others that the real gold standard listening really walks on stage. What is certain is that people usually pick up when they are not listened to. The refrain of 'He's not listening' is usually connected to ' He doesn't care'. This is a real issue as listening really is connected to caring for someone.

We recently heard a moving story about listening that we would like to share. Someone known to both of us had to go to a meeting where a team was going through a tough time. This person started to feel the trepidation and anxiety most of us would feel. What to say ? What to do? The friend concerned spoke to a wise colleague. The idea that came through was that the person should go to the meeting but not to offer solutions and 'magic answers' but rather themselves in presence and listening. They would go and listen and be there with people even if it was difficult. This just 'being there' and 'just listening' was what our friend did. Our friend describes the effect of this approach. 'I have to say that this was one of the most invigorating and humbling days of my career. All I did was listen and be with those individuals. They achieved what they wanted to achieve, but more importantly for me, they had the space to be themselves.'

There are three fundamental lessons here for us all. The first is that when our friend had a problem she spoke freely about her feelings to someone she trusted. That person listened and supported the emergence of possible approaches. Here we see the therapeutic process in a nutshell. Honesty, feelings, trust , listening and answers emerging from the encounter. Here we have a framework to create solutions and possibilities. We would guess that this is bit like a wizards spell in a fairy story book. If one of the ingredients is missing, it doesn't work or doesn't work fully. However, when all the components are there that's when the magic of options opening up starts. The second thing that we see is our friend decided to be part of the process rather than a 'fixer' or 'outsider'. She decided to go to the meeting to be present, to be alongside, to listen. A psychiatric social worker known to one of the writers used to do what he called 'the practice of presence'. He would visit patients on wards who had serious mental health problems and just be with them. He didn't seek to offer forms or solutions but himself as positive and listening presence. We are sure his presence was a healing and helpful one. This sort of listening and being present can only come from the depths of who we are. It really does mean putting aside our robe of importance and talking and 'just being there...just listening'. The third life lesson is what the result of this approach was. Our friend had an experience which was invigorating and humbling. The team did what they needed to do and were able to be themselves. This isn't a guaranteed result every time but there is something about humility, listening and openness to others that can help clear a way through difficult times.

Can we develop fantastic listening skills? Can we really move away from being people who are desperately waiting for the pause in another words to jump in with our words and statements? The good news is that we can. There are probably many things that can help this. We will pinpoint two. We will call them the direct and indirect approaches. The direct approach is to try to do what our friend actually did. To sit and listen and be open to the other person. To try to avoid the distractions - the looking at our watches, checking our phones and thinking about something else. If we try this again and again we will probably find out how difficult it is to really listen and be present. This practice will however start to sow the seeds that makes us great listeners. From these small acorns great trees can grow.

The indirect approach is that if we focus on developing ourselves in an authentic way we will become skilled listeners because to develop ourselves we have to listen to ourselves. Those on this journey will find their listening faculty developing as they progress. Not because they work on it but because they work on themselves. It reminds us a bit of students coming to York Street. They were totally focused on ticking certain competency boxes. We would tell them not to worry about this. They would tell us they had to get these competences passed. We would say 'Do the work and the boxes will get ticked. Focus on the work and you'll display the competences' and they always did. If we work on ourselves we will have to do a lot of humble listening and just being there with ourselves and others.

Is it worth walking this path of developing ourselves? Yes it is. Abraham Maslow, the eminent psychologist, did his studies not so much with the mentally unwell but rather those who had good mental health and stability. He spoke about the greatest of these people as those who were 'self actualized'. He went on to describe this state of self actualization - ' What a man can be, he must be. This need we may call self-actualization...It refers to the desire for self-fulfillment, namely, to the tendency for him to become actualized in what he is potentially. This tendency might be phrased as the desire to become more and more what one is, to become everything that one is capable of becoming.'  This promise and possibility is what will make us not just the best listeners possible but the best people possible too. And surely that's worth it.   

Lisa Falkingham, LCH Service Improvement Team

John Walsh, York Street Health Practice  

Raising awareness of Sickle Cell & Thalassaemia

On Thursday 31 July, the Leeds Sickle Cell and Thalassaemia Service joined together with Black Health Initiative to host an awareness event at St George’s Centre in the city centre.

Trina Glynn, clinical lead

The event was organised as it felt there was a lack of awareness in the city about the conditions and the services and treatments available. During the morning session, health professionals and practitioners were invited to listen to presentations from Dr Mike Richards, paediatric consultant, Trina Glynn, clinical lead from the Leeds Sickle Cell and Thalassaemia Service and patients that have used the service.

Dr Richards gave an informative presentation about the conditions as well as the treatments that are available. A few facts from his presentations;

·         In Leeds, the paediatric team works with 73 children who have sickle cell disease.  

·         The modern life expectancy of a person with sickle cell disease is 53 to 60 years. This has increased over recent years due to the available treatments.

·         A newborn child will be screened within four weeks to check for sickle cell

Trina followed Dr Richards presentation and talked about what the Leeds Sickle Cell and Thalassaemia Service offers. She talked through how they will work with patients to provide care, offer counselling, do screening as well as health promotion, particularly with employers as sickle cell can affect a person’s attendance at work. As the condition are not always evident, it is important that employers are aware of how it can affect a person.

Annette, guest speaker

Annette, who has sickle cell disease, and Maserat, who has Thalassaemia, spoke to the attendees about how they manage their health. They described how it has affected them, from their time at school or whilst at work, however they were very positive about how the conditions can be managed. Both described that there is stigma around having the conditions, however with events such as this, we can raise awareness and increase knowledge.

The morning session as well as the afternoon session, which the community were invited to, were both well attended. As well as the presentations, Carers Leeds, the Thalassaemia Society and the National Blood Service also had stalls for people to pick up information or speak to staff.

If you would like to find out more about the Leeds Sickle Cell and Thalassaemia Service, please click here.

Alice in Workland

Anyone reading this title may think we have mis-quoted the title of the Lewis Carroll classic 'Alice in Wonderland' (actually the full title is 'Alice's Adventures in Wonderland'). Others may ask that we are not surely saying there is some cross over between Wonderland and the workplace - between Alice and the actual daily life we all have. Well actually, we are saying this. Books and stories like dreams carry inner meanings. Some branches of psycho-therapy, especially the Jungian school,  recognise not just the power and relevance of stories but how the stories we tell and the stories that move us are resonating because they link in with our own stories and journeys seeking wholeness, identity and meaning. At the end of the story, Alice runs off to tea while her sister starts to have the same dream. The story goes on. So what does this novel written in 1865 teach us in 2014? What lessons can this young girl lost in a world where the incredible is commonplace give us today? We cannot cover a whole book but offer a few themes which we hope may resonate with some. We will give a quote and then offer a few words on it's importance. 

“Who in the world am I? Ah, that's the great puzzle.” asks Alice.

This is interesting as it brings us to the question of identity - who and what we actually are. A few months ago one of the writers sat in a coffee shop with a leading national figure in the NHS. The conversation turned to identity and how it was so vital that people found out who they really were. The national figure went on to say these words 'It's only when we find ourselves that everything makes sense. It's only when we find ourselves that it all fits together'. This is so true not just of individuals but also of services. We can walk around in the words of the Tom Cruise film with 'Eyes Wide Shut'. This is something truly tragic. It's only when we know ourselves that our gifts and potential can really start to function and flow as they should. This is not a new idea. It is said by some that The Temple of Apollo at Delphi in Ancient Greece had over its entrance the amazing words 'Know thyself and all the mysteries of the gods and the universe will reveal themselves to you.' Self knowledge is the key. The magic starts when we start to see who and what we truly are. The Temple builders knew this and Alice points to this too. 

“You used to be much more..."muchier." You've lost your muchness.” said the Mad Hatter.

Muchness. What can this mean? We would offer the following definition. Muchness is who we have become through our life journey. Yes, its who we are at work , what we do at work but its more than that. It’s what we stand for and how we offer our own self into the community we live in. It is about all the learning we have done in our whole lives , the ups and the downs,  not just our work lives. It’s about what we choose to pay attention to, give our attention and our effort to. In the recent past one of the authors was fortunate enough to be trained in ‘social movement methods’  , this approach  developed by Marshall Ganz at Harvard Business School and brought to the NHS by Helen Bevan (Chief Transformation Officer, NHSIQ). This approach offers us the opportunity to view all the resources we have within ourselves. These resources of  time, skills, knowledge,  and most importantly our passion are powerful  resources we can offer if we choose to. This is important learning as we often think about resources in the public sector as access to budgets, but actually the resource we have within our own selves are often much more potent.  

We would suggest that these are the things of our muchness. Our best business is to make sure our muchness remains intact in the struggles and vicissitudes of life and work. That's what our focus should be. The Duchess in the novel says, 'If everybody minded their own business, the world would go around a great deal faster than it does.' Maybe if our focus was on our own development what challenges us most would change too.

So Alice points us to  our muchness and links to the point above about identity. In chapter two ,Alice grows to massive size. Her body fills the house and her head hits the ceiling. She becomes very unhappy and starts to cry.

Out of control ego is an awful thing. We hear phrases like 'He's full of himself' and 'Her ego is so big it can be seen from space'. This sort of ego takes us to places where we cannot see others or really care for them. Like poor Alice, ego fills a room with our importance, position, title and demands. It also like Alice brings us to tears. Ego could stand for 'Edging good out'. It looks away from others and their good and riches and wants all the glory and limelight. Usually those who follow this path end up very disappointed as the world will not follow and dance around them. This genus of ego is also such a destructive thing. It's the power that won't forget, won't forgive and won't share. The hard knocks at work are not easy to take but they do help us to realise that we are not the chain just a link. They have the power and energy to teach us humility.

'How puzzling all these changes are! I'm never sure what I'm going to be, from one minute to another.' said Alice.

Change is a fact of our life and work. We probably undergo more changes in our lives than any of our ancestors and certainly at a more rapid rate. In the story Alice has to learn each game and its rules. She has to learn how to adapt and cope with each changing and bewildering event. Not easy but doable. There is an adaptability alongside a questioning and searching in Alice. Neither a passive 'going along with things as they are' nor a fiery refusal and confrontation but rather a learning, questioning and further search.

There is also the deep truth about change from Alice. She says, 'I can't go back to yesterday because I was a different person then.' There are actually two deep truths here. The first is the power of today. A famous actress once spoke of her fight with alcohol. She said that one of the valuable lessons she learnt was that she didn't have a time machine to go back and change the past. Neither did she have a crystal ball to see the future. What she had was today and she could make the very best of that to herself and others. Alice's point that we can't go back should challenge us to live in the now. The second thing is that we are not static unchangeable fixed objects. We can change and we do change. The challenge is will we take the direction and initiative to direct that change? Becoming a different person - a better person is certainly possible but it  doesn't come free or without a price tag. In times of change we need the acceptance and learning spirit of Alice. We also need to seek whatever change and growth we ourselves may need.

So Alice points to our need to discover our true self. To own, nurture and protect our muchness. To control our egos. To work with change and even change ourselves. Some one may still ask 'What has this to do with work?' Here we come to the chasm separating those who see work mainly as concerned with systems and those who see work as centrally about people. For those of us in the latter camp - and we are proud to be there - the story of Alice points to what we all should be and can be. Just think what life and work would be like then.

John Walsh, York Street Health Practice

Dr Maxine Craig, Head of Organisation Development at South Tees NHS Trust and Visiting Professor at Sunderland University.