Flying High

Humankind has been interested in flying for a long time. Leonardo Da Vinci in the 15th century drew pictures of what a flying machine might look like. He had studied the flight of birds for his work. In the early years of the 20th century the Wright brothers managed to get a plane they had built to fly a few hundred feet. Before the century was out we were not just flying planes in the air but space ships to the moon. The ancient literature of the world also speaks of flight in powerful engaging ways. In ancient Greece there is the story of Icarus who flew with wings made by his father. He ignored his father's instructions and flew too close to the sun and fell down into the sea. The Book of Psalms also speaks of  flying. It says, 'Oh, that I had the wings of a dove! I would fly away and be at rest.  I would flee far away and stay in the desert;  I would hurry to my place of shelter, far from the tempest and storm.' (Psalm. 55:6-8).

 What is this attraction to flying and rising up to the heavens? It marks the centuries and as a race we have dreamed about, written about and worked to fly. There are probably multiple reasons for this interest. One as the Psalmist records is to escape from problems and dangers and find a place of rest. Another is that we have an inborn ( it seems ) need to rise and reach out. To ascend and transcend. To fly a bird needs wings. If a wing is badly broken it may not be able to take flight or fly again. While we do not as humans have wings the analogy is an interesting one connected to work and work values. It is a useful framework in which to ask the perennial question of what is a good health worker. What does great nursing and GP work look like? What are its component parts? What makes the difference between the average and the exceptional?

Louise and myself met recently and talked about the themes of this post. Louise is a third year nurse student at Wolverhampton University and I, a manager at York Street Practice, part of Leeds Community Healthcare NHS Trust. We will try to point to the two wings of good health work. We reckon that there are also the wings of good social work, care work and every valuable human endeavor. We believe these two wings enable those who discover and exercise them wisely and well to soar and move forward. This post is a distillation of the words of the emails and tweets we have sent to each other. In them we were asking what makes us fly - what makes us do the incredible.

The first wing is compassion. Compassion means to care for another. It means that heart connection that moves us to help and support another. The word compassion is from the Latin words for 'with' and 'suffer' or 'suffering'. So we have the idea of suffering with or being alongside someone in pain or difficulty. Recently I attended the NHS England event on NHS Citizenship in London. This event was to support and develop the public voice in the NHS. We broke into small discussion groups and our first task was to draw what the NHS meant for us or what we wanted from it. In a group of 6 people (mostly public and patients) three of us drew a heart. Another person drew a picture of matchstick men and women all holding hands in a circle. We know instinctively our service is all about compassion and care. The NHS in its intent, constitution and purpose is founded on principles of compassion and care where need is the basis. 

In response to the question of why she was wanted to be a nurse, Louise offers three reasons: 

 (1) "To care for patients and their families in time of need. no matter what their social background,ethnicity or choice in life. I believe we all need someone to care and who cares."

 (2) "To make a difference. I am keen to become a change maker, in that I really want to help and guide others, not just stand for the norm, be proactive in the face of adversity. I really want to make that difference, and inspire many who doubt that they can. If I can they they can! We can all be change makers. To stick our heads above the parapet is an immense feeling; one that at times I would love to hide from. But I myself am out there now, and I will make a difference, somewhere, somehow."

 (3) "Because this is all I have ever wanted to do! If I can help then it would really make me happy
  These sentiments are not rare. We find them across the NHS and in many places. Compassion is the heart we bring to a world in pain and worry. We really can be that difference. Healthcare without compassion has no values, focus or future."

The second wing is true leadership. We say true as there is unfortunately some confusion around leadership. People think leadership is management. We would rather say that the difference is management deals with systems and leadership works with people. One can be a good manager and poor leader and vice versa. To place an equals sign between manager and leader is a mistake. Leadership is a presence which we bring. Leadership is about people. It's seeing the best and bringing out the best in others and also seeing the best in ourselves. The best leaders are people of vision, values, care and compassion. It's what we learn and give that makes good leadership. Some leaders are quiet, some are not. Leadership is a possibility to us all. Like the cosmos with its stars, meteorites, suns , planets and galaxies it takes a myriad of forms and expressions. The trick is to see the possibility of leadership and keep our minds open to this and see what happens. We may find doors open today, tomorrow or in the future. We may not sometimes be the first to see it. People (usually fellow leaders who instinctively know it when they see it) may see in us what we may not at that moment see in ourselves. Leadership like life is all about us seeing, owning and releasing our gifts.

When people start to see our leadership emerging they will often say very nice and affirming things. We may find this difficult to see and accept. We may struggle with their compliments and affirmations. This is understandable. It is a sign however that our gifts and identity are starting to express themselves in visible and effective ways. We need to listen to the praise and compliments others give. We are always greater than we think ( much much greater, despite all our faults and flaws ) but we need to remain modest and humble when we start to see it too. So authentic leadership is the other wing. These wings fly together. Great leadership is compassionate and to inspire others is a truly compassionate act. Compassion feeds good leadership as fuel a fire.

Compassion and true leadership offer a vision of what the NHS is and can be. It offers the greatest perspective of all. That is transformation. The spiritual writer Richard Rohr talks of how it is transformed people who transform others. It's those who are themselves transformed that transform situations and support others to make that journey also. When we find our wings we find energy, meaning and direction. When compassion and good leadership are our wings we fly and fly high.

John Walsh. York Street Health Practice. 

Louise Goodyear, Student Nurse at Wolverhampton University

The good we do

We have wanted to write a blog post about goodness for some time. We have also wanted to write a post about our identity, who and what we really are. Last week gave us the inspiration we needed to try to write. I (John) attended the leaving party of Dave Ashton, the Head of Practice at the NHS Leadership Academy. It was a real joy to join many good colleagues including Dave Thornton. The evening was a toast to Dave on his retirement and a recollection of his unique qualities and presence. I have met a number of people who work or who have worked with Dave. The constant appellation used by them in connection to Dave is the word "good." Phrases such a "such a good man" and 'good people like Dave' pepper the conversations. The same word is used unfailingly of Yvonne Coghill of the Academy too. There is clearly something about Dave and Yvonne that touches, connects and inspires others. The people who have used this appellation come from different levels of the NHS and some don't even know each other.  I sat at the event and heard tribute after tribute to a kind, warm and wise man who had made such an impression on so many.

Goodness is an incredible power. It lifts and lights us up when we are not in a good place. True goodness never makes us feel little, inferior or ashamed. It rather illumines what we are and can be at our best. It draws us to a dimension of being where we know that we are good and can be even better. A dazzling witness to the fragrance of goodness is Anne Frank the young Jewish girl arrested by the Nazis. 60 years ago this month she was arrested by the occupying Nazis in Amsterdam. She died the following year in the camp at Belsen.

Anne Frank in the midst of the darkness that Nazism was holds out a message of what we are all called to be. Anne was an ordinary girl who offers a voice for what really matters. She writes that, "In spite of everything, I still believe that people are really good at heart." This amazing statement should give us hope that all can change and that there is, in the darkest heart, a good spark. That flicker can become a flame and that flame, the light of possibility. Anne actually gives us a living guide in her words to life and a better world. They are a charter for goodness despite the darkness. We will share a selection here.

Anne speaks of "How wonderful it is that nobody need wait a single moment before starting to improve the world." Yes - we don't need a degree or permission. We can start right now where we are. One of the most beautiful services in Leeds is PAFRAS ( Positive Action for Refugees and Asylum Seekers ). It started when one generous person opened up her car boot to give our clothing, food and help to the most destitute. Today it is a thriving and caring service in the city. Right where we are is the place our positive passions and hopes can start to be realised. Anne describes this, "Parents can only give good advice or put them on the right paths, but the final forming of a person's character lies in their own hands."

Anne teaches us that in the darkness we mustn't give into its grip and power. She talks of how her own principles were challenged. She writes "It's really a wonder that I haven't dropped all my ideals, because they seem so absurd and impossible to carry out. Yet I keep them, because in spite of everything, I still believe that people are really good at heart." Her hope was grounded on the fact that good exists in all and who knows when that good will start to flow and happen. She wrote that "Human greatness does not lie in wealth or power, but in character and goodness. People are just people, and all people have faults and shortcomings, but all of us are born with a basic goodness.”

Anne also knew how this approach illumines the world. "Look at how a single candle can both defy and define the darkness." The single candle of a good human candle can shine and bring light to many. This light doesn't burn solely for itself but for others. She knew how goodness is infectious and once started is like a mighty wave. "Whoever is happy will make others happy" she writes in her diary.

Anne's focus on goodness was aligned to kindness. Her words are "In the long run, the sharpest weapon of all is a kind and gentle spirit.” This 14 year old girl going through such a nightmare was possessed no doubt of a deep wisdom. She found her joy in the beautiful things of life. "I don't think of all the misery, but of the beauty that still remains."  Anne mentions her death. "I don't want to have lived in vain like most people. I want to be useful or bring enjoyment to all people, even those I've never met. I want to go on living even after my death!'' And this has happened. A young girl living in an encroaching darkness speaks words of goodness, kindness and light - words that help us along on our daily path today. A child teaches us out of her wisdom what we should know but often don't.

Anne possessed a deep awareness of life, beauty and goodness. This was, we believe, her deep identity; her true self. Goodness is that heart that warms and cheers another. It's those words, actions and even looks actions that connect us and touch us. People like Dave and Yvonne shine with this.

Anne Franks' experience in Amsterdam seems a long time ago. Yet its message burns brightly whenever someone, despite the problems, reaches out to love, care and do good. Out of such actions the hope of a better tomorrow will come and it is those who do so who really make history. It tells us that goodness is our true identity. To fully live is to be fully good. That's the promise what Anne's message offers. It's a clear and bright message to a world that often seems so very lost. It's incredible that in the midst of a system that stood for destruction she pointed to goodness.

John Walsh. York Street Health Practice. Leeds Community Healthcare.

Lisa Falkingham. Service Improvement Team, Leeds Community Healthcare 

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  

What can we see?

I was invited to meet the members of the Executive Coaching Register at the NHS Leadership Academy. These are top coaches from around the UK who work with the academy to support and coach NHS colleagues. The executive coaches' are experienced in working with the most senior leaders in the public and private sector and will support healthcare staff in developing into the high quality leaders the NHS needs (http://www.leadershipacademy.nhs.uk/support/executive-coaching-register/) Over dinner, it was a real privilege to meet such inspirational people as Julie Hickton and Neslyn Watson-Druee. I was invited to this event by Yvonne Coghill who is the Senior Programme Lead for Inclusion and Coaching at the NHS Leadership Academy. As a grateful beneficiary of coaching (via LCH's Liz Whitworth), it was great to meet and talk with these good people.  

I was sat most of the evening next to Elaine Patterson. Elaine is an executive coach and has just finished her Masters on the theme of reflection and leadership. Her research question was 'What are leaders experiences of reflection?'. Elaine's website describes her practice as specialising 'in enabling leaders and practitioners to become all of 'who they are' because 'who you are' directly shapes 'how you work', your impact on others, your results and your reputation.' Speaking to Elaine was one of those conversations where new mental vistas open up and one saw the value and vitality of reflective practice much more clearly than ever before. We had a long conversation full of insights and ideas from Elaine. The following are some of the things that really struck me:

(1) Reflection is not an added extra. I don't think anyone thinks reflection is a bad thing. Many of us may regard it as a luxury - some of us maybe as not the best use of our time. Elaine's argument is that reflection should be and always is at the heart of good practice. Reflection is the act of creation. It is in reflection that we see ourselves and our work and the possibility of new options and practice arise. Habitual ways of thinking and acting get challenged and new insights emerge.  Through reflection we create the possibility of bringing something new into the world. Elaine quotes Einstein as saying, ''problems cannot be solved from the same level of thinking which created them; they cannot be changed without changing our thinking (http://www.elainepattersonexecutivecoaching.com/real-work-leaders/)

(2) Leadership is always connected to reflection. Who we are is how we lead. There is circular reality here. Good leaders are born from reflection. Great reflection is generated by good leaders. Not so much chicken and egg as how leadership and reflection both nurture and develop each other. I asked Elaine what the opposite of good reflective practice was? Her answer was 'that leaders stumble'. I thought this was a very interesting and important answer. Leaders, staff and mangers stumble because we don't reflect. Reflection gives us focus and vision. Without it we can only stumble. 

(3) Reflection is a constant practice and more. Reflection should be a daily practice. This leads to it being a being more and more a state of consciousness / a way of work life. My guess is some of the best reflectors do their reflection anywhere - on a bus, train or walking to the office. Of course, the need of conducive space and the use of exercises such as journaling can be of great assistance. I once heard the analogy of firing an arrow applied to meditation. The idea is that we withdraw, retreat in a sense. Yet it is precisely this withdrawal that gives the arrow it's power and energy. Similarly reflection is that retreat and withdrawal that gives our work practice energy and power. If we don't use these moments we either won't reflect at all or end up in negative reflection by just letting worries and problems dance around our minds.

(4) If we want good leadership, better staff morale and more innovative practice reflection will be a great key to this. I asked Elaine if the Mid Staffs tragedy would have happened if all the staff had been involved in reflective conversations and practice. Her answer was 'No, I believe not'. If we can create reflective culture and consciousness we can start to build the best services for all including staff. Elaine’s research also uncovered that costs of not reflecting. These were identified as poor decision-making and losses in understanding, creativity, relationship, energy and productivity.

Elaine's website is here - http://www.elainepattersonexecutivecoaching.com/ - and plans to publish her full research findings in the autumn. I hope colleagues will hear the message this all points to - we lead as we are. Reflection can be a great friend in the process of us being the best people we can be and creating the best cultures and outcomes for our services.

 

John Walsh, York Street Practice

 

Leading when you feel useless

John Walsh speaking to guests at a Men's Health Week
event at the Crypt

Many good leaders - even great leaders can sometimes feel useless or hopeless. The same has happened to me. I remember a while ago I did a leadership development talk and came back to York Street feeling all positive and inspirational. I had a client booked in to see me so I went into the one of the rooms at York Street to see her. After we sat down, she shared some awful news with me. She was devastated and not seeing any hope or way forward. I suddenly felt very useless, having no words or easy options to offer. The positivity and inspiration evaporated very quickly as the story unfolded and I saw in this woman's face and features deep grief. I listened and offered words of support that seemed so weak and ineffective when compared to the anguish this woman bore. We talked for a while and then she left. I left the room feeling of no use at all to a fellow human being in need. 

I have thought about this incident since. I have got to a place where I think feeling useless is actually OK. What isn't OK is not managing it and working to transform it. To feel negative emotions is part of being human - it's what we do with them that makes or breaks us. There are personal and organisational behaviours that facilitate the transformation of these negative states. If we practice these consistently and patiently we start to build good cultures and practice. We also end up better people as we are focused on the positive. The great thing about these things is they cost nothing and can change everything.  So what are these actions or approaches? I'll touch on a few.

The most wonderful thing we can offer someone is not our words or sentiments (although they can be really helpful and powerful). The greatest thing we can offer someone else is our presence, listening and attention. A friend of mine was a psychiatric social worker in Bradford. He's retired now. He told me the story of meeting a homeless man and sitting on a wall in Bradford talking and listening to this man. The man spoke of his story and life. After half an hour my friend explained he had to go and instinctively put his hand in his pocket to offer some change. The man looked at him with deep and sad eyes and said, 'Put your money away my friend. You've given me what I really needed. You gave me yourself'. When my friend described the man, I actually recognised him. I was inwardly surprised as there is no way this man would ordinarily have turned down a 'hand out' but he did. Probably because he found something better - something more healing and helpful. I'm not advising people to approach homeless men on their own in Bradford or any other city, it's always safer to do this work with others through an organisation. What I am saying is we bring to every conversation, meeting and consultation what we are. We can be like my friend - a presence that brought peace and connection or the opposite. That's the power we hold in our hands. It's actually an awesome responsibility. So reflecting on the sort of presence we will be today is no small thing.

Another thing is that we can be a mirror to people struggling. This mirror reflects back to them what they cannot see at the moment or are not hearing. A friend of mine who is a mental health chaplain in a hospital outside Leeds will often talk to the nurses on the wards. The nurses tell him of their work. He tells them they are doing a fantastic job and sometimes he thanks them for all their care for the patients. The nurses tend to light up and are clearly thrilled to hear these words. My friend usually then says, 'Doesn't your manager say these things to you?' The answer is always the same, 'Never.'  This is so sad. We need desperately to re-discover the beautiful art of affirming others. We need to speak truth to feelings of uselessness in ourselves or others. We need to help others see what we see in them. Negative emotional states blind us to what we have and are. We can see so easily the gnat and miss the elephant. I have been very fortunate to have had such great NHS colleagues as Yvonne Coghill at the NHS Leadership Academy, Catherine Hall at York Street and Andrea North at LCH Specialist Services speak to me of my own gifts and qualities in ways that nurture and develop. This really is transformational work. People start to see who they are and what that means. Accepting at times our own feelings of inner poverty is fine as long as we don't stay there. We have to own them to transform them. Own it but go through it. See it but then look up and onwards.

The woman at York Street I mentioned early on in this post got through the incident, we were able to offer support and she moved on to a life and place of recovery. York Street is somewhere where we see again and again people face the worst and somehow get through it. It's incredible how things can turn around and work out as we work it through.

If you are reading this and feeling not too great about yourself and your leadership skills and practice, take heart, good and even world class leaders go though the same. You're in good company! There's an Oscar Wilde quote that says, 'We are all in the gutter, but some of us are looking at the stars.' I hope no one reading this is in the gutter. I also hope next time you feel useless you also look at the stars too. 

 

John Walsh, York Street Practice

Nursing and what really matters

John Walsh at Men's Health Week event at the Crypt
alongside Councillor Mulherin

On Monday 9 June I attended the Nursing Times Leaders event in London. This was an award ceremony for the top 50 nursing leaders in the UK. It was to honour nurses and midwives who are "pioneers, entrepreneurs and inspirational role models in their profession...practitioners who have changed practice for the better, shown visionary thinking, had a major positive impact." (Jenni Middleton, editor of the Nursing Times, official brochure). The awards were decided by a very esteemed panel including Dame Christine Beasley. The night was a wonderful celebration of people who have made the NHS what it is at its best. It was a great privilege to be there. I was there as the guest of my dear friend, colleague and mentor, Yvonne Coghill, the national lead for inclusion at the NHS Leadership Academy. Yvonne herself won one of the awards.

I met many good people that evening. It was great to meet NHS leaders such as Jane Cummings, chief nursing officer and Caroline Alexander, chief nurse for the London region. It was a special moment to join senior colleagues from the NHS Leadership Academy to support and celebrate our Yvonne winning this award. Meeting Dr Dave Ashton and Karen Lynas from the Academy was a real joy too. They are two fabulous people and we had some great discussions about how the Leadership Academy and York Street/Leeds Community Healthcare (LCH) can work together to develop the best patient care models, staff and leadership development and work for and in the city of Leeds.  I hope these exchanges can continue as they hold tremendous promise and possibility.

 

So what really matters for nursing and all health professions in the NHS? To answer this I think we have to answer why, despite all the current problems, the NHS is still popular with the mass of British people. Why it still holds such a special place in the minds and hearts of a nation? I think the answer is that the NHS is special because it makes us feel special. And it makes us feel special because it promotes and incarnates the most powerful of human virtues - goodness. It connects us with this in a very real way. It is a commitment to care, to heal, to do good. It represents this a social body and daily practice. That's why Mid Staffs was so appalling and shocking to us. The very spirit and heart of the NHS was denied and subverted by awful practice and culture. A healing service ended up it's opposite. When people see the NHS in it's real form, they remember the fantastic nursing team that looked after their mum. They think of the kind doctor who was so helpful to them when they had a medical problem. After nearly twenty years working with homeless people on the streets of Leeds, it's exactly the same. It's the goodness and kindness that breaks through. It's goodness that starts to transform us. I've seen big tough men, no strangers to the police and prison system, crying at some act of genuine goodness that has affected their lives. I have also seen where homeless people have been lit up with happiness as they have shared what little they had with others. There's an immense energy and power in goodness. Yet I think goodness isn't an easy thing to define. It's more felt than spelt out. Most of us will know when we encounter it. It lifts us up and makes us open to hope and engagement. Goodness is a mirror that shows us what we can be. I believe goodness is what all of us in the NHS need. It is what makes everything else tick. From the 6 C's through to vision and values to good patient care, goodness has to be the core and life.

This bring me to Yvonne. Yvonne is someone with many gifts and qualities. The list of these would be a very long one. Intelligence, courage, integrity, compassion, wisdom ,strength, gentleness, energy, panoramic vision, deep psychological insight (she's the best psychologist I know), fairness, understanding and so on. For me the one defining quality one sees shining in Yvonne - the jewel in the crown so to speak -is goodness. I don't find it a surprise that what makes the NHS an incredible service at its best is what makes Yvonne such a wonderful human being. Yvonne is a very special person in a very special service. It's people like Yvonne who show us the best in ourselves and encourage its manifestation.  I feel very blessed to know Yvonne as mentor and friend. I'll finish this posting sending Yvonne from all her friends at LCH a big well done for the award and an even bigger thank you for what she is and does for this service of ours. 

John Walsh, York Street Practice