Monday 3 February 2014

NHS Change Day is about a different approach to leadership | Interview with Jackie Lynton

NHS Change Day is about a different approach to leadership | Interview with Jackie Lynton

A former mental health nurse organising pledges to improve patient care explains how to empower frontline staff .  In March, staff across the NHS will be asked to make pledges to improve patient care, as part of the second-ever NHS Change Day.
The first NHS Change Day took place in March 2013 as a concept that sprang from frontline staff. It has been described as the largest ever health and care social movement, and one of the unusual aspects of this grassroots movement is that it has no single figurehead, but aims to make healthcare staff themselves leaders of change.

But of course, such a large day can't happen on its own. Former mental health nurse Jackie Lynton is one of the members of the core team helping organise this year's Change Day on 3 March 2014, alongside emerging leaders within the NHS.
Lynton sees her role as supporting and taking advice from people on the frontline and says it's unhelpful when people describe her as the leader of Change Day. "We work in a hierarchical organisation," she says. "Developing a social movement within a hierarchy is challenging enough. For me to then stand up and say I'm the leader of Change Day totally takes away from the fact that it's a grassroots movement."
Lynton is head of transformation for the NHS Horizons team at NHS Improving Quality, a team "on the edge of the organisation rather than at the core centre", focused on encouraging new trends and challenging the status quo. She got involved with this year's Change Day when she saw the impact of the first event last year.
"As soon as I heard about it I just believed in it," she says. "I thought this is exactly what we need to be doing in terms of mobilising. It came at a time when the NHS needed that hope, that motivation – a different approach to change. Change from the bottom up."
At 189,000 online pledges, the response to the first NHS Change Day in 2013 was unprecedented. The timing was optimal; the NHS had been blighted by a series of high profile scandals in recent years, including the inquiry into "appalling" standards of care at Stafford Hospital – and staff morale was sinking.
Change Day, which has been presented by some people as a backlash to "ill-thought out NHS reforms", does have its critics. But Lynton counters the suggestion that pledges to improve patient care will not create lasting change, saying that a snapshot survey undertaken following last year's Change Day showed 50% of pledgers said their actions had a long term impact on them or their organisations.
Last year's pledges were varied: Change Day co-founder Dr Damian Roland pledged to taste the paediatric medicines he prescribes to understand better what his young patients are going through; some NHS staff pledged to have a cup of tea with patients who don't receive many visitors; market research agency MRUK pledged to set up a computer on Change Day where staff could sign up for blood, marrow and organ donation.
Lynton herself made three pledges – to spend some time on the front line, to help improve patient care at her local GP practice, and to ensure hierarchy never gets in the way of patient care.
This year the core leadership team is hoping for 500,000 online pledges from individuals, organisations or teams. But Lynton's favourite pledge from 2013 was not even put up on their website. A second-year student nurse from York galvanised her peers to set up a ward simulation – everyone put their pyjamas on and played patients and nurses.
This gave the students a deep understanding of what it's like to be a patient – from how it feels when someone is dying in the next bed to the devastating impact it can have when someone asks for information and they are fobbed off with a leaflet. The University of York has now taken the simulation on as part of their teaching programme, and several of the student nurses have become part of Change Day's core leadership team.
"They got so into it; it became so real to them. What they learned will last for the rest of their careers," says Lynton. "You start out as a student nurse with every hope that you are going to change the world. And some people ask, after 30 years or five or 10 years, is that going to be knocked out of you, or does the system wear you down? Change Day is about how to recreate that hope and reignite that energy."
The Change Day movement challenges the status quo and, through informal networks, empowers front line staff to take action. But the leadership team also works with traditional NHS power structures to get "the best of both worlds", says Lynton. It's a concept that's starting to catch on globally; Northern Ireland, Australia and Sweden are running their own Change Days this year.
The movement is very personal to Lynton. "It really reconnected me with my values and why I came to the NHS in the first place," she says. "I still remember my very first patient and she continues to be my reference 30 years on. Her name is Blanche and she taught me how to be a clinician. She taught me how to listen, and care with someone."
It's this kind of ethos that Lynton feeds into her leadership style. She is an inclusive, enabling manager, who gives her staff permission to take action for themselves, she says. Sometimes she steps back and lets others lead, even if she's the most senior person in the room. "The NHS is about those resounding values of equality for all, and the NHS belongs to us all," she says. "The essential thing for me about being a leader is creating hope, but being realistic at the same time."
On the back of Change Day, Lynton has also helped set up the School for Health and Care Radicals, a virtual learning programme for people who want to learn how to work in a different way. Kicking off today (31 January), more than 800 people have signed up to weekly seminars that will equip them with the tools necessary to make positive changes in health and patient care. Healthcare Network

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