A different kind of patient

We woke up on New Year’s Day to hear of the riots at Ford Prison in West Sussex.  There has been criticism of the staffing levels on New Year’s Eve; the National Prison Officer’s Association claim that nationally there is a shortage of 1,000 prison officers before the planned redundancies take place over the next year; The National Governor’s Association provided insight into the judgement calls that staff have to make when staffing levels are low and the impossibility of robustly monitoring the perimeter fences.   Last night, it was announced there would be a review into staffing levels at the prison.

The whole situation raises the profile of how difficult it can be to manage the workforce within the prison service and the day-to-day challenges that they face. Prison officers are required to hold a particular skill set which will enable them to manage the delicate tensions between prisons and staff such as treating others with dignity & respect, conflict management skills, and emotional intelligence.

I have no experience of HR within the prison service, and so I cannot comment on the extent that the prison workforce has the necessary skills to support them in this difficult role.  However, issues relating to staff competency had previously been identified within Prison Inspection reports as highlighted in today’s Guardian Editorial .

I have worked with healthcare teams within prisons.   Last year I was asked to provide individual and group coaching to a team who had been through a difficult period:  two members of the team had “moved on”, and a new manager had been appointed.  My role was to enable the team to move forwards and positively approach the new challenges that they faced.

Unsurprisingly, the factors that affected them went beyond the interpersonal relationships between the remaining team members and included the environmental factors in which they worked.  A key theme that emerged was the behaviour of the prisoners towards the healthcare team.

The told me stories of how prisoners would kick the door repeatedly if they felt that a consultation was taking too long.  There would be verbal abuse if a nurse would not provide non-prescription medication (eg for a headache) when she judged that the prisoner was not in need of it.  And in quiet moments, some of the prisoners told the staff that they were the best healthcare team they’d experienced within the prison service.

The prisoners treated the healthcare staff with disrespect and this had a direct impact on their attitude towards their work.  They made decisions that were influenced by how a prisoner was acting, and they recognised at times that these decisions led to inequality in their treatment of prisoners.  In order to gain respect, they needed to ensure that they were acting professionally, fairly and appropriately according to need.  They also needed to work as a team, not just with the prison-based healthcare team, but with the wider set of healthcare professionals who undertook sessional work.

Another impact of the prisoner’s behaviour was that they felt that they were always fire-fighting; they were reactive to the demands that changed from day-to-day.  Their vision was very different:  they wanted was to deliver pro-active healthcare that would have a lasting effect on the prisoner’s health long after they had left prison (eg helping prisoners to give up smoking).   The team decided that they no longer to accept “the way things are” and set about changing the culture so that they could achieve their vision.

So my thoughts in the aftermath of the Ford Prision riots are for the healthcare team.  I hope that the review includes the views of this valuable (but often unrecognised) team as they will be able to provide a different perspective into the issues that contributed to the events on New Year’s Eve.


A Post About Faith Restored

I’ve written before about my journey, and how after 10 years I was a jaded NHS senior manager.  I tried and failed to be made redundant (how ironic in today’s climate). Instead, I resigned and went free-lance. I haven’t looked back since.

Over the last few years I have worked with a range of NHS organisations.  My blog has related my frustrations with NHS bureaucracy, and my dispair of disengaged HR staff who deliver poor service. 

About 8 months ago I heard of an opportunity at Kings College Hospital, London.  I was keen to get inside this high-profile organisation, who are known for being leaders in their field, including their approach to workforce intiatives and their “can-do” attitude.

However the timing was off, and so I couldn’t throw my hat in the ring.   A couple of months later I got another call and I was subsequently successful in being offered the opportunity to work a number of challenging and rewarding projects.

My first impressions are still vivid in my mind.   Whatever stone I unturned, there was a reasoned, well-thought through approach or response to how or why things were done in that particular way.  I wasn’t just looking at good practice – but excellent practice. 

I’m used to working with HR teams on their journey to improve their performance, moving them from mediocre to average.   But at Kings, I was faced with a different challenge.  I was out of my comfort zone, and I liked it. 

The most striking aspect of the Workforce Directorate is their attitude to team work.  It’s a stable team, with several members of staff having long service.  This hasn’t led to a culture of nepotism; there are friendships, but there aren’t any cliques.  All relationships are highly professional and everyone looks out for each other. 

Another key element is the fact that there isn’t a  blame culture.  Staff are willing to stand up and be accountable for human errors.  And in the same breath, they take a proactive, pragmatic appraoch to sorting them out.  No-one is afraid to make a mistake, which in turn leads to a more engaged and productive workforce.

My final observation was summed up by Tim Smart, the current Chief Executive at the staff’s Winter Diversity Event earlier this week.  He talked about how Kings is seen as an exemplar;  he is regularly being asked to speak at events to talk about the Trust’s approach to becoming “effortlessly inclusive”.  He highlighted that that Trust is still on its journey and there is still a lot of work to be done.  So it was important to recognise and be proud of all that the Trust has achieved to date with the acknowledgement that there is still much to be done.   And this gives the staff the drive, energy and passion to keep on improving performance.

I think over the last few years I have been searching for the Holy Grail.  And at Kings, I think I’ve found it.   

If I was 10 years younger, without kids and lived 10 minutes away, I would glady apply for a job at this Trust.  As it is, my personal circumstances are different.  But instead, all I can give is this post: a tribute to those within that Trust and for the fabulous experience I had working with them this last year.