TCM bring solution and resolution to an NHS Trust

TCM bring solution and resolution to an NHS Trust

Confident Conversations™ across Kent, Surrey and Sussex Leadership Collaborative

NHS Trusts have been making great strides to improve how employees deal with difficult conversations in the light of the Berwick, Keogh and Francis reports and the Francis follow-up report on whistleblowing, Freedom to Speak Up. In 2013, a staff survey found that 72% of staff felt confident to raise a concern, suggesting there was still a need for training and development in this area.

The Kent, Surrey and Sussex Leadership Collaborative is an authorised leadership delivery partner to the NHS Leadership Academy and operates as the leadership directorate of Health Education England working across Kent, Surrey, Sussex (HEE KSS), commissioning leadership development for NHS organisations within Kent, Surrey and Sussex.

The subject of difficult conversations was further explored at the HEE KSS Sound of the Student and Trainee Voice, an event which ensures the voices of the region’s learners and educators from health and social care, allied professionals, support staff and employing organisations, are heard. Participants were asked what the blockers to them using their voice were, identifying a number of reasons including confidence, fear and apathy as to why they might not use their voice.

The KSS Leadership Collaborative commissioned mediation experts The TCM Group to work in collaboration with NHS organisations in the KSS region and develop a one-day workshop called Confident Conversations™, designed specifically for NHS staff to help them identify and respond to issues that are raised, and foster a culture of open communication.

Through a pre-course questionnaire, participants suggested some of the areas they would like the workshop to address, such as:

“helping me feel more confident in having difficult conversations with staff, medical colleagues and even senior management.” “learning tools and techniques which will aid me when faced with difficult situations and when experiencing conflict to ensure the desired outcome is achieved.” Tips in planning how to have a challenging conversation, allowing all parties to leave with dignity, but aims and objectives to be delivered.”

The solution

The reception for Confident Conversations™ was overwhelmingly positive. Following an initial pilot, seven open workshops were held and in total, over 200 NHS staff from across the KSS region attended the Confident Conversations™ workshops.

Two expert facilitators from The TCM Group hosted the workshop, providing participants with tools and strategies to manage difficult conversations and negotiate outcomes that would be best for everyone.

Role-plays formed a part of the day, with participants experiencing the point of view of patients, staff, and observers. There were also scenario-based discussions, tailored to the types of situations this particular workforce might face – these scenarios were a reflection of real workplace situations based on the responses to the pre-course questionnaire.

Participants were encouraged to practice ‘active listening’: a structured form of listening and responding that focuses the attention on the speaker. One of the core techniques in managing difficult conversations is to summarise – as this demonstrates whether someone has really been listening and has understood what the other party has to say. Participants experienced using silence in an emotionally charged situation and the positive effect this could have on managing an emotionally charged situation.

At the end of the workshop, everyone who had attended was provided with a toolkit outlining the various theories they had learnt, with helpful tips on how to manage difficult conversations in the future. This toolkit has been shared with the wider NHS workforce and can be viewed on the KSS Leadership Collaborative’s website (http://www.kssleadership.nhs.uk/resources)

The results

Feedback 24 hours after the workshop showed that the majority of attendees felt they had an increase in knowledge of active listening, managing strong emotions and summarising what people had to say.

Three months after the workshops, a further feedback questionnaire was carried out to see how delegates were using the learning and whether it had been retained. Almost half (49%) said that the course had made either a significant impact or very significant impact in the workplace. One participant shared in their questionnaire how a member of her team had become defensive following changes in their work. She was able to utilise tools practised on the workshop, such as listening and summarising to help engage her team member in coming up with solutions to support their shared work.

“I have certainly applied the learning. I’m more aware of how much even a small conversation with colleagues or patients makes a different.

I can be on-call outside usual working hours and it can feel like everyone wants a piece of you at the same time. Patient issues can become more difficult, there are fewer staff and the situation becomes quite stressful.

I’ve more awareness now of how to prioritise and how to prevent something escalating. I’m more patient, I take a pause before I act and I’m more aware of what I’m saying. It’s been very positive.”

A CT3 Psychiatry Trainee from a mental health trust.

– David Liddle

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