Saying yes to the mess: what we learnt from the Diabetes UK Leadership Alumni Event – by Beth Stout

At the beginning of July, we brought together some of the greatest people we know working in diabetes care improvement: our Professional Leadership Alumni.

The Professional Leadership Alumni is made up of clinicians who have participated in our leadership programmes: Clinical Champions and Tomorrow’s Leaders. These programmes are designed for healthcare professionals from across the country and across the NHS, to give them a louder voice to make improvements in diabetes care.

The day kicked off with a welcome from our Chief Executive, Chris Askew. Chris told the Alumni that at Diabetes UK, we’re committed to supporting emerging local leaders, as we know that good care is strongly linked to local clinical leadership. This leadership isn’t necessarily linked to traditional NHS hierarchies, it’s about people who work in clinical practice, with patients, being able to use this experience to determine how the NHS delivers care.

We then welcomed Allison Trimble, a Consultant from the King’s Fund, who led the day.  Allison opened the session by talking about her experiences with Type 1 diabetes in her family, and how the work that the Alumni do is close to her heart. She moved on to introduce the theme for the day – what’s going on at an unconscious level in relationships, and how we work with complex problems.

Systems thinking

One of the things we encourage both the Clinical Champions and Tomorrow’s Leaders to do is to think about systems – about the broader implications of changes you make. On this subject, Allison gave the Alumni a great piece of advice: “Thinking about systems gives you permission not to have to fix everything in front of you. Sometimes you can just make progress.”

In a health system with so many connected challenges, the inability to fix everything can often seem demoralising. However, Allison told us that by understanding diabetes care as part of a bigger system, we realise we can’t fix everything – we can only do our best to make progress. Allison went on to say, “The tyranny of trying to fix everything and get everything right is no longer relevant. Because of this, we need to give ourselves permission to ask really good questions.”

We shouldn’t try to make everything work, and make everything neat – systems don’t work like that. Instead, we need to ‘say yes to the mess’. We shouldn’t worry about opening a can of worms, we should ask the questions we need to ask to get the information we need. In the context of complex challenges, Allison encouraged us to think about ‘sweet spots’ – what’s the smallest thing you can do that will have the biggest impact? Sometimes we get wrapped up in trying to change everything. Are there little things we can do that will actually have a big impact? If so, focusing on these could be a lot better for us than trying to change everything.

It’s all about relationships

We discussed some assumptions we might be making about people that could be affecting relationships. Allison gave us great food for thought by bringing our attention to why we might see people in certain ways. Do we ‘categorise’ people based on our past experiences, rather than getting to know them? This can hinder our working relationships and effectiveness as leaders.

Allison highlighted some beliefs that might affect our willingness to lead change. Do we shy away from speaking out because we want to fit in? Are we worried that by challenging the status quo we will become isolated? These are things we all do as part of being human – but do they stand in the way of our ability to work well with others or speak up when things are going wrong? Do they hinder our ability to lead change?

We finished the day with some ‘peer consulting’ – giving Alumni members the opportunity to bring a problem to the group and explore it in detail, with peers asking helpful questions. It was amazing to see how the conversations we’d had earlier in the day helped people understand their own challenges in a new way. Having the time and space to explore an issue with peers really helped people to think about how to solve a problem.

Well, perhaps not how to solve the whole problem. But to think about the next steps they can take, making progress rather than fixing everything, and saying yes to the mess.
A huge thank you to Allison Trimble for leading the day.

The Clinical Champions and Tomorrow’s Leaders programmes are Diabetes UK projects. Novo Nordisk are providing support and funding.

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