This morning I was up early (for a Saturday), scrolling through twitter, wondering how to kick start my weekend. Last weekend wasn’t my best one and I was hopeful for something to set a different path. Jodi Brown and friends didn’t disappoint:
Genuinely killer question. I don’t know Jodi at all well, we’ve exchanged tweets occasionally but no more than that, Annie C had shared this and so I thought about replying and decided to jump in. The first point of reflection is that I did think about whether to join in, a couple of years ago I’d not have engaged in any thought, I’d have just jumped into the mix and saw what came from it, but these days I tend to be a bit more cautious about engaging in #NHS chat online.
A truly fantastic conversation followed, Jodi, Annie and I were joined by about ten others, including @ @ @ @ @ @ @ @gleefulkaz @carollread @NHS_rants. Not surprisingly we didn’t agree with each other on everything, in fact there were some of us who probably didn’t agree with much that others were saying, but it was respectful, challenging and for me personally a reassurance that it was still possible to have a non-scheduled, chat on twitter and have your mind stretched with multiple perspectives. Here’s an excerpt from this discussion where Jodi and I were disagreeing over what/who counts as ‘radical':
Our chat continued, others joined in, think we were at it for about an hour in total. Really made me think and question, what I consider radical and what it must be like to work in a system (the NHS) that was repeatedly described as, without putting too fine a point on it, toxic. Lots of talk about cultures of repression, fear and hierarchy. We all went about our ways, Jodi had to take her kids swimming, Richard was off to a food festival and I hit the gym.
I left the gym an hour or so later, grabbed my phone and was bouncing home to the weekend and was hit with this tweet:
Booooooooom, smack, bang. Sorry, what just happened? I looked around for further discussion, NHS_Rants had questioned this but there had been no response. I checked the sender’s stream, they hadn’t joined in on any of the rest of our hour of conversation, just singled in on my one comment about NHS Change Day and decided that I was wrong. Not just wrong, but obviously wrong *and* stupid or deaf – I need to be told that BOTH of the previous change days had been groundbreaking.
I lost my cool, didn’t ignore this (which I probably should have) and questioned how they could be so rude. Thing is I think social media is a conversation, and when there are ten people talking, I imagine in my head it’s a bit like we’re all sat around in a room trying to understand each other, the reality could be far from that, some were travelling, others juggling family commitments, no doubt there were PJs and gym gear worn alike – so, unconventional, but still we’d had a great conversation. How I experienced this tweet was that the sender listened into our conversation, picked one bit that they had an issue (or pride about), walked into our room, shouted their opinion (literally in those capitals), in no uncertain terms and then walked out again.
This was the exact sort of conversation I’d been nervous about getting involved with first thing. You see there are loads more NHS people on social media these days, and that’s a great thing. It also means it’s much harder to hear balance, and to truly discuss things without being shouted down by the party line. In the context of our conversation about cultures of control and challenge this was a perfect example. The sender’s biog is clearly claiming expertise in this area, they’re a ‘Social Media Innovator – NHS Change Day 2014 Social Media Lead. NHS Leadership Academy SoMe tutor. Passionate SoMe practitioner’. Their response perfectly embodied what I’d been querying in the first place. Whether all of these NHS initiatives are now seeking to use #socmed and indeed the initiatives themselves to control and centralise the messages. Ironic that the very strength of social media could be lost in so many ways. As ever I wasn’t claiming this to be an absolute truth, or even a truth at all, hence my delight at the genuinely open conversation earlier in the morning.
When I got this tweet though, it’s safe to say I didn’t feel I’d been listened to. The sender hadn’t engaged in our conversation and didn’t seek to understand where I was coming from. They just let me know that I was wrong. I don’t want to make this about the tweet though, and the lovely Anne Marie pulled me up on ‘public shaming’, which wasn’t my intention at all, hence no identifying features on this blog post. I could have exercised more tact, but I also (strongly) feel that the tweeter was incredibly selective in what they picked on, and incredibly blinkered in their engagement. This was exactly the type of conversation that is all too familiar on social media these days, and precisely what I wanted to avoid.
The NHS seems obsessed with Cs at the moment, but rather than the #6Cs that are admirable yet seemingly a distant ambition in these cultures of ‘repression, fear and hierarchy’, I’d like to reflect on a few Cs of my own – I’m not offering an opinion, just a few (deliberately loaded) questions. I’d love to hear your thoughts:
Control: Are leadership programmes/away days/initiatives provided to help sustain and support weary folk in (toxic) cultures to really bring about change, or are they used to control and pacify?
Construction: Social movements are by their nature fluid, open and dynamic, has the new obsession with initiatives killed the very essence of these strengths through overly constructing them with approved hashtags, conversation times, and self-appointed experts?
Centralisation: Is it possible to develop and improve practice in one area, then try to roll it out centrally, without losing why it worked in the first place?
Challenge: When was the last time someone challenged you? Outwardly, openly and in public? Are the social media conversations of today vanilla in colour, weak in strength and just affirming our own biases?
Conformity: How many dissenting voices feed back into your viewpoint each day? How many patients or citizens are involved and attending the many leadership courses, initiatives and awards ceremonies that you frequent?
Candour: I’ve been elbow deep in redacted documents of late through JusticeforLB, I’ve seen the inner workings of the NHS Spin Machine at its worst, I honestly think there is a long way to go before candour becomes meaningful within the NHS; that said I’ll be eternally grateful to those medical professionals (especially our GP) who showed an extraordinary level of candour (and compassion) when Dad was ill. I’ve spent years praising the NHS and all it stands for, but if we can’t criticise openly we’re never going to improve anything.
Courage: It’s hard to be a lone voice, it’s even harder to be a lone voice when your voice can be taken out of context or one thing you say can be pounced on for someone else’s agenda. I’ve learnt so much in the last 9 months about courage from Sara Ryan. I’ve also experienced first hand how utterly exhausting (and pointless) it is to be a lone voice in the face of the NHS spin machine.
I understand why people are proud of the NHS, it’s care and it’s staff. I am too. That said, if people like me need to psych themselves up to engage in conversations, something is very, very wrong. I think it’s time we had some courageous challenge, I think it’s the only way the NHS will survive and people will retain their confidence in it. I remain grateful for the chat first thing this morning, and would love people’s views on my deliberately loaded questions, because I’m genuinely open to challenge and want to learn. Thank you.
PS Thought it was worth adding a note on here that I should have included when it was first published. I know it may take courage to disagree with me (not sure why but guess we’re programmed to avoid conflict or challenge), and I know sometimes adding a blog comment feels more finite than a tweet or an email or a DM, but I really *really* would like to develop this conversation further. Since I’ve been involved with JusticeforLB I’ve had more DM/email traffic of support, and less public agreement although not necessarily less challenge. Given the actions of the Trust where Connor was ‘cared for’ before his preventable death, I feel I have had to criticise the NHS, and I’ve been exposed to the worst of spin and poor manipulative communications; but I am not for a minute ‘tarring everyone with the same brush’, nor do I doubt the good intentions of most people (even some of those who seemingly lack competence or skill or support), so please, please do disagree or agree or comment or whatever, or don’t if you’d rather not, but please don’t feel afraid to do what’s right for you.
I’ve lost my blogging mojo at the mo, but I couldn’t let the sun set on this week without recording what an amazing week it has been.
It started off with a trip to the big smoke on Monday to have an initial meeting about the #LBBill, a proposed private members bill instigated by the legends that are Mark Neary and Steve Broach. You can read more about what it contains in Mark’s summary of the day here or in more detail in several posts on Steve’s blog here. The first draft will be launched in the next month or so and we’ll be looking for input from you all. The meeting was small and just involved Mark, Steve, Sara, Richard and myself. We kept it intentionally small to try and nail the process, roles and responsibilities and actions required to take it forward. In true #JusticeforLB style we’re taking an organic route (making it up as we go along with all the expertise we can gather on the way).
Sara and I have been in very close contact since February this year, but we’ve only actually met in the flesh once before, so it was a real treat to spend the next few days together, starting with the train from London to Lancaster with very precious cargo, the amazing LB Justice Quilt. 273 patches of hope stitched together into an astonishing banner that demands Justice for LB and for all dudes. A perfect reflection of all that was magnificent about the #107days campaign, crowdsourced and volunteer run, and absolutely determined to keep a spotlight on the dire ‘care’ and support that existed for LB, and for so many others.
Lancaster University was the venue of the CEDR Disability Studies Conference 2014. I can honestly say I have never been to a more welcoming, accessible, passionate or fascinating conference. Every keynote, every breakout session, every evening had my brain firing off in all directions, listening through the #JusticeforLB lens, that appears to cover my line of sight most of the time these days. Love isn’t really a word I’d associate with a conference, but I felt surrounded by love, and commitment, and support for JusticeforLB (and for many others). I had only met three people in real life before the conference, and yet there was no point when I felt out of it. It really was remarkable, and it was a real honour to meet so many people who had supported #107days and shake them by the hand/give them a hug. Sara and I are very aware that there are so many people who have supported the campaign who we’ve yet to meet, so we’re thinking about what we can do about that, perhaps a festival or unfestival in the spring!
The final act before the long journey home, was a quick ‘what next’ meeting with Sara, Damian, Chris and Hannah. We are plotting and planning and there will be more on that in due course, suffice to say that we’re not planning on becoming silent any time soon. We’re all in this for the long haul, and I for one feel overwhelmed with the love and support and shared commitment to get JusticeforLB. Thanks to each and every one of you, progress may feel slow at times, but we are getting there, there is a blazing light at the end of this dark and murky tunnel, and its shining a lot brighter after last week.
Once I’ve started something I always try my hardest to finish it, so having deconstructed and analysed paragraphs 1-9 of a letter from Katrina Percy to Sara Ryan, this post attempts to finish the rest of it. If you’d like to catch up before reading this, you can read the analysis of paras 1-3 here, then paras 4-6 here and finally paras 7-9 here. Sara’s original letter is here and Katrina Percy’s response here. So, where were we, Sara’s son drowned in bath in hospital, an entirely preventable death. Katrina Percy is the CEO of the hospital trust responsible. Sara asked for some answers, this is Katrina avoiding giving them.
‘I also do not believe a series of bi-lateral exchanged letters and protracted written correspondence in isolation from genuine dialogue would best serve to do justice for all parties concerned. Nor would they enable all of us to fully understand, engage with and respect everyone else’s perspectives. This does not mean I am opposed to answering any of your questions. I am not. Not least because I know we have nothing to hide and am absolutely confident we have done the right thing. It is simply that I believe it to be very important that we do so in the best and most effective way possible, taking into account the views, insight and interests of all concerned. I believe this can only be done through talking face to face and sharing perspectives, not through impersonal correspondence’.
Every time I start to deconstruct a paragraph I’m surprised it can be even worse than the previous, this one is no exception. So, let’s start.
‘I also do not believe’ anyone else tired of this yet? Me, me, me, I, I, I. It really does appear that KP isn’t aware that the world does not pivot around her.
‘a series of bi-lateral exchanged letters and protracted written correspondence in isolation from genuine dialogue would best serve to do justice for all parties concerned’ Well ok, there wouldn’t be much point of letters if they weren’t exchanged would there, as for bi-lateral a letter between two people nearly always is bi-lateral, one person presents their perspective, then the other presents there. I’m not aware of a letter that it’s possible to write and share in real time, that would require an alternative method of communication, perhaps like tweets or social media. So yes, bi-lateral exchanged is pointless and can easily be disregarded if you’re struggling to understand this letter as much as I was. As for protracted written correspondence Sara’s blog post wasn’t protracted, it was quite succinct really, mostly contained just the sixteen questions, as opposed to KP’s missive on three sides of A4. So perhaps some internal editing before sending would help with that.
In ‘isolation from genuine dialogue’ ummm, is this some sort of admission of guilt that this epic missive isn’t genuine? Many of KP’s staff were in no hurry to meet Connor face to face for genuine dialogue when they were meant to be assessing him, so anyone else think it’s a bit of a case of too little and too late to be jumping on a genuine dialogue bandwagon now?
As for ‘justice for all parties’, ummm, when does this nonsense stop? This isn’t about justice for all, what is unjust about someone taking home a significant salary, who claims to Lead her tribe of 9000, being asked to be accountable for Her Trust’s failings? Surely that’s the least that can be done. Sara doesn’t owe Katrina anything. This isn’t about all parties involved. The only person who needs justice here is Sara, in the name of her beautiful son, Connor, known as LB, short for laughing boy, hence JusticeforLB.
That laugh will never be heard again thanks to the failings of Southern Health. Would someone please explain to KP that Sara has no legal or moral obligation to help improve services (paragraphs four and five), or to provide justice to all parties. I’m sure there will be time enough to debate justice, if and when the long hoped for corporate manslaughter case is brought.
‘Nor would they enable all of us to fully understand, engage with and respect everyone else’s perspectives‘ Again Sara has no obligation to understand, engage or respect anyone else’s perspective. So far KP has magnificently and publicly demonstrated her inability to show empathy, compassion or candour, so why on earth would Sara wish to risk engaging in this conversation?
‘This does not mean I am opposed to answering any of your questions. I am not‘ sounds promising doesn’t it, after a side and a half of KP’s diatribe, we can now look forward to the answers to the questions Sara has requested.
‘Not least because I know we have nothing to hide and am absolutely confident we have done the right thing’ ummm, Connor drowned, it was dismissed as natural causes, pages and pages of records have been sent to Sara redacted. Nothing to hide? Was that just a photocopier error then? As for absolutely confident, this sounds a little like KP’s absolute right to assert what she likes. Good to know she’s ‘absolutely confident we have done the right thing’ that will make things much clearer if it gets to court then, the right thing being what exactly? Allowing Connor to drown? Redacting paperwork? Being generally obstructive? Trying to stop the independent report being published? Keeping the family waiting all day and publishing it after six in the evening? KP not bothering to do media herself? Glad she has absolute confidence in her behaviour and actions.
‘It is simply that I believe it to be very important that we do so in the best and most effective way possible, taking into account the views, insight and interests of all concerned. I believe this can only be done through talking face to face and sharing perspectives, not through impersonal correspondence’. OK, KP is entitled to yet more of her opinions and her beliefs; my guess if that she throws the simply in to again assert herself and let anyone reading know that Sara is just not getting the very, very simple point. Umm, as for the ‘best and most effective way possible’ given the appalling treatment of this family since their son’s preventable death, I’m not sure what gives KP the right to make this judgement call.
Southern Health Board Minutes from March 2014 include the following statement:
4.3 Simon Waugh [Chair of the Board] emphasised that there was full commitment to ensuring awareness of the circumstances surrounding Connor’s death; he noted that whilst the Trust had openly indicated the desire to meet with Connor’s family, he was aware of the feelings of the family in relation to this; as such he committed that the Trust would not continue to reiterate this intention to Connor’s family‘
So where does that leave us, less than five months ago, the Chair of the Southern Health Board promised that the Trust would stop hassling to meet Sara and Connor’s family. Surprising then that KP still seems intent on this course of action, or indeed that she feels absolutely right to send this bullying, aggrandising letter. Sort of implies she thinks she’s above her Board, as well as Sara, the law and the NHS Constitution.
OK, I’m almost done with this now, in paragraphs eleven, twelve and thirteen KP repeats her earlier beliefs and statements, again asserts that she knows Sara will not want to hear this, really twice in one letter. Anyone else consider this bullying and an abuse of public office; a calculated and continued attack on a grieving mother.
The final paragraphs really reveal in my opinion the intention of the whole missive.
‘I am more than happy for this letter to remain private between ourselves, should you so wish. If you prefer to place its content in the public domain, including via social media, I would respectfully request that you publish it in full rather than individual extracts or public commentary on its contents without making the full context also available. I hope you will understand and accept this request. Should you prefer to choose to make it public, either in full or in part, I will also discuss with my colleagues whether or not we should do likewise through our own communications and social media channels to ensure all interested parties are aware of it’.
I’m a little confused whether this was some attempt at a threat, or what exactly. First up this letter could never remain private between Sara and Katrina, because she chose to send it to Sara’s solicitor, not directly to Sara. I don’t know why Sara should give a toss about what KP ‘respectfully requests‘ after such an appallingly, bullying letter, but Sara did post the letter in full.
It goes without saying that the slick machine that is Southern Health communications have done nothing so far, not publicly anyway, despite being great supporters of social media. They must be struggling though, given their homespun development, as detailed in their Communication and Engagement Managers blog:
I really admire Nicola’s honesty, this really is transparent, and a world away from KP’s letter. That said, it doesn’t exactly sound like there is much internal skill for this, despite their big support for social media. The communications team had an apprentice for six months this year (I’m deliberately not providing a link), suffice to say it’s quite offensive to see their twitter biog reads ‘If you cant blow them away with your brilliance, baffle them with your bullshit‘. Sounds like the culture at Southern Health has a very deeply ingrained approach to transparency and honesty.
The final statement of Katrina’s letter is:
‘It might also be useful to confirm that my Chairman is fully aware of my views on this matter and is fully supportive of them’.
Notice the use of ‘my Chairman’ almost sounds like KP is referring to her pet dog or something. I wasn’t aware that a CEO owned the Chair of their Board, and I can’t imagine how that could be a healthy relationship if the Board are there to provide accountability and challenge. If this statement is true then the Chairman is rescinding a promise he made less than six months ago, which appears surprising. It is of course possible that Katrina is asserting her absolute right again here, and that he is not fully aware and on board. I’m not sure which is the scarier prospect.
What I do know is that in my opinion this letter is an appalling example of the sort of underhand, intimidating and bullying tactics that appear to be in place across the culture of this organisation. I feel sorry for the good staff who do their bests to provide care in what must be very difficult circumstances, and I feel a renewed determination to stand proudly as one of Sara’s supporters until we have #JusticeforLB.
I continue, huge respect to anyone with the stamina to keep coming back to this issue, but as the conversation on twitter suggests it needs unpacking. You can read the analysis of paras 1-3 here and paras 4-6 here. Sara’s original letter is here and Katrina Percy’s response here. If you’re sitting comfortably, cuppa, chocolate, drink at the ready (whatever you fancy but you may need some sustenance), I’ll continue with paragraph seven:
‘I would like you to know that this offer will remain permanently in place should you feel able at any time in the future to accept it. If you would prefer not to meet with me personally, but deal with another member of my management team, that offer will also remain open to you’.
OK, so in case you’re starting at this point the history is Connor died a preventable death in KP’s hospital, she offered to meet Sara, who has declined that invitation ad nauseam to the point where the Chair of the Board told people to leave her alone! Earlier in this letter KP made clear she knew how Sara felt, but she was wrong.
‘I would like you to know’ this statement serves to make it personal again, it’s I, me Katrina Percy CEO who has the knowledge and the power, my opinion is what counts and I’m asserting it. To the innocent observer it could also have an inference that Sara is a little slow on the uptake, sheeesh you know what these grieving mothers are like, so I’ll just have to make it clear to her that I really would appreciate it if she’d take this on board now and fall into line like I’m used to.
‘this offer will remain permanently in place’ OK, we’ll suspend the previous paragraph where KP made it crystal clear she knew Sara didn’t want this, and we’ll take this little snippet at face value that it’s simply restating what Sara doesn’t want in an attempt to make KP look generous and open.
‘should you feel able at any time in the future to accept it’, ummmm, anyone else getting undertones of ‘pesky grieving parent too bloody broken and emotional, eventually she’ll pull herself together, move on, and become a useful pawn in my masterplan/awards crusade/service improvement strategy’?
‘deal with another member of my management team‘, there we go again, me me me, my management team, let me make it absolutely clear that they are my minions doing my bidding, so you can meet them but they’re my puppets….sorry I must have lost the plot there, of course this is a genuine offer of open communication.
‘In your Open Letter to me published via your blog and promoted via your Twitter account and those of some of your friends and supporters, you have set out a number of detailed questions to which you would like public answers’.
Short and acrid this paragraph. We didn’t actually analyse the opening paragraph, but it thanks Sara for reading Katrina’s wisdom on the NHS Leadership Academy blog and providing a link to her Open Letter there. So this is a bit confused, you’ve already acknowledged that’s where it was, but now is this suggesting Sara was only alerting KP via her blog and twitter?
‘published via your blog and promoted via your Twitter account’ this short statement reveals a lot about Southern Health’s understanding of social media. The inference that Sara’s blog is her publishing platform and she uses Twitter (note the capital T) to promote her thoughts. No, no, no KP, that is your understanding of what blogging and twitter is for, no doubt what you intended with your own blog post on the Leadership Academy website and your own corporate twitter account, since your account has lay dormant since before your maternity leave. Sara has a long history of blogging, she had shared the highs and lows of her family life for years, before your careless ‘care’ resulted in the preventable death of her son. As for twitter, Sara does not use it to simply promote herself or her views, she uses it for engagement and discussion, for learning and debate, for mind expansion and of late for crowdsourcing support, but this is the point of these platforms, the clue is in the social bit of social media…we’ll come back to this.
‘those of some of your friends and supporters’ this actually made me guffaw, friends and supporters, like what, like Sara is some minor Z list celebrity, or some bent politician, or a Miss England candidate? At what point might someone in the Percy camp be brave enough to raise the question as to why there is such support and popular opinion in favour of Sara? I know that this is a shocking thing to contemplate, but has it entered KP’s head yet that maybe Sara has the moral high ground here, and she should be putting all her energy into giving her answers and diffusing this car crash of a situation instead of making it worse?
‘a number of detailed questions to which you would like public answers‘ Nope, a number of questions, at no point did Sara request them to be provided publicly, she is simply looking for answers about how her son died a preventable death, and how on earth an NHS Foundation Trust has deemed their behaviour to be appropriate since. This missive is the latest in a long line of shots fired at Connor’s family, friends and supporters; sadly for you Ms Percy every time you fire a shot you gather more support, stamina and fuel to their Justice fire. Anyhow, answers yes, public answers no. That said in the spirit of openness and transparency, in the age of candour, why not public answers? It will all come out eventually, you can keep engaging in these school yard bullying tactics, or you can do the decent thing and face up to the responsibilities of your position. Either way, letters like this really don’t appear to be helping. Anyone.
‘I and my Trust are big supporters of social media and the opportunities it offers for engagement, co-learning and partnership between management, staff, local stakeholders, service users and their families. However I am afraid I do not consider social media to be an appropriate medium or set of channels to deal in public with these types of detailed requests on specific cases. By their very nature, Twitter, other social media channels and blogs can sometimes unintentionally over-simplify or distort facts and context, provoke misunderstanding or unnecessarily polarise views on what are often complex, multi-faceted and sensitive issues. I am sure you would not wish this to happen, even by accident’.
This is another humdinger of a paragraph, a near perfect microcosm of the whole letter, a heady mix of arrogance, ignorance and utter hypocrisy.
‘I and my Trust’ me, me, me, I, I, I and my Trust – what the whole 9000 members of staff that she’s exceedingly proud of? This statement has a touch of the gang leader making it clear they’ve got a bigger crew than Sara if you ask me (if only she knew the truth).
‘are big supporters of social media‘ what does that even mean? What is it that she’s referring to? What are they supporting? Would you write we’re big supporters of talking? Or writing? Far better they were big supporters of epilepsy care, or of mental capacity assessment, or of keeping healthy young men alive I’d have thought.
‘the opportunities it offers for engagement, co-learning and partnership‘ Wow, that’s an impressive promise. Yet Katrina’s own twitter account has lay dormant for 548 days now, how do you engage, co-learn and develop partnerships without any engagement, or is that just an indicator of the fact she knows everything there is to know already? Ironic really that Sara has been blogging throughout all this time, offering crystal clear indications of how she’d like to be engaged, more to the point KP has acknowledged she knows that, but also that she intends to disregard it (paragraph six), how’s that partnership working working out?
‘I do not consider social media to be an appropriate medium or set of channels to deal in public with these types of detailed requests on specific cases‘ Hmmm interesting, another me/I statement. Anyone care to point out to KP that just because she doesn’t consider something appropriate it doesn’t actually mean she’s right.
Also anyone else catch that whiff of hypocrisy, so social media (medium or channels, cough) is perfectly appropriate for KP to proffer her wisdom to the leadership world about leading in tough times, it’s perfectly appropriate for her to tout her wares and false promises of openness and transparency, but when we come down to it she’d like to play a complexity card. In case anyone isn’t up to speed, we’re not discussing a complaint from Sara about a parking ticket, we’re discussing the preventable death of her son, so who gives KP the right to decide what is, or isn’t appropriate?
More to the point, even if you were to just accept her dictat, it kind of doesn’t explain why she’s now spent one and a half pages of A4 laying out her manifesto and belief for the world without addressing Sara’s questions. This was a letter sent to Sara via her solicitor – so not on social media – a letter, could have been delivered by carrier pigeon for all we know given how cutting edge communications appear to be; so why can’t the detailed responses be given in writing, in this letter? Is it an unreasonable request for a grieving family to just be given answers to their questions. Let’s cut through the crap of ego and identity and hierarchy and strip it back to the basics, Connor died a preventable death in KP’s hospital – why does her consideration about communication methods come into it? Just answer their questions.
This will all come out in the end, even if it takes years of Sara and her family and ‘supporters’ submitting FOIs and requests for records, and pouring over Board Papers, and a Police investigation and an Inquest – it will all come out in the end, all of this just appears to be a desperate attempt to wear Sara down. Stalling tactics for what? KP looking for a new job? Hoping that enough people leave so the blame can be pinned on them, ‘oops I’m sorry our party donkey went lame so we pinned all the blame on him, took him out back and shot him?’ Nothing to see here, now can we move on? That sort of thing?
‘By their very nature, Twitter, other social media channels and blogs can sometimes unintentionally over-simplify or distort facts and context, provoke misunderstanding or unnecessarily polarise views on what are often complex, multi-faceted and sensitive issues. I am sure you would not wish this to happen, even by accident‘
Wowwwww. This statement clearly indicate that KP doesn’t really have a clue what she’s talking about here. Social media relies on interaction, it doesn’t have a ‘nature’ or identity without people interacting, a bit like a conversation, or any other form of communication. So blogs, tweets and other ‘channels’ don’t distort or over-simplify, people do. One could say a little like KP is attempting to do in this very missive. How very dare she assert what Sara would or would not wish to happen, does she honestly think she’s that omnipotent?
We’re all intelligent ‘fellow human beings’ here, of course any of these platforms could be used to over-simplify, to distort facts and context, to provoke misunderstanding, to polarise views, yep, all possible. Indeed, one may conclude that KP is fairly expert in that herself, in spin and manipulation of language, let’s not forget Chris Hatton’s brilliant post analysing the opening pages of the Southern Health Annual Report, Welcome from our Chair and Chief Executive.
Communications can of course be used to manipulate, but social media can also be used as a force for good. I have been repeatedly told by many that it is being expertly used in this case, to shine light on complexity, to highlight facts and contexts, to promote understanding, and to mobilise views.
Of course KP might not like this, in fact the very nature of it being hard to control has already bothered her and her Trust, such as the occasion when we were accused of trolling. I can’t finish the letter right now, it literally makes my head hurt. Instead I’ll leave you with the final tips from Victoria’s post When is a troll not a troll and who decides? The advice came from @Digitalastair and focused on how communications might want to respond from an NHS Trust point of view, the post itself is worth a read in full, but he ends with…
- Don’t make this about social media, it’s not.
- Do remember that these people are better at social media than you as an NHS Trust are, so don’t ever try and control the conversation
- Don’t take it personally if you’re the comms person receiving all these tweets. It’s not about you. Equally, never forget precisely *why* people are so angry and upset.
Tomorrow I’ll come back to the rest of the letter. Comments on progress so far very welcome.
This post continues on from Impersonal correspondence: paras 1-3, all the context is there. This post continues to deconstruct the letter, starting at paragraph 4:
‘Like every single organisation and individual in the world, we are not perfect and on a rare number of occasions we get things wrong, sometimes with deeply distressing consequences. On these rare occasions, my role as a Leader is to do everything in mine and my organisation’s power to offer our deep and sincere apologies, to work with everyone concerned – including relatives and regulators – in as positive and productive a way as possible to learn from what went wrong and put in place arrangements to try to ensure nothing similar happens in future’
Wooooooooow there, another storming paragraph, let’s take it bit by bit.
‘Like every single organisation and individual in the world’ paragraph three introduced ‘fellow human beings‘ and now we’re stepping it up to everyone in the world. Now this either reads like a primary school homework task gone wrong, or it’s an attempt to paint poor KP as just your average Joe, like anyone else in the world. This entire statement is pointless.
‘we are not perfect’ there’s a first time for everything, at this point you may be on the verge of expecting candour, compassion, empathy, is this a trigger warning for self awareness? We keep hoping, but don’t hold your breath for too long…
‘on a rare number of occasions we get things wrong, sometimes with deeply distressing consequences’ Here’s a free piece of advice to anyone reading this wondering how the hell do we convey our apology when we’ve let someone die in our care. Don’t frame it as a rare, one off. It’s a bloody given that it should be a one off (of course in this environment we’re not sure, hence NHS England have agreed to review deaths in their care), but paragraph three spoke of KP’s pride in their brilliant provision, then next on the continuum was reasonably well and now we have rare occasions. If my son, brother, father, sister, mother, friend, relative, hell any fellow human being had died a preventable death in hospital I’d hope it was bloody rare. Couching the response in this language almost infers that Sara is being a nuisance, imagine the tenacity and courage it takes for a grieving mother to even have to ask these questions, then to be framed in this language, subtext of simmer down luv it’s a rare event. As for the deeply distressing consequences it is impossible to read this letter and believe that they have any modicum of realisation of the consequences that they have not only created, but continue to enflame and stoke.
‘my role as a Leader’ I would think this comical if it wasn’t that this entire interaction sparked from the blog at NHS Leadership Academy about how KP is leading in these difficult times. Leader with a Capital L!! Is this ego at play, some sort of self appointed name badge? Does KP actually see herself as some sort of superhero Leader for the NHS? Does she look in the mirror every morning, tell herself to keep the faith, pin on a Leader badge and head off into the depths of Southern Health?
‘everything in mine and my organisation’s power to offer our deep and sincere apologies’ Ummm, this is up there with rarity, it’s a given that if you and your organisation are responsible for someone’s preventable death you bloody well apologise, it would be amazing if it was actually deep and sincere, but suspect they’re relative concepts! Notice the ownership language again, me me me, my organisation, my power – glad to know she takes it so personally.
‘to work with everyone concerned – including relatives and regulators’ Another blow me moment this one. How generously condescending of KP to state this, perhaps this reveals the level of expectation behind the statement. If it’s noteworthy that they will work with the relatives and regulators, it’s obviously deemed some sort of exception. Well we know it is given Connor’s death was chalked down to natural causes before his body was cold in the morgue. FOI reports clearly show that activity quickly moved to creating a narrative of ‘tragic accident’ within 24 hours of Connor’s death, it immediately became about managing reputation and managing media. Shame that this was more important than truth or candour, and even as communications professionals you can see the need for this (everyone can comprehend the need), to do so *so* badly is quite breathtaking. Oh and in case anyone isn’t up to speed working with regulators is not usually optional, so again stating this is like it’s some generous concession is bizarre.
‘positive and productive a way as possible’ Good to hear, but very value laden statement. Who judges positive and productive? When writing to a grieving family do you really consider it’s time to roll out efficiency statements? I’ll reiterate a point in the last post, Sara and Connor’s family and friends are not equal to a woman paid £165k a year to deal with this. One party in this equation is heartbroken, lost, seeking answers, the other is seeking to protect herself, one might wonder her self concept and ego based on this letter, and ‘her organisation’ – these are not equal parties, given that, you’d think it would be for the grieving and injured party to decide on what is positive and productive to them – hold onto that thought.
‘learn from what went wrong and put in place arrangements to try to ensure nothing similar happens in future’ Reasonable aspiration, but again you’d allow the person who you wish to learn from to decide on how they’d want to do that right? Or would you fix your own agenda and refuse to engage unless it suits you?
‘In this regard, I believe it was absolutely right for us to offer our profound and public apologies to you for the death in our care of your son, Connor. It was also absolutely right for us to commission and publish in full an independent review of the events leading up to his death. It was absolutely right for us to then put in place a series of measures and improvements, helped by input from the Care Quality Commission, to address some of the weaknesses in our care arrangements identified’.
At this stage if you’ve not read Sara’s original letter, I really suggest you do so. Otherwise you could be mistaken to think that this was a reply to Sara was complaining about KP apologising. There is nothing in this response so far that addresses any of Sara’s questions raised. Honesty? Candour? Openness? So what do we have in this paragraph exactly, we have KP asserting her absolute authority, or trying to, no less than three times.
‘I believe‘ there we go again, I, I, I, me, me, me
‘it was absolutely right for us to offer our profound and public apologies to you for the death in our care of your son, Connor’ Wow. At last, five paragraphs in, almost at the bottom of the page, word 373 is Connor. Finally, it stops being about KP, her reputation, her ego, her organisation and actually mentions the young man that her organisation is responsible for dying a preventable death. As for you offering apologies, are you really writing this stuff? Really? You’re asserting your absolute right to offer apologies for a young man’s death in your organisation?
‘for us to commission and publish in full an independent review of the events leading up to his death‘. Hmmmm, yes. Again someone new to this may think that this was KP’s contribution, that as soon as Connor died her team jumped into action to commission a review to learn everything they could to ensure something similar didn’t happen again. Again, documents clearly show that this was not the case, that Connor’s death was dismissed as natural causes, that Sara and Connor’s family had to fight to ensure his death wasn’t swept under the carpet like it so easily could have been. Yes Southern Health commissioned the review, at the families insistence, and one of Sara’s questions to KP was
- Can you explain why we had to fight so hard to get the final copy of the independent report into LB’s death published?
Now either Sara is mistaken or KP is. Luckily the documentation on this matter is quite clear. The independent review in question states:
4.1 The trust would usually carry out a internal investigation following the death of a patient or other serious incidents. Due to the seriousness of this incident and after discussion with CS’ family the trust commissioned Verita to conduct an independent review.
Given the absolute right and certainty elsewhere, one can assume that ‘discussion with CS’ family’ wasn’t because Southern Health were desperate to learn more and they requested Connor’s family help them with that. Enough said.
‘absolutely right for us to then put in place a series of measures and improvements, helped by input from the Care Quality Commission, to address some of the weaknesses in our care arrangements identified’ Man alive, this sentence. OK, firstly there is no need to stress an ‘absolute right’ for something that is so common sensical.
If you run an NHS organisation you have a duty of care, it’s not anything to do with the CEO’s absolute rights (because believe it or not this provision does not exist for their benefit and wages), it is a legal requirement that they provide safe care. First line of the NHS Constitution is that it belongs to the people, us, mere citizens with absolute rights to safe care and accountability and the rest. So yes there is a legal requirement to keep people safe and make improvements, in fact I’m left wondering whether the Trust could be considered negligent in waiting to commission a report before making improvements but that’s an aside.
The other fascinating language reference in this paragraph is to the helpful input from CQC. Ummm, CQC sent inspectors into the provision where Connor died, months later and they issued enforcement notices due to the poor standard of care. Months after Connor died. If you didn’t know who the CQC were, you could be mistaken for thinking they’re a little improvement consultancy, who helpfully agreed to give Southern Health some advice on improving their practice. They’re the bloody regulator. They closed down the unit where Connor died, and later on uncovered a bath ban in another unit, a seismic indicator of the complete inability to provide personalised care and support, that people with learning disabilities have an absolute right to receive.
‘I also strongly believe it was – and remains – absolutely right to invite you to work in partnership with us to identify, learn and apply any further lessons. I am well aware that you do not agree with this and do not feel able at this time to accept this offer and fully respect your views and decision at this time. That does not mean it is the wrong course of action. I strongly believe it is’.
Phew, I can only analyse this letter in chunks of three paragraphs at a time because it’s so dense and the rational, processing bit of my brain struggles to compute it. Paragraph six is another corker.
‘I also strongly believe‘ I, I, I, me, me, me
‘absolutely right to invite you to work in partnership with us to identify, learn and apply any further lessons’. She’s off on her absolute rights again, if you’re left drafting a letter like this in your work, why not give it to someone external to review before sending it, I’m sure they’d be able to point out that four absolute rights about the author, in the face of the preventable and avoidable snuffing out of the absolute right to life of Connor, isn’t wise.
As for inviting Sara to work in partnership, ummm, really? This is a grieving mother who has repeatedly blogged and shared insight and information about how things could be improved, you could start with this post Imagine written back in February. Let’s not paint Sara in a light of selfish, self indulgent grief. This is a woman who has been on a campaign and a mission to ensure no more lives are lost, this is a woman who has gone above and beyond what anyone could consider necessary in the light of such horrendous circumstances. So yes Katrina, you can invite her, you can’t command her, or expect her, or demand her, or insist her, or infer that she should meet you or work with you, because life and death and grief is not all about you. Back to an earlier point Sara is a grieving mother, not an improvement consultant. She doesn’t get a £165k salary to ensure quality, she doesn’t have any obligation to do anything, and KP’s complete inability to acknowledge what Sara has contributed is mind blowing – more on that later.
‘I am well aware that you do not agree with this’ ummm, hang on a minute, if this letter is for Sara (the recipient at the top) why are you telling her what she doesn’t agree with? If you’re well aware surely you wouldn’t assert your absolute right? Surely?
‘do not feel able at this time to accept this offer’, there we go again, another attempt to discredit Sara as some weak, victim like figure. What is the inference, that she’s not strong/ready/selfless enough?
‘fully respect your views and decision at this time’ not sure if this is just bad grammar/wording but you should fully respect her views at any time, it’s another bloody given. You may think this is progress, an acceptance and respect for Sara’s position, but wait, hang on…
‘that does not mean it is the wrong course of action’ wowwww there Nellie, how can you fully respect someone’s view and then tell them that they’re wrong? Your absolute right is right? This letter is torturous.
‘I strongly believe it is’ Ummm, not sure whether KP strongly believes that her course of action is wrong, or Sara’s, diabolically written letter with zero attention to comprehension. Think we can safely assume Katrina strongly believes herself to be right again, absolutely right I imagine. We’ll come back to this.
The next instalment will look at paragraphs 7 to 9, maybe more if I can manage it. Once we’ve analysed this fascinating missive, I’ll attempt to pull some learning points together and maybe even crowdsource a more appropriate alternative. I know there are some great people working in NHS communications, sadly I suspect they didn’t get anywhere near this letter, we can of course learn from it. We’ve an absolute right to do so.
I’ve been involved with the JusticeforLB campaign now for over six months, a number of people who work in communications roles, especially in the NHS, have been in touch in that time to say how useful this campaign has been for their learning, indeed one person described Southern Health’s behaviour as the ugly, of the good, the bad and the ugly of #NHSSM. Enough said. There have been many many times when I’ve been astounded at what I’ve heard, seen or read, I offer this to help with yet more learning. Last night Sara published a letter from Katrina Percy, the CEO of Southern Health NHS Foundation Trust, the trust responsible for Connor’s ‘care’ at the time of his preventable death. The chronology of this is as follows:
NHS Leadership Academy published Leadership: When the going gets tough sharing Katrina’s experience of leading in challenging times [I will refrain from offering commentary or opinion on that piece but suggest you read it]
Sara published Dear Katrina Percy in response, welcoming Katrina’s new commitment to transparency and openness with 16 questions relating to her son’s care and death
In the context of Board minutes being clear that the Chairman suggested all staff should stop pressuring Sara to meet Katrina, as she did not wish to do so [obviously that instruction didn’t get as far as the comms team).
Then silence until the reply. You can read it on Sara’s blog, Katrina Percy. The Reply I’m not going to include it here in full because there’s more than two pages of what I’ve come to realise is self-promoting, narcissistic leadership and dire PR speak. So I’m going to deconstruct some of it below, sort of interpretation and learning points from my perspective as an interested observer.
‘As you will have read, I believe one of the hallmarks of good leadership is a commitment to as much openness and transparency as can be provided within the context of providing health and care services to often vulnerable people, their families and carers in sometimes deeply challenging circumstances’.
‘As you will have read‘ is surplus to requirements and included simply to try and introduce a framing of KP’s knowledge as something that Sara should be deferential to.
‘I believe’ the first of many, you could argue this is a personal language, or you could consider it to be coming from a place of ego and belief that the authors position is of prime importance.
‘one of the hallmarks‘ so suddenly it’s not all about transparency and openness (it was in the article that initiated this exchange), suddenly it’s conditional and of lesser importance than initially suggested
‘a commitment to…’ not actually being open and transparent but committing to it, you know we have it on our intranet but no-one has to do it sort of thing
‘as much openness and transparency as can be provided…’ here we get another conditional clause, silly Sara, pesky of you to take us at our word, you obviously don’t understand the complexity of our working environment
‘often vulnerable people….in sometimes deeply challenging circumstances’ Really? This is in there? Did whoever wrote this not recognise the irony of informing Sara of this? Her son died, in their care, a preventable death, really you think she doesn’t live, breathe and grieve in challenging circumstances?
‘I also strongly believe that good leadership is founded on a determination and deep commitment to do what is right for all parties concerned, not necessarily what might be either easiest or most popular at any particular moment in time or demanded more loudly or persistently by one group or interest than another – no matter how strongly their views are held or how often they are repeated’.
‘determination and deep commitment’ to assert your own truth and belief of what is right in a situation. Subtext I know my view and I’m top of this tree so what I say goes, even to the facing of a grieving parent.
‘all parties concerned’ ohhh right, all parties, we’ll not be explicit about that, but as much as I’m all for equality and justice, I don’t think all parties in this situation have an equal footing, some of those parties are responsible for a young man’s death…
‘easiest or most popular‘ this astounds me, quite clearly this letter has been through multiple draftings, experts, members sign off – but somehow this reference to what is easy or popular remains. What happened to compassion and candour? Instead of somehow worrying about the impact on herself, ‘her staff’ and closing her ears to public opinion, has she once considered why something may be viewed as popular, has it ever entered her head that the popular opinion may be right, and her’s wrong?
‘more loudly or persistently’ really can’t imagine what this refers to, unless of course it’s these pesky online supporters who have gathered around Sara and Connor’s case, demanding better.
‘I am deeply proud to lead Southern Health NHS Foundation Trust and the around 9,000 dedicated people who devote their working lives to caring for and supporting their fellow human beings. The thousands of staff I lead do very many things brilliantly and I am always keen to support and promote them wherever and whenever they do. Some other things we do reasonably well and we are always looking to work with our staff and partners, service users and their families and carers, stakeholders and regulators to improve in those areas to match the best’
Phew, where to start with this paragraph. Think it reads clearly as for internal benefit, there are some soundbites here that will be recycled into staff briefings and slide sets and internal reports no doubt.
‘deeply proud to lead…’ yep, I’d hope so, that’s what your six figure salary is for (£165k rising to £225k if you include pension payments). When KP communicates she seemingly always manages to make it personal and never manages to acknowledge that all is not equal. Sara is a grieving parent, trying to find answers about her son’s death, with a grieving devastated family, her own job and life….this is KP’s job. They are not equals.
‘devote their working lives’ wowwww there. We’re not talking about callings or vocations, we’re talking about staff members paid to provide a service. I’m not doubting some are dedicated but this isn’t about devotion, it’s about standards of care and quality.
‘do very many things brilliantly’ Seriously? In paragraph three, we’re brilliant, what is your fuss about, we have thousands of brilliant staff providing brilliant support….we’ve little evidence of this, CQC and Monitor repeatedly find otherwise, but we’re brilliant, I say so, how dare you challenge us?
Even if we acknowledge that this is true, and Sara has been explicit since day one that there must be brilliant caring staff, indeed if you read the independent report that found Connor’s death was preventable you can see there were some brilliant staff, seemingly working in a vortex and vacuum of good leadership, brilliant against the odds, not as a matter of KP’s leadership. So if we take this statement as true. Connor still died, in their care, a preventable death….so to rub a grieving families nose in their brilliance just seems beyond comprehensible. Is it deliberately done to cause further pain?
‘reasonably well’ is then introduced, reasonably well. Surely not. Then the notion that services users, families and carers should want to work with them to make things better, to improve things. Is KP going to share her salary around to ensure those people are remunerated for their time and effort then? As for wanting to learn, Sara has been sharing her thoughts and ideas for years on her blog. She knows from FOI and personal records requested that her blog has been discussed by staff in Southern Health, so one would think this would be an appropriate time to acknowledge it and share gratitude for that? No, oops, moving on….
This is the first three paragraphs, I’ll leave you to read the rest and will revisit later if I have time or inclination. If you work in NHS Communications and you’d ever dream of sending a letter like this, please please please think again. Thank you.
Fallen cold and dead.
You’ve fallen cold and dead.
Fallen cold and dead.
Pick what you’re interested in…
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