05.12.19
Conversational Intelligence within the NHS
Source: NHE Nov/Dec
Conversational Intelligence Within The NHS Sue Kennard, Head Of Employee Wellbeing service,Barts Health NHS Trust
In health services there’s a good deal of talking - but are they the kinds of conversations that make workplaces better places to be?
At Barts Health NHS Trust a team of 12 people in occupational health are dealing with an average of around 260 referrals a week: 17,000 staff working across four very different hospital sites with their own structures and cultures, as well as serving external customers in the public sector locally (GP surgeries, schools, maintenance staff).
When I joined the NHS Trust in 2017 there were inconsistencies. Information from managers about referrals to Occupational Health (OH) could be poor - giving the reason as “stress”, nothing more; it wouldn’t be clear whether the employee was actually in work or not; whether the cause was even work-related. OH staff would, as a rule, hear about needs and then produce a report.
An employee might then summarise a situation as how they’re just not getting on with their manager, or the pressure of the job has recently escalated and they’re not coping. But there may well be underlying issues behind these feelings - OH need to know about all the issues that can be influenced in order to have any chance of having an impact on events and circumstances that can’t in themselves be changed.
We set about building new attitudes and understanding of OH through a case management process and information campaigns: resources for individual audiences about what information was needed from a referral, what to consider, what to expect, ensuring all the different needs from the service were being met.
At the heart of the change was the quality of the conversations or what’s known as ‘Conversational Intelligence’ (CI). We made use of the expertise of CMP, a workplace relationships specialist, to deliver training across the team. It wasn’t a case of questioning the team’s level of clinical knowledge or their counselling skills - but going back to essentials, to core soft skills, ways to widen discussions without being overly assertive.
Critically, having CI means being able to create a sense of safety, so that the staff member feels able to be entirely open rather than giving expected answers. The one-day training programme focuses on building an awareness of the role of conversations in relationships, how the quality of conversations changes dynamics and the huge influence they have on the outcome of situations, particularly those most difficult of conversations where we’re most likely to want to rush to the easiest conclusions.
All the staff who took part in CI training reported benefits to them as individuals - one senior practitioner who’d been reluctant became its biggest champion. The package of changes has transformed the nature of the services. CI was important for that: the quality of reports has improved, with more insights, more purposeful ways forward. Barts has plans to keep CI skills part of “how we do things around here”, looking at harder evaluation of the impact of changes, monitoring for absence, and getting more feedback from HR.