There’s a disconnect.
We know there is.
What’s going on at the top of the shop has no bearing on what’s happening on the shop floor.
The politics, wrapped in senseless new initiatives with ludicrous timelines. The C-suite, focused on keeping the system going.
In their own worlds… they are probably both right.
Streeting has to look busy and as much like a prime minister as he dares.
Penny Dash, NHSE chair, with a rubber mallet, trying to hammer the 10-year Plan into three years.
Jim Mackey, making one pound do the job of two, or three. Juggling workforce, balancing budgets. Trying not to spook the Treasury and the bond markets… fix everything before the economy dissolves.
Let’s face it. Streeting is weird. The NHS Board is away with the fairies and Jim is worried.
That leaves you…
You. Your life… where reality and theory collide.
Ambiguity. Figuring out what is plausible. What’s rational… in the context of you.
Karl Weick’s Sensemaking in Organisations, a 1995 seminal book, introduces us to the concept that:
‘…organisation members create reality by making retrospective sense of their experiences…’
What happened in the past, which in the context of now, means the present will be full of vagueness and uncertainty.
Ontologically incompatible. In plain English, smoke-versus-concrete… what ‘they’ think is happening and ‘your’ actuality.
Weick says, the trick is not to fight the ambiguity. The trick is to find a way of working alongside it.
It makes sense…
…we can’t fight the spiral of nonsensical initiatives, political ambition, the state of the economy, global events when…
…none of our previous experiences gives any meaning to where we are now.
Weick’s work helps us and our organisations understand how to manage ambiguous situations by developing wisdom in what he calls the sensemaking process…
…a collective ‘accomplishment’… where individuals, through interaction and shared communication, build a common understanding of their organisational context.
Simply… finding your balance in uncertain times.
I’d say six things:
Face Reality Together
Change is happening; pretending it isn’t only adds to the stress.
Talk openly with each other. Sensemaking together helps keep perspective. Share what you know (and what you don’t) to cut down on rumours.
Find Meaning in Work
The NHS is unique. Its purpose and achievements aren’t measured by commercial and industrial yardsticks… balance sheets and pieces of the action.
For the NHS it’s ‘bed-sheets’ and peace of mind. Focus on why you joined.
Your purpose is a powerful anchor… it gives stability when everything else is wobbling.
Small wins; a colleague helped, a team supported, it all matters.
Be Nimble, Stay Open
Old ways of working are not going to fit the new world. Be prepared to adapt. Trying new roles or responsibilities doesn’t mean disloyalty to the past, it means resilience.
Think about your ‘working identity’. What skills and strengths you bring, not just your job title.
Look After Each Other
Support your team, each other. Kindness builds psychological safety. Make space for honest conversations, sensemaking, without fear of blame.
Peer networks are powerful. Join the IHSCM. You aren’t and shouldn’t face change alone. A trouble shared is a trouble halved. Honest conversations foster psychological safety.
Focus on What You Can Control
You can’t control the machinations of the Treasury, political ambition or bonkers national plans like virtual hospitals or AI diagnostic platforms.
You can control how you develop, learn and connect. Invest in your skills. Adaptability makes you stronger to face the future.
Let Go and Begin Again
Every change has three stages:
- endings, letting go of the old is painful
- a messy middle, confusing and anxious
- new beginnings, fearful or optimistic
It’s natural to feel loss for ‘the way things were.’ Allow yourself that, but don’t stay stuck there.
You need your energy for what’s next. Let go of what’s beyond your control. If it has to happen, it’s no sin to leave the NHS. I don’t want to see you go. But…
…it’s a greater sin to be unhappy and to worry about your family.
The danger in turbulent times isn’t the turbulence itself…
…it’s trying to build a shelter from it, using yesterday’s logic. Funding, reorganising, AI, new ways of working can create a cocktail or a poisoned chalice.
Think of the four Bs:
Be grounded in purpose.
Be nimble.
Be open to change and above all,
Be good to each other.
Small wins matter, so do you.
Have the best week you can.
News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at thetrainingnet.com by kind permission of Roy Lilley.
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