Robyn Vesey – Leadership and Management in Health and Social Care During the COVID-19 Crisis

I’m Robyn Vesey, Organisational Consultant at Tavistock Consulting, talking in this podcast about leadership and management in health and social care during the COVID-19 crisis.

Building on much of what has already been said in this series of excellent podcasts I want to highlight a few of the areas particularly relevant for leaders and managers, and for each area offer practical pointers for leaders and managers in their role.

First of all, we know this is an unprecedented, intense period of time, with a range – a kaleidoscope – of different feelings, particularly feelings of anxiety, grief, and helplessness. All of us are managing our personal feelings about our own family, friends and living situations, and many people’s work in health and social care has been hugely impacted.  Redeployment into new roles or having new staff join a team, usual routines and expected career plans disrupted, not being able to support people in the usual way when working remotely, and – most painfully – witnessing the distress and suffering of people, whether in intensive care with pneumonia, grieving for a lost family member, or someone struggling with their mental health now that face to face services are on hold.

At a time of such real crisis, the role leaders and managers play in practically supporting their teams is paramount, and in this communication is key.  Leaders need to be able to listen to staff concerns, especially where there are inevitable difficulties in the system and failures to provide what is needed, such as, in some trusts, PPE.  Leaders need to be transparent about what is happening, why, what is being done to address the situation, and tell staff when they will next be updated.  Responding to concerns, even when leaders are not able to provide the response they, and their staff wish, is crucial, so that staff can see what it is leaders and managers are doing to support them, and make some sense of the wider systems in place, as challenging as these may be.

Secondly, in this context of a global health crisis, the function of leaders and managers as emotional containers cannot be underestimated.  Many leaders and managers know and understand this, and that it will be managing and holding a particularly intense emotional load at this time. Leaders and managers need to continue to be aware of this crucial role and keep in touch with whatever they need to enable them to feel contained and supported themselves.

In particular leaders and managers need to be present and responsive to staff’s emotions, model empathy and kindness, validate what staff communicate and listen to difficult things without becoming defensive or retaliatory.  In doing so leaders and managers can create an environment where others feel safe to talk about the challenges and worries they are facing, so that staff teams feel more supported and connected to each other.

Leaders and managers need to give staff a message that their work – whatever it is – is valued, and to support staff in what they need in order to maintain relationships and feel connected. For example helping a member of staff to take part in a team meeting with their usual team, even if redeployed

And leaders and managers need to resist the urge to do, to rush, or to fix things out of anxiety, and instead seek the support that the time that is needed. For example, taking the time to think, talking something through with a colleague. Recognising one’s own limits in this way models self-care and means that better decisions are made.

Finally, leaders, like staff can recognise that they are operating in an imperfect system, and resist the pressure to be a heroic leader.  One helpful idea, especially in the time of a global pandemic – is that of tolerating the contradictions, and dissonance that are thrown up in this situation.

Just because there is anxiety, loss and even overwhelming feelings, does not mean there isn’t effective and productive work.  Every day people are carrying out important and valuable work across health and social care.

Just because there is conflict or anger doesn’t mean there isn’t collaboration and solidarity, with staff able to support and follow leaders and managers.

Just because there is helplessness and guilt about what cannot be achieved doesn’t mean there are no spaces where decisions and actions can helpfully be taken.

And just because leaders do not know what the next steps are, does not mean there cannot be trustworthy and competent leadership, responsive to the reality of the current context.

The more leaders and managers are able to bear the uncertainty and tolerate the contradictions, the better they and their teams will be able to work within the uncertainty and challenges of this crisis, with less need to take up unhelpful ways of functioning and so being able to continue to do their work effectively.