There is a real danger that Groupthink by Government servants, politicians and journalists will now prevent reasoned arguments being aired in Court concerning the current and future welfare and wellbeing of children at risk. There are a number of vectors that are moving in the direction of hiding what these cases are all about.

1. Cafcass is imposing a regime that reduces the amount of time available to investigate the circumstances surrounding cases – providing the opportunity for significant concealment.

2. the detail required by the Courts is now minuscule compared to the detail needed to examine arguments – providing the opportunity for significant concealment.

3. the media is adopting an attitude towards revelation of detail that is contrary to their interrogative journalism traditions – they challenge the ability of expert witnesses to disclose the evidence needed to mount a reasoned argument in Court

4. the mounting antagonism against expert witnesses is being inspired by the same people who are wanting to limit exposure in Court of the background and arguments needed to reach a reasoned and well argued case for action concerning the future of a child.

5. the quick fix society is about to gain another scalp – vulnerable children. Societies are judged on how they support the vulnerable in their society; who can reasonable people turn to now? – not the Government; not Public Servants; not serious Journalists; not the Politicians. Who?

On the 25th January 2012 Dame Carol Black launched the Institute of Healthcare Management’s Code of Conduct for Managers of Health and Social Care. In the audience were Sir Paul Williams, former chief executive of Wales, and Mike Farrar, chief executive of the NHS Confederation, along with several Trust CEOs and many others.

Dame Carol explained the significance of codes and the importance of this code in relation to its promotion of health and wellbeing. The code is an enabling code, one that has been designed to change culture and promote a positive working environment with its focus on wellbeing and performance.

We want to establish Centres for Applied Psychology around the country, mirroring, if you like, medical practices, so that applied psychologists can work together across the psychological domains to provide to business and communities psychological services that facilitate wellbeing and performance.

We have sufficient numbers of expressions of genuine interest to make this happen. The interest is coming from established independent psychologists who have, already, developed successful practices. Interest from the public sector has also been expressed.

We see these Centres as offering tried and tested services currently provided in different ways, combined with innovative services that are formed from the integration of psychological domains within the Centres – and to offer services to all kinds of communities as well as individuals within them.

The Cotswold Centre for Applied Psychology has been started – slowly and gradually. It has its first project.

Derek

I’ve been reading the latest edition of The Psychologist and marvel at the range of fascinating psychological adventures that contributors have been going on recently.

The richness of the psychological world really does need to be more accessible to the population at large.

In the discussions surrounding the establishment of a National Centre for Applied Psychology I have been struck most about the nervousness that some psychologists appear to have about elevating applied psychology in the consciousness of ordinary people. I can understand this nervousness. I have experienced it myself when knocking on doors pleading to gain entrance to the working world where I am convinced I can help a lot of people. It is nerve racking standing up in front of audiences at conferences and talking liberally about how exciting psychology is and how it can help many people avoid suffering distress.

However, I think psychologists have so much to offer that it is important to try to improve access to the services that applied psychologists can provide, even though some psychologists may feel nervous about this.

We’re launching The National Centre for Applied Psychology in 2012. The National Centre will rely on contributions from applied psychologists across the range of psychological domains. The kind of contributions will be horizon scanning, responding to national policy initiatives, stimulating psychological questions to be answered, engaging with clients and commissioners, promoting research commissioning research. We shall start slowly, testing the water, seeing how we go.

Our first challenge is describing applied psychology – to facilitate psychological wellbeing and performance in business and communities – seems pretty good to me.

This is the time of the year when lines may be drawn under the past and the optimists look forward to getting going again in the future.

So, what have we managed to do in 2011?

We’ve managed to obtain agreement for pilots of our Wellbeing and performance Agenda, that incorporates the primary prevention of psychological distress at its core. The agenda itself is in four parts, with an overriding element of adaptive leadership. Introducing the principles of adaptive leadership make the rest of the agenda that much easier to implement.

The four elements of the Wellbeing and Performance Agenda are each addressing the prevalence of psychological distress at work. We know the incidence of cases of distress is rising, due in part to the combined impact of the economic climate on individuals, and the impact on the workplace, together with the expected number of cases arising from organisations that do not adopt a prevention strategy.

We don’t know the prevalence rates for distress, but, given the rise in incidence, the prevalence rate may be either neutral or increasing, adding further costs to businesses and services as a consequence 0f the rise in psychological presenteeism.

the four elements of The Wellbeing and Performance Agenda are:

creating and sustaining a healthy organisation

adaptive leadership and effective management

personal resilience

lifestyle@work

Healthy organisations create the cultural environment that infects everyone with a positive attitude towards work. This nudges people to feel well at work, even if they may have good cause to feel unwell, either from ill health or from adverse events outside work. Using the word infects is important here because a culture that does infect people with a positive attitude plays directly to social proof. Where people look around and see others feeling and performing positively, they tend to follow. It’s not true for everyone – McKinsey research in this field suggests that, even in healthy organisations, some 18% of the workforce will not be elevated from a sense of antagonism towards the workplace. This is a high proportion, but it’s worth remembering that 82% will be elevated to perform at their best by influencing the cultural environment within which people work.

Adaptive leadership is about sharing the responsibility for leading the organisation amongst those who work in it. This is akin to generating a sense of ‘ownership’ which is well established as a process that heightens social engagement between the worker and the organisation. A strong social engagement leads to heightened psychological wellbeing and high level performance. Adaptive leadership expects independent judgement from all staff, and the style creates the secure envelope within which all ‘elephants in the Room’ are exposed and dealt with.

Effective management is focused on the behaviours that promote high level performance – these being the behaviours that result in commitment, trust and engagement between managers and their staff. Managers are the controllers of organisations, and are the people who reflect the culture of the organisation most of all in their dealings and style of interacting with staff. As the principal cause of distress is people, and in the workplace, managers, the role of managers in producing high performing staff is crucial, and often misunderstood.

Personal resilience is the degree of psychological immunity that individuals have against adverse events. Using personal resilience in the face of an adverse event is a matter of attitude, based on an evaluation of the event and the imagined outcome. Once more, the cultural environment for workers plays a crucial role in forming the attitude of staff towards adverse events. A culture that abandons individuals to fend for themselves in the face of adversity is unlikely to produce a level of performance that an organisation which nurtures and supports people through adversity produces.

Lifestyle@work focuses on the type of lifestyle that nurtures the workforce and keeps it healthy and feeling well. This includes attention to nutrition in food during the day; exercise; life balance issues, and the support services that produce effective support when needed – so excellent occupational health services, excellent HR services, excellent employee assistance programmes, and excellent absence management systems that understand ill health. The social aspects of work are also part of this element, together with such items as formality and informality, dress codes, and entertainment. Ergonomics is another important aspect of this element, ensuring the physical environment nurtures high level performance.

We look forward to implementation of our pilots and for the Wellbeing and Performance Agenda to cascade throughout organisations as a vehicle for transforming the working world.

Preventing Stress @ Work

2nd November is National Stress Awareness Day (NSAD) which is organised and hosted by the International Stress Management Association (ISMA).  As a trustee of ISMA, Derek Mowbray is pleased to support NSAD and the work of ISMA.  Do visit their website for further information.

There are two ways to prevent stress @ work:

• create and sustain a working environment that eliminates the risk of stress; and
• strengthen people’s psychological immunity against stress through stengtheing their resilience.

BOTH THESE APPROACHES TO PREVENTING STRESS @ WORK REPRESENT
A LOW COST INVESTMENT FOR A HIGH PERFORMANCE DIVIDEND.

For further information about how MAS can help your organisation with these 2 different approaches , contact barbara.leigh@mas.org.uk.

I’ve now completed the development of Management Standards for a Healthy Organisation which incorporates standards to promote wellbeing and performance, and the prevention of stress at work.

There are only two ways to prevent stress at work -

a) to build and sustain a working environment that eliminates the risks of stress

b) strengthen the psychological immunity of people against stressful events causing a stressful reaction.

The Management Standards address both. The standards describe the actions required to create a working environment that eliminates, or at least, attenuates, the risks of stress causing events, by focusing on the culture, rules of how the organisation is meant to work and the behaviour of managers in building and sustaining commitment, trust and engagement. These add up to a Healthy Organisation.

The Management Standards also describe the elements that help to strengthen psychological immunity against stressful events, the building and sustaining of personal resilience.

Copies of the Management Standards are available from barbara.leigh@orghealth.co.uk

Copies of The Manager’s Code are available from barbara.leigh@mas.org.uk

OrganisationHealth and The Management Advisory Service are members of The Wellbeing and Performance Group

Diligent followers of the MAS blog will have already read the supplement in this weeks Health Service Journal entitled A Licence to Manage? This is taken from a round table discussion about the possibility of regulating NHS Managers in the aftermath of Staffordshire and a few other disasters, where managers have been implicated.

I’m against regulation. Regulation is a stressor, and it is difficult to see who has the rounded knowledge to design the regulations, which is probably why they would regulate the wrong things.

I’m for licensing. I think the striving to obtain your licence to manage is something that is a stimulant, and provides the opportunity to use discretionary action within the confines or envelope of the licence. I can see a general licence to manage, with add ons for specific managerial expertise, such as the need for a specialist licence for strategists and high level leadership.

I see the general licence aligned with the Managers’ Code, and the Institute of Healthcare Management’s version – Management Code. This will link the licence to manager behaviour, the behaviour needed to manage people effectively, something that is almost completely lacking in the array of manager training generally. I see an alignment with the IHM’s accreditation programme. I, also, see an alignment with our own programmes – Manager’s Code, Resilience, Management Standards for a Healthy Organisation and Manager Behaviours – which are going through the process of being accredited for level 7 CATS.

I believe the requirement is to facilitate the exposure of manager talent, rather than confining talent to within some form of regulation. The NHS has a large number of managers, some of whom have the talent to restore the NHS to world class, and they need to be exposed and placed in positions that enable them to influence the future.

There’s much talk about the need for regulating NHS managers as the principal influence over the prevention of events at Staffordshire and elsewhere. In the wider context of most professionals being de-professionalised by the intense desire to short cut the thoroughness of training, development and experience needed to make professionals truly professional in most situations, and the intense desire to find causes for adverse behaviour, regulation of most professions is now in place.

Has regulation really made any positive difference?

On the negative side, regulation is a stressor. This is because the regulations are quite frequently the brain child of people whose own abilities in the field are not super human, and so they tend to be averages, or the lowest common denominator that a group of people can agree on, rather than something to aim at. Quite often, regulation compliance is required to keep one’s job. Professional discretion, the ability to respond according to the issue or problem, is the essence of professionalism, but may be very poorly constrained by regulation.

On the positive side, regulation protects the professional from accusations of being implicated in a disaster, so long as the regulations are followed. This is, often, most dissatisfying for us, the consumer, and for the professional, hiding behind a regulation when he/she knows full well that a more professional approach to the mess would not have resulted in the disaster. Hiding behind fig leaves of regulation.

The more we regulate the more we reinforce the movement away from personal responsibility, the worse the motivation, enthusiasm, risk taking and spontaneity becomes. Is this what is required for growth, development and expansion? Absolutely not.

It is, I believe, more important to raise the professional standards of the professional, and to have some kind of benchmark to judge the professional on a daily basis, which when breeched badly, results in the professional losing the right to be a professional as well as compensating for the breech.

The most effective regulation process is that relating to the driving license. The ingredients of this include a Code upon which the granting of the license is made. Individuals have complete freedom of how they can be trained to the standard of the test, that tests their understanding and practical ability to drive. Other ingredients include the level of insurance premiums that go down the better the driver you become; there are advanced tests that influence the insurance premiums from certain insurers. You are completely free to increase your expertise in driving in order to ensure you both enjoy driving and avoid the consequences of other people’s errors, and the consequences of breeching the code and the regulations.

The regulations and law are few in number, obvious, make good sense in the main, and reinforce the code. They are enabling regulations, enabling us to drive safely, and in the main we do.

Other ingredients in this cake are also important and essential for the whole cake to be a success. They are the design of the roads that facilitate good driving and safety (accident black spots being poorly designed for example) and the design of cars and other vehicles, increasingly sophisticated and designed to support the driver’s ability to drive successfully and with high levels of concentration leading to high performance.

The people who observe how well or poorly we drive have the power to start the process that can lead to us losing our license to drive. There are, however, many stages to go through before that happens, including re-training, and the giving of points on a license that are time limited, thereby demonstrating that improvements in driving occur, with out the need for further examination.

All of these ingredients of this cake are focused on the individual driver – the professional if you like. The system works in that the number of drivers driving successfully compared to the number of people who have tragically suffered as a result of poor driving is very small. The driving process for the majority seamlessly slips into daily life, but makes us conscious of our responsibilities each time we drive. The system is built to encourage us to become brilliant drivers as the enforcers are themselves subjected to a higher level test and must achieve higher criteria, and this enables them to judge more effectively the abilities of those with routine level abilities.

Using this as a model for regulating managers, we can identify the type and nature of the ingredients of the cake. For a start, drivers come in all shapes and sizes, as do managers. A code is the basis of the whole system, so we could use the Manager’s Code I’ve developed. Then there is the training to pass a test. There is a test. Then there is the license; there could be a license to practice. Then there is the ability to practice in different environments – different cultures, but the regulations apply to all cultures (the law). There are the initiatives to improve the overall cultures (the roads), and the individual organisations have initiatives to improve their own working environments (the cars). Those who inspect (the police) could be part of the NHS regulatory industry. If the whole attitude is to create, grow and reinforce the most spectacular manager professionals on earth, we could design a process that helps to achieve that, using this model.

Who grants the license, you ask? An independent DVLC type place, contributed to by all the professional organisations that serve the NHS.

100 Flowers Workshop for Applied Psychologists – 18th November, London

The intent of the workshop is to take forward the ideas discussed at a workshop in May in York in which it was suggested that Centres for Psychological Health and Wellbeing may be one approach to elevating the impact that applied psychology can have on communities of all kinds and individuals.

The model of a social enterprise franchise will form part of the workshop discussion in November, and there will be examples of how some psychologists have been getting on in developing the Centre ideas locally. So, the workshop is really about helping psychologists to think about the steps to be taken in establishing a Centre locally, having identified that this is what they may wish to do.

The development of the Centres is formative; there is no blueprint as such, but an outline of the purpose and the range of possible services that could be provided, depending on the nature of the grouping of psychologists. If the idea of establishing a Centre is appealing, then we will be discussing how such Centres could get started.

Some of the contextual items are:

• a recognition that current ways of delivering applied psychology appear not to facilitate the critical mass of applied psychologists required to deliver large contracts;
• a recognition that existing employer organisations, such as the NHS, pose a threat to the continuation of applied clinical psychology services;
• an understanding of the benefits to clients and to psychologists of grouping together applied psychologists with differering interests and skills, so that a broader range of opportunities can be positively responded to;
• an understanding that marketing applied psychology can be more easily facilitated with a Centre being the focus of provision, even if the Centre is virtual;
• an understanding of the benefits to applied psychologists of owning their own Centre within a social enterprise context;
• the co-ordination of centres being organised by a National Centre for Applied Psychology which will help with providing various services, including marketing and will be the franchisor.

Further information about the workshop is available at http://www.mas.org.uk/applied-psychology/2nd-100-flowers-workshop.html