NHS Yorkshire & the Humber Leadership Academy

Supporting your leadership journey

How breaking down organisational barriers is leading to better public engagement in Sheffield

04 March 2020

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Rachel Hawley, (Yorkshire and the Humber Leadership Academy), Patrick Marshall (Sheffield Hallam University), and Charlotte Turnbull (Sheffield Teaching Hospitals NHS Foundation Trust) share their experiences of a collaborative approach for patient and citizen and leadership. 

We share a passion for collaborative leadership, bringing together different perspectives on public engagement; leadership, research and organisational development. Healthcare touches all our lives; yet interactions between health professionals and the public are often characterised by an imbalance of power, control and information. Rachel, a nurse by background, recalls that reflecting on her own story was formative to her practice, guiding her to work especially in involvement, leadership and change. She became interested in how to achieve the cultural and behaviour changes that are needed to effectively embed collaborative ways of working, in every day practice.

The question we grappled with together was: How do we get such diverse health and social care organisations, with different governance, cultures, finance and values, to really work collaboratively?  We recognised the challenge people face in the move from traditional siloed working (doing ‘to’ people) to more collaborative working (doing ‘with’ people). To embed collaborative working in everyday working, and build future system leaders, required a fresh approach – one that mirrored systems principles of working beyond traditional boundaries.  Charlotte, identified the need to take system leadership out of the boardroom and into day-to-day practice. Leadership in health and care settings has become increasingly complex. With so many leadership theories and models it is challenging for practitioners and the public to find ways for achieving this kind of cultural change. There was a need to weave through the complexity, to find an approach that could better connect organisations and people, across the Sheffield community. It needed genuine collaborative curiosity so we could find ways to listen, reflect and experiment together. The unifying element was not the interest of ‘self’ or ‘employer’, but improvements to the health of the Sheffield community, and this was a shared endeavour.

Against this backdrop, Yorkshire and the Humber Leadership Academy funded a project which led to a programme of events in Sheffield. These were designed to disrupt the boundaries of a range of health and social care organisations and embrace the challenges that underpin collaborative working.  In this project, we looked to Grint (2010, 2005) who discusses ‘tame’ and ‘wicked’ problems in organisational contexts. Although tame problems may be highly complex, solutions do exist. In contrast wicked problems tend not to have known solutions. He says that leaders in the 21st Century will engage in many wicked problems. We view building collaborative leadership in this way.  

People met from across the Sheffield community, from diverse organisations and backgrounds. We describe this approach as the ‘Liminal Way’.  The ‘Liminal Way’ emerged organically as an approach, which moved away from viewing leadership development as a ‘programme’, towards the creation of a safe space for development; coming together for an agreed time. The Liminal approach focused on leaders connecting from across the Sheffield community to engage with the health and care system more widely. Connecting in this way sparked new thoughts, emotions and actions, during the time of the first cohort and beyond. It was especially successful in helping people see past the boundaries of their organisations and building up the trust between colleagues to develop their relationship further.   

The impact of the first cohort was immediate. We discovered that people adopted the ‘Liminal Way’ approach and used this in a variety of ways across the Sheffield health and care system. What the approach we describe has done so far is to foster new relationships and develop trust. For example, a local charity is using the methodology and forging new relationships with partners like universities. Liminal is different because we bring together the next generation of a diverse group of leaders to work practically on issues on which they are experts. We invited people to be in the present but also live in the as yet unknown future (this includes both structures and relationships). As a consequence, we are building on early, organic successes, by embarking on a new chapter of the project. In this new phase, we are focusing particularly on how this approach can be adopted to build capacity, capability and confidence for patient and citizen engagement and development. We believe that public engagement and leadership thrive best, when viewed not as process, but rather as a social movement for which we create the right conditions. 
Reference:  Grint, k. (2010) Leadership: a very short introduction. Oxford University Press. Oxford.  Grint, K. (2005) Problems, problems, problems: the social construction of leadership. Human Relations 58 (11): 1467 - 94

For further information

contact Rachel Hawley