People & Culture Essentials with Dave Harris at Cheshire & Wirral Partnership NHS Foundation Trust

David: Tell us about yourself and career path.

Dave: I’ve never had a career plan – it’s always been “am I learning, growing and making a difference?” If one of things starts to fall, it’s not the place for me. I’ve always worked in the public sector and latterly ended up in the NHS. My current organisation, Cheshire & Wirral, is the best job I’ve ever had.

David: What is your interest in the area of people and culture within organisations?

Dave: Without people, you don’t have culture or organisations. You have empty offices. People are at the heart of everything, particularly in healthcare which is about the interface of human beings. It’s bonkers not to be thinking about the critical importance of people within our organisations. We’re not brains on sticks that sit in rooms and make decisions. What drives human beings? What’s the emotional component? I’ve always been fascinated by looking at companies as complex human systems – we need to understand how humans behave and interact in the way that we do and to what extent can you influence that with external factors.

David: It’s strange to me how easy people are overlooked in favour of policy and procedures. What does the word culture mean to you?

Dave: People. Culture is the outcome of what’s going on inside people in terms of what they think, feel and assumptions they make about behaviour. It’s what’s going on internally and the external connection between people – so policy, structure, rules, but also emotions and behaviours. If you don’t have people, there is no culture.

David: That requires people to listen, understand and engage in comfortable, safe spaces. This puts a demand on our managers to be people- rather than process-led. Do you have any experience of this within the NHS – of culture becoming stagnant?

Dave: It’s often said that you can “feel” culture. The cultures that really matter and make a difference are the local microcultures within the wider organisational culture. Team leaders can set tones for inclusivity and communication in one unit – but down the corridor in another team the culture can feel completely different. In that respect, the manager is the “culture carrier” of team cultures that should be nurtured and copied within other microcultures.

David: Helping people to flourish and thrive is crucial. From a HR and OD perspective, what work have you done in Cheshire & Wirral to integrate this people-centred, purpose-led culture that you describe?

Dave: We developed a model in the last couple of years called Aligning Capabilities. It’s about drawing upon all these areas, acknowledging that it’s a complex human system and designing values and beliefs to be aligned with the outcomes we deliver to the communities that we serve. Essentially, aligning philosophy to framework and providing coherence and confluence between these intersecting domains of culture. It’s macro and micro, understanding culture as internal/external or individual/collective.

David: So, it’s a double axis of culture.

Dave: Yes, it’s understanding that the basis of decisions is driven by people’s emotions and not the policies that guide them. So, what do we do to get that out on the table? Having the ability to dive deep into the individual and then go broadly out into the external environment is a crucial balance to leadership and business success.

David: Compassion, empathy and dialogue don’t seem to be soft skills anymore. These are tough skills that help businesses to flourish.

Dave: Yes, absolutely. Those skills come more naturally to some than others, but energy comes from this creative tension. Understanding, incorporating and celebrating difference is crucial to building an inclusive culture.

David: To what extent does your Aligning Capabilities model feed into your leadership and management models?

Dave: We’re working on that at the moment. Now, when we look to implement a HR policy for instance, we use an Aligning Capabilities Assessment. This informs the required behaviours, skill sets and values rather than just blankly enforcing a new policy without having conversations. Our line managers and leaders are looked at against our capability framework: capacity, competence and confidence.

David: You’re clearly working on nuancing language to drive values, behaviours and the climate of your organisation. Within that system, what are your thoughts on retributive versus restorative justice within your system given your insights on learning, engagement and empathy?

Dave: The importance of justice and resolution first connected us! There’s definitely a misalignment between our values and beliefs and the language of our policies and processes. We’re currently having conversations with our staff networks about the experience and language of our HR procedures and disciplinary policies. Typical language is quite aggressive – are we really trying to find ways of punishing people in a black and white approach? That can’t be right – life is far greyer than that. This language doesn’t align to our organisational values so how do we phrase this differently? There may still be consequences if the circumstance requires this route of punitive justice, but the entire framework must reflect the complexity of our emotional needs. Policies and processes should be based around restoring our wellbeing and sense of worth. We then need to support, nurture and give permission to our leaders and managers to think and act in this nuanced way.

David: That’s a really important shift. Without that, it becomes a barrier to building a nurturing culture that is not punitive but collaborative. I’ve spent some time with your Trust Board over the years – what are your thoughts around the role that your leaders have been playing in driving this change?

Dave: It starts with who we select in the first place. My experience of joining was lengthy and challenging with a real focus on values. This part of recruitment is carefully protected and maintained, and then overlaid with people’s skills. We spend a lot of time as a Board thinking about our personal and team behaviours and how this affects our working climate, making sure that we role model the culture that we’d like to cultivate. Recently we took some time to sit with our teams and thank them for their hard work and sacrifice over the extreme intensity of the past two years – because we want to role model certain values of compassion and commitment. That ongoing self-reflection has been really important. We also like to empower our staff to be values-based and person-centred too – it goes beyond the Board – so ensuring that we supply colleagues with this confidence, capacity and capability is crucial.

David: It sounds like leaning into vulnerability, talking and listening is a key component of your culture. You’ve clearly demonstrated a clear commitment to those common values which then cultivate your culture.

Dave: Yes, vulnerability is so important. We need to feel safe enough to make ourselves vulnerable which requires the creation of a safe environment. Allowing people to say how they feel often leads to a deeper, far more complex conversation.

David: Vulnerability turns into powerful togetherness, alignment and connection which can only come from person-centred processes.

Dave: Authentic conversation is crucial to developing genuine relationships based on real connection. This is so central to the NHS – going beyond job titles, sectors and roles to people and how they really feel and function.

David: I was reading the NHS England report that was published earlier this week. It triggers a powerful conversation about the future of HR – you’re describing a shift away from bureaucratic procedures within the NHS. What do you see as being the future of HR within your own Trust or more widely across the NHS?

Dave: We’re exploring this at the moment. Is human resources still a helpful phrase anymore? Maybe human is, but perhaps not resources. The department is for people, not the police force: the focus needs to be less around policing and more towards coaching when developing and embedding frameworks. That’s the future of the function and the profession. It’s recognising that people really, really do matter. This is about what makes people tick and, after all, we are a people organisation: without people, we don’t deliver healthcare. We’re not quite there yet but we’re making progress and having real conversations.

David: The people and culture function can be so strategically powerful, acting as the glue that holds values, behaviours and processes together.

Dave: I think that’s absolutely right. It’s about understanding the cross-section of all those functions, capabilities and people and how they’re either helping or hindering our business. Flow between functions is the future of business.

David: Flow is a really interesting word – something I speak about a lot in my book Transformational Culture. Why do you see this as being so central to the function of a business?

Dave: Flow is all about release and connection. Creativity and energy combine through dialogue between colleagues, teams and leader. Essentially, it unleashes creativity energy.

David: You’ve been recognised for your work, accolades and achievements for the provision of outstanding care. How does it feel to win these recognitions?

Dave: The Outstanding for Care award really matters to us because it circles back to our culture and belief system. We definitely want to nurture and protect that. But that’s good – what else can we align to that to continue bettering our services? It’s never perfect. Awards remind us that we’re on the right path but we always have improvements to make.

David: In brief, do you have any thoughts or reflections through the pandemic as a healthcare organisation? How are you building your recovery strategy post-covid?

Dave: We’ve sat with teams and listened to their thoughts and feelings about working through the last two years. Once we got them talking, the pride that came out in supporting communities was immense. They found such incredibly innovative ways of getting around the challenges of COVID to still deliver care. Yes, people are really, truly tired being knee-deep in a pandemic, running their third or fourth marathon, but I think the imagination, innovation and care that our people have shown needs to be nurtured, protected and taken into the future. We need to create spaces for these people to take a breath so that they can continue to unleash creativity going forwards.

David: The analogy of a marathon is really interesting. Is there anything you’d like to share about any projects that you’re currently working on?

Dave: I’ve started a PhD which takes my everyday job and combines it into an intellectual approach. Hopefully, the benefits of this research will be useful for furthering the service of communities.

David: How might you reassure other Trust leaders who are wanting to develop a similar people-centred culture within their organisations? Where do they start?

Dave: I think there’s two things here. One is to pause, step back and question the assumptions you’re making about how decisions are made. Do you think life is linear and statistical? It’s important to understand your frame of reference. Secondly, if like me you think there are instances that you need a complex human system, then focus on parts at a time to bring the whole systems approach together. Taking it one step at a time will help to build a truly transformational culture.

David: You’re very aware of the interconnectedness within systems – even if we can’t change the whole thing, we can focus on certain aspects. That’s a very practical and realistic way of viewing culture. What or who has inspired you along the way?

Dave: My current line manager and my previous line manager have inspired me a lot. They’ve been authentic by speaking and living their values, seeking to understand what led to all situations. They never made assumptions, taking the harder path to understand first and solve after. That’s what I aspire to now in my work.