Sensitive honesty

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As part of the Academy’s two year story, we have asked a range of people from across health and social care to share their own stories and experiences of what leadership means to them.

A couple of months ago, David Behan reminded everyone at CQC of a Maya Angelou quote: “I’ve learned that people will forget what you said, people will forget what you did but people will never forget how you made them feel.” 

Giving developmental feedback – bad news, to call it for what it usually is – is much harder than congratulating people. It’s an issue in all organisations, and a particular one for CQC. We rightly have zero tolerance of bullying and harassment, as we tackle the problems highlighted in previous staff surveys. At the same time we are asking more of each other than I suspect we ever have, as we make progress on our transformation journey. So, how do we have honest conversations – as peers and as managers – where things fall short of our expectations? How do we do so without leaving the person we are talking to feeling unsafe, dis-respected, bullied or harassed?

There’s a big consultancy that thought long and hard about what its values were, one of which became ‘brutal honesty’. The point, as I understand it, is that their clients need and are paying for unalloyed advice. I fundamentally disagree with this approach, because it assumes that sensitivity dulls the honest message. From what I understand of the research evidence, the opposite is true. Fear prevents effective performance – it switches off the parts of the brain that guide our ability to learn. And at least as importantly, it’s no way to treat another human being who’s very likely trying to do the right thing. Do any of us come to work with the aim of failing – for ourselves or for our organisations? Very occasionally, people are reckless, and in those cases a just culture requires a swift, hard-edged response. But in all cases, what’s needed is sensitive honesty, not brutality.

To be absolutely clear, sensitive honesty doesn’t mean hiding the truth or minimising the impact that a problem has caused. It means being mindful of how the discussion will leave the person feeling – will it help them to be better next time, or worse? I phrase this as a question deliberately – we can each reflect and do the things that work for us as individuals.

For me, there are some big elements. Over-use of emails is a serious problem, and face-to-face communication is one way to help conversations since so much is conveyed non-verbally and through tone of voice. Being clear about what the issue really is, and the impact it had, is very important. So too is being clear about expectations. Agreeing an achievable goal is a positive thing – a vague aspiration that never appears to be met clearly isn’t. And I’m acutely aware that in most conversations, my role means I’m in a ‘powerful’ position – I may not feel it, but if I’m talking to someone more junior in the organisation, I suspect that feeling of power imbalance can be acute. That puts a onus on me, and senior colleagues, to be particularly sensitive.

Above all, it’s the way in which the conversation is approached – I’m pushing myself to have more coaching, learning discussions about difficult problems – more time spent on clarifying what already works well and celebrating this, more emphasis on the specifics of what the expectations are, more questions about the support needed to get better. And more listening. I’m not getting it right all the time – I was honest, but far from sensitive, in a senior management team meeting recently, and I’ve apologised to everyone involved for this. I’m learning, as we all are – and part of this is being honest with ourselves where we come up short.

Ultimately, success in leadership can be seen as building an organisation fit to house the human spirit. The tone of our conversations greatly affects our spirits – and I hope yours soar, wherever you work.

4 thoughts on “Sensitive honesty

  1. Brilliant blog…very thought provoking. It ultimately comes down to being mindful of how we would want to be treated if we were in that situation…with kindness and compassionate honesty.

    1. Thank you, June – completely agree that “is this how I’d want to be treated?”is a great test of behaviours. Paul

  2. I am pleased to read zero tolerance and so on. But CQC has no BME leader at the top. CQC must lead by example and this shown poor diversity. There is close link between patient safety, staff well-being and BME staff. CQC must walk the walk and lead by example.

    Leadership is simply about doing the right thing for our patients and our staff. Happy staff – happy patients.

  3. Great post and I agree with it entirely. I would also like to point out that “zero tolerance” is barrier language rather than building language – the opposite message to what you are trying to convey in your post.