Brave New World - working towards values-based realism

Last Monday, I was a non-participant observer at our Integrated Performance Group meeting at our Trust, Greater Manchester Mental Health (GMMH). This is a new element of our re-engineered governance processes. It’s an approach that aims to make sure decision-making takes place at the most appropriate level of the organisation; in this case, the Care Group leaders. They form an important group of our senior leadership colleagues. Each Care Group presented on their progress to date, issues to be escalated and achievements to be celebrated. I was impressed with their depth of knowledge, their willingness to appropriately challenge each other, and their determination to make a difference.

To draw on the words of the Canadian Prime Minster, Mark Carney, it was a sign that the old order was disappearing. What I was witnessing was something new, fresh, and hopeful. Mark Carney also quoted Alexander Stubb, the Finnish President, and his approach to the current global uncertainty. The term he used in capturing this approach was ‘values-based realism’. The notion of being both principled and pragmatic. It is an approach that feels equally applicable to the increasing challenges we face in the NHS.

The past year has seen much turbulence, change and yes, uncertainty across all levels of the NHS. It has not been NHS England’s finest hour. Over the past 12 months, this turbulence has formed the backcloth to our recovery work as an organisation. One thing that has become clear over this time, is the need for all NHS Foundation Trust Boards to take ownership of the issues they face, find the solutions and be accountable for all their actions. To quote from Mark Carney’s speech once again*, we have become ‘middle powers’. As an NHS Foundation Trust, we sit between the Regional Offices of NHS England and the Integrated Care Boards of our integrated care system.

It feels like a good place to be. This was something I was able to explore twice last week. The first was at a small dinner party hosted by the wonderful folk at the Good Governance Institute (GGi). Andrew Corbett-Nolan, GGi’s Chief Executive was there in person. He is one of the good guys for sure. We were in Liverpool, at a restaurant on the Albert Docks. It was a great evening of good food and equally good discussion and conversation.

Although Jane wasn’t at the dinner, she travelled to Liverpool with me and watched the football. We stayed over, and spent a wonderful time the following day exploring Liverpool city centre. One of the things Jane wanted to do was visit the Walker Art Gallery, which had a special exhibition of Turner’s paintings. We weren’t disappointed. Next stop was to visit both the city’s cathedrals. Whilst they were both magnificent in their own right, we did prefer the majestic Anglican cathedral. Then it was back home and a late afternoon meeting with my Non-Executive Director (NED) colleagues.

The next day I was once more in the company of Andrew, albeit we were in a Zoom meeting. It was the first NHS Chairs and NED webinar of 2026. I was there to present a little of my experience of being a Chair at GMMH during our recovery journey. It was an opportunity to reflect on where we had come from as an organisation – not a place I ever want to return to – and where we are today. At one time, we were top of NHS England’s worry list. Thankfully we no longer occupy that position. The telling of my story revolved around a shared approach that both our Chief Executive, Karen Howell OBE and I had relentlessly pursued over the nearly two years that we have worked together. Our approach was and is centred around consistently promoting trust, authenticity, and transparency.

Building great leadership teams that bought into our three organisational priorities (recovery, reengineering of governance process and strategic aspirations) was where we were able to start to build trust. Nurturing neglected relationships, within the Trust and with partners, through consistently presenting one version of the truth helped promote authenticity. And finally, improving the quality and safety of our services, alongside financial sustainability, and good governance, ensured we remained transparent in all we did. At the meeting last Monday, I think I caught more than a glimpse of the difference such an approach can make, and I say a big THANK YOU to all my colleagues who have helped us get this point – the next phase of our improvement journey is about to begin.     

 

*I found Mark Carney’s speech at Davros inspirational, and I would encourage folk to try and read it in its entirety.