Sustainable clinical leadership: More tips for engaging your Trust on sustainability (part 3)

Following on from last week's post, we continue with some more tips about engaging your Trust around the topic of sustainability.

Write a blog

Write something on your Trust website or intranet about sustainability. Write what you know. Keep it brief and lively. Write about de-prescribing, over-investigating, nature walks, gardening. Blogs can work. A piece about bumblebees inspired one of the ward managers to ask me for advice on how to make their ward garden more attractive to pollinators, which in turn led me to contact a charity who are going to help them do just that. Emails, especially ones addressed 'To All' can be perceived as intrusive, dictatorial, but an idea you pick up from a blog you’ve chosen to read might stick. Always make sure you remember to include at the end of your blog a point of contact for people who want to know more.

Get your senior leadership team on board

I took our Trust Board on a fungal foray round one of our hospital sites. They loved it. We found some honey fungus killing an oak, some horse mushrooms and some mysterious toadstools related to panthercaps poking their caps out from an old lawn. We talked about hallucinogens and deathcaps and the wood wide web. It was a great way to get the leadership team to think about the biodiversity crisis and the beauty of the magical beings living on their estate, and directly illustrated the therapeutic value of getting your shoes muddy and meeting new species. Why not do similar? I’m sure in your Trust there’s at least one fungal fanatic, a birder, or someone who knows their flowers. Amateur naturalists love sharing their knowledge, and the leadership team will love half an hour in the drizzle as a change from poring over spreadsheets.

But that’s only a start. Trust Executives and Boards are preoccupied with money. They know money, they understand it. Money is pretty much the only thing they’re concerned about, unless the CQC or a member of the Royal Family are visiting. There is no point in expecting this to be otherwise- it’s been like this ever since I’ve been in the NHS and always will be. We must learn to speak the language of the people we are trying to influence if we want them to change.

And we need them to change, don’t we? We want them to lead on more prevention, more empowerment of service users, less reliance on carbon emitting technology, scans and drugs. Fewer admissions, fewer people having to wait two days in Casualty for a bed.

Then let’s engage with the issues that keep the Chief Finance Officer and CEO awake at night. If you want support from the Board or some funding for a sustainability lead role (that would be nice) make a case that sustainable interventions will save money. When choosing a project choose one that you think has got a pretty good chance of saving money if rolled out. Like plans to optimise medication, schemes to divert people from unnecessary admissions or prevent out of area placements. When setting up the pilot project make sure you measure outcomes, including financial ones. So that when you present the outcomes to your managers you can use the projected cost savings to ask for funding for a larger project or even support for a business case for a service change.

Value your time

Saying 'no' is very hard for me. But if we are to be effective leaders in sustainability we must say “no” sometimes. Concentrate on doing a few things, well. Probably the biggest waste of time lies in projects that have been started by a once enthusiastic clinician, but which have now withered for a whole host of reasons. I find myself picking up these pieces of work. Don’t do this. We need to be ruthless. We need to work with people who can get on with stuff. Drop your support for projects which are going nowhere. Because there is no shortage of other important things you can do. People respect and value those who say 'no'.

Summary

Do you believe that people with mental illness are stigmatised, marginalised and not treated with enough care and compassion? Do you believe that we are on the brink of a global climate catastrophe? And do you believe that mass extinction is not just round the corner, but actually happening, now?

If you believe these things, as I do, then we can’t just sit around communing with like-minded people in committee meetings, sending each other links to interesting articles and moaning about American politics.

We have to change what the influential people do. Those who sit on the Board, the Exec Team, the Chief Medical Officer, Clinical Directors, and the consultants (who have much more influence than they think they have, but rarely use it). Approach your colleagues and managers with respect, but with firmness and seriousness and with a clear plan linked to things they care about (i.e. saving money) and you will not only be more successful, you may even find yourself on that hard- to-find road to saving our planet.

Dr Dan Harwood