“I can never truly understand the lived experience of those who face daily ‘micro-aggressions’.”

Written by Stephen Hart on 29 November 2017

The NHS Leadership Academy is striving to ensure the presence of inclusive and passionate leadership knowledge, skills, attitudes and behaviours at all levels of health and care.

Our work on Building Leadership for Inclusion is a system-wide intervention to build knowledge on what needs to be done to increase the pace of change towards cultures of inclusion, to equip leaders with the knowledge and skills required to leave a legacy of inclusion and to increase our ambition on developing inclusive cultures.

In service of these ambitions I am sharing my own experience of what it is to be an inclusive leader, how my privilege as a white man has played to that experience, and what I think I need to do to be better.

I joined the NHS in 2016 after a 20-year career in the Royal Marines. My experiences and privileges have been those of wearing my values proudly, but rarely having to look at things through the eyes of those who are most impacted by issues of inclusion.

As I engage with the specific contexts of leadership in health and care, I’m learning how behaviours - including my own - that are well-intentioned, can land as compounding rather than supporting. 

This perspective is one that is now being challenged by two key changes: my mixed-race daughters are now going to school and are facing issues of inclusion that I never faced, and I’m leading an organisation which is genuinely diverse – something that I never did during 20 years of military service.

These experiences are highlighting to me that I can never truly understand the lived experience of those who face the ‘daily mosquito bites’ of micro-aggressions. As I engage with the specific contexts of leadership in health and care, I’m learning how behaviours - including my own - that are well-intentioned, can land as compounding rather than supporting.

This might include being fearful of having difficult conversations and quickly moving discussion out of the ‘zone of uncomfortable debate’ (ZOUD) where actually it is only in the ZOUD that we are likely to explore issues of inclusion and diversity.

Avoidance and timidity to have the most difficult conversations continue to marginalise and minimise the issues we’re facing. Parachuting in to ‘save’ can further-compound the challenges, reinforcing rather than challenging expectations of power.


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For me, my experiences and ambitions at work and my experiences and ambitions at home aren’t just linked - they’re the same. Our NHS is privileged to employ 1.5m people in England against a
working population of 31.5m.

That means nearly 1 in 20 people who has a job in England works in the NHS. In that context, all of us in the NHS, and across health and care, have the opportunity to not only change the cultures where we work, but to change the cultures of the society we live in.

Achieving these grand ambitions and huge scale starts with the smallest scale - it means me starting with me. Starting with me means going forward and having difficult conversations, building my knowledge guided by those who have the greatest lived experience of the impact of issues of inclusion, alongside developing skills to operate as a leader in diverse groups.

This means remaining in the ZOUD and facing my fears. Courage for me in the future won’t be firefights and one foot carefully in front of the other; it will be one conversation and engagement at a time responding and adapting to the question: ‘what is it like to be led by me?’

I’d be keen to hear how you are progressing your own inclusion agenda, be it with yourself or in your organisation.

 

About the author

Stephen Hart is national director of leadership development at Health Education England and managing director of the NHS Leadership Academy.

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