Top Tips for Tackling Difficult Conversations Clive Lewis OBE DL NHS Employers Equality & Diversity Session February 2015

Strategic Health Context  Do more to tackle the root causes of ill health. Action needed on obesity, alcohol and other major health risks.  Commit to giving patients more control of their own care, including the option of combining health and social care, and new support for carers and volunteers.  Change to meet the needs of a population that lives longer. Break down the boundaries between family doctors and hospitals, between physical and mental health and between health and social care.  Action needed to develop and deliver the new models of care, local flexibility and more investment in our workforce, technology and innovation. 2

Operational Health Context  Local Health Community discussions  Job Plans  Re-admissions rates  A&E 4 hour wait  Safety  Sickness & Absence  Performance  Seven Day Working 3

Difficult Conversations Survey  Over 200 managers tell us why they dodge difficult conversations  97% are concerned about stress caused  Over 80% are concerned about an angry response  80% believe difficult conversations are a part of their role  But more than half lack the training and experience to tackle difficult conversations 4

Difficult Conversations Survey  Top 10 Influencing Factors on Your Choice  Concern about associated levels of stress for the other person – 97.4%  Concern about damaging others self esteem – 94%  Concern about causing upset – 92.3%  Recognition that expectations were not made clear enough – 90.6%  Concern about being fair – 84.6%  Concern about an angry response – 80.3%  Concern about permanent or long term damage to the relationship – 79.5%  Concern about short term awkwardness in the relationship – 78.6%  Concern you may have got the wrong end of the stick – 77.8%  Hadn’t gathered sufficient evidence to tackle the issue – 77.8% 5

Reckless Tackling TacklingDodging Difficult Conversations 6

1. Fear of other person’s response 2. Fear of litigation or other action 3. Fear of the time required to deal with it 4. Fear of the other person’s verbal dexterity 5. Fear of where it will go 6. Will the organisation back you? 7. What if I’m wrong? Top Fears about Tackling Difficult Conversations 7 In 2013, Globis published ground-breaking research into the reasons why managers dodge difficult conversations. Visit to request your copy of the report.

1. Problems continue 2. Problems get worse 3. Damaged relationships 4. Impact on business outcomes 5. Person does more harm to themselves, pupils, colleagues or school reputation 6. Viability of the organisation 7. Impact on Patient safety Top Consequences of Avoiding Difficult Conversations 8

1. Establish the facts 2. Schedule the conversation wisely 3. Seek advice from a trusted colleague 4. Consider the bigger picture 5. Choose the right location 6. Plan enough time Top Tips when Preparing for Difficult Conversations 9

1. Put it into perspective – becoming angry, upset, defensive is common 2. “Would you like me to give you a few moments before continuing?” 3. Stick to the facts 4. Say nothing 5. Be careful of histrionics Top Tips for Handling Emotional Responses 10

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