If you're going to talk about & promote the importance of the human side- about valuing relationships, engagement, being curious about diverse views, then you need to model & demonstrate this in practice. If you're routinely 'too busy' for this, then stop with the rhetoric...

For all the remarkable breakthroughs in medicine, lets not lose sight of the preciousness of the human side- continuity of care, a relationship over time, being alongside- having a coffee together & doing a crossword with a person at the end of life. We must treasure this always.

It's a big red flag for me when a service takes more time & effort to 'gate keep' & not see a patient than it would to just see the patient & try to have a helpful conversation.

I just dont think it's realistic for people to come & see a psychologist & have clear goals they want to work on. Maybe there's a starting point- a 'presenting problem', but so often other perhaps more hidden things come up & services need to have space & flexibility for this.

As a basic guide- "treat people well & trust each other to do good work"- seems a useful starting point. And let things grow from there. There'll be exceptions to this obvsly, but I think the best work happens when we feel genuinely supported & there's freedom to think & create.

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If someone's expressing hopelessness, make room for it, don't rush to 'find' hope or offer something 'positive'. Be alongside, listen, care, let things be. Aim just to be there- to *really* be there. Some kind of felt connection in the most vulnerable of times is worth a lot.

Chronic health conditions carry a big psychological burden & services need to understand the mental, emotional & physical toll this takes on people. This isnt about signposting people for ‘mental health’, it’s about whole services being psychological in their approach as standard

Seems to me valuable to take a ‘complex system’ approach in healthcare- to invest in relationships & networks, to engage & learn, to make space for emergence. All that. But it can feel like you’re working hard at this & making absolutely no difference, bc it's all so intangible.

It's so true that there are little moments to appreciate in the most mundane things. Some bits of DIY going ok, doing some reading & numbers with the kids, just thinking of people you care about. A slow thoughtful sunday- noticing lots of simple good things, & appreciating them.

We're in constant threat mode in NHS-- lends itself to being reactive, simplistic, judgemental in our thinking. Space to be slow down & have time away from fire fighting is so important- for our personal wellbeing, & also our capacity to think more clearly & be compassionate.

It can seem like everything's falling apart, like struggle, like breakdown... & STILL be true that a person's trying their best. We all have our limits, & despite our efforts, sometimes circumstances are just too much. Understand the context, the history- don't judge the effort.

why do we have so many formal meetings when we all know that nobody actually says what they think? why don't we make more time & space for more informal conversations where people actually talk normally? why do we do this the wrong way around?

When we focus on 'managing risk' it can take us away from being alongside a person, it can actually increase isolation & distress. Important ofc to take risk seriously but needs to be done in a way that upholds a sense of relationship & connection. A caring, thoughtful approach.

Everything starts with the team... it's like the secure base, & it's a priority to give it care & attention. How are we all doing? How are energy levels? What’s going on for each of us? What do we all need? Have we each got a bit of space to check in with each other about this?

What a monumental shift it'd be to go from tightly defined criteria/diagnosis based services, to properly understanding what a person really needs & identifying next steps for what might help.

So much clinical need doesnt fit neatly into one service. I saw today the huge value of small, informal networks of people from multiple orgs. It didn't need any permission from 'the powers that be' or a formal 'pathway'- just people deciding to come together to share views.

Makes such a difference when leaders care about the human side as well as performance. You can feel when it's genuine- you can feel it in the way they listen, in the way decisions are made, in the tone of what they say. An undercurrent of warmth & care even when times are tough.

We need to be far more open about the power dynamics between public services & people trying to get help. Ofc there are attempts to have inclusive participation as part of processes. But we just need to name it more, recognise that it's there- talk about it as part of the work.

The graphics & models that go around about how we transform NHS services always make things look so neat & straightforward. But they never seem to take into account the reality of how everyone is knackered, stressed, burnt out, overwhelmed. This is the norm & impacts everything.