Some system leaders have shared a growing unease about the relational and cultural consequences of the focus on Covid-19, describing this as being hard to talk about without seeming churlish or challenging, especially during a national crisis that needs everyone to pull together. There is a risk that some of the more difficult relational aspects of the crisis period are unresolved and may potentially lead to future relational breakdown. Here are some of the things we’ve been hearing about.
Damage to collaborative working and team relationships as a consequence of the shift to command-and-control leadership
Covid-19 has changed the balance of power in many teams, organisations and systems. For some leaders this has brought the exhilaration of power and control – opportunities to get things done quickly without having to consult or collaborate. Others are left feeling frustrated, undermined, voiceless and side-lined. And while, initially, people were willing to set aside frustrations to support the emergency measures, that willingness is now waning.
Bruised relationships and damage to collaborative processes have brought tensions to the surface in a heightened and often emotional way. People describe being overly sensitive, scratchy or irritable, with cracks in effectiveness beginning to appear. Some are worried about whether the damage is recoverable; whether the emotional backdrop to Covid-19 means a return to old tensions; and whether the value of collaborative leadership, which is often disputed by those who favour a more directive approach, can now be openly dismissed.
A sense of rejection and worthlessness felt by some individuals and specialisms about being redeployed, furloughed or held at home until Covid-19 recedes
For many of these people, the experience of their ‘place in the system’ during Covid-19 has evoked unexpectedly difficult feelings of exclusion, not being valued, or being lost. For some, this has been a powerfully felt loss of purpose and role. Some examples shared with us include clinicians without patients; managers redeployed to old roles or given time-filling tasks; experienced leaders left out of decision-making while other colleagues are now authorised to lead instead of them.
Many capable people describe the frustration of just waiting… waiting to be called, to be allowed to be useful again. The risk of depression and demotivation in those who feel side-lined is significant in terms of future relationships and working cultures. Some people are describing feelings of embarrassment and even shame, making the experience of work during Covid-19 very difficult to talk about.
The loss of voice experienced by some groups
As data emerges about the differential experience of some groups during Covid-19, the question of how to speak about the reality of lived experience, especially for those who have less formal power, has come up time and again in our conversations with system leaders. Anecdotally, some equality leads and middle managers have found themselves unable to speak about difficult issues, describing how they are often heard as challenging rather than helpful in raising questions. This matters because the power to privilege some perspectives and realities over others can reinforce existing inequalities and deepen systemic disadvantage.
Recently, another hard-to-talk-about fear – scapegoating – has begun to emerge. Some integration and social care leads have described a struggle to be heard and a loss of influence as the requirements for public health assurance vie with social care accountabilities . The anticipation of post-Covid-19 inquiries has raised fears about who will be blamed for the impact of Covid-19, not least the impact on black, Asian and minority ethnic communities and the deaths in care homes.
In the future, this may affect morale and confidence to act in a crisis situation where no one has certainty about decision-making. But more worryingly, for some it has created an environment of fear, hesitancy to speak and disempowerment. For some staff, staying safe during Covid-19 has meant keeping quiet about issues that should be raised collectively, trying to stay out of the firing line as the gaze of blame gets stronger in our society, as well as in our health and social care system.
These relational and cultural unmet needs are harder to quantify than reduced A&E attendance but the seeds of relationship damage for many are already planted and growing. These need to be addressed in the recovery narrative, perhaps with a sense of urgency that allows us to capitalise on the opportunity for a more inclusive ‘new normal’. If we brush these under the carpet now, we risk having a resentful and demotivated workforce as the system begins work to recover, as well as an exhausted one.
If we can reacquaint ourselves with the principles set out in Dale Carnegies "how to win friends and influence people", it should not be too hard to heal the wounds. Indeed, there is no reason, that I can see, for why these principles should not be valid during any crisis. It is, by any measure, the bible on how to foster good relationships, in any setting.