Without trust, we will fall, says Clare Gerada

We find ourselves in testing times. Challenges of all kinds are no stranger to us, tough decisions are our daily portion and tricky waters undoubtedly await us. The Francis report cast a bright spotlight on us all at a dim moment for the NHS. Never has it been more important for those of us in positions of leadership to earn and keep the trust of those we lead and serve – it is the one thing that will keep us afloat.

As the bedrock of leadership, trust – of the public, our patients and our staff – is an invaluable element we simply cannot afford to lose. All the checklist qualities of good leadership – honesty, courage, integrity etc – amount to nothing if trust is absent. Trust in our word, ability and actions is a precious element in the fragile relationship people have with our health service.

So, how can we actually build trust with the people we lead and serve? How can we retain it? And how can we restore trust that has been lost? Well, I suggest there are a number of ways.

Firstly, a pragmatic step – we must watch our language. I am concerned that the language of marketing is changing the precious clinician-patient relationship into a crudely costed financial procedure. If we want to keep serving the best interests of our patients and retain trust, we must reject the language of the market and embrace the language of caring.

Care first, budgets later – we must make sure that the rationing of care is as far removed from the consulting room as possible. Patients must be confident that any decisions about their care are made in their best interests, rather than those of a budget.

Speak up – we need to challenge inequalities and unfairness wherever we see them. We must hold fast to the principle that good healthcare should be available for all.

Lead with compassion – we need to refocus on what matters most to patients – kindness, caring and compassion. All of us will need to fix our gaze on how leaders and leadership can become the vehicle for this.

Collaborate to ameliorate – we need to move away from an environment where micro-managers demand targets and rarely collaborate. Instead, we must create an environment where the boundaries of leadership are widened and people work together to pool their initiative, talents, distinct perspectives, energy and expertise. In this environment, the outcome will always be richer and greater than the sum of their individual actions.

Welcome candid conversations – we have to learn to welcome dissent, disagreement, and truth, however uncomfortable and inconvenient that may be. For this to happen, leaders need to have the courage to enable and facilitate vital, honest conversations in a blame-free environment.

Listen and learn – as good leaders, we need to show our dedication to caring for service users, which means really listening to what staff and patients have to say.

Trust makes the world go round and can only be built by leaders who show care and compassion for patients and their staff. Without trust, we will fall. It’s as simple as that.

Read Clare’s report on leadership on the NHS Confederation website.

Clare Gerada is Chair of the Royal College of General Practitioners