Born leaders – you need to regress to progress

This blog originally featured on Third Force News.


The leadership industry offers numerous theoretical frameworks and models, ranging from the instructional to the inspirational. The majority of these models are focused on external factors and offer up-skilling and progression as a solution to overcoming leadership challenges. But is this enough?

After spending 2016 as a Clore Social Leadership Fellow, I don’t claim to be an expert on the subject, but with the knowledge that I have gained from that intense fellowship year and reflecting on my 15 years of working towards social justice I offer this: leadership should be more about regression than progression.

The chances are we probably once had many of the qualities that would make us a strong leader, but we have lost or forgotten them. Perhaps more concerning, we might have learned not to value them as we should. We need to tap into our inner-child and re-learn the qualities that childhood gifted us, and value them as leadership traits.

Key to this is our curiosity. I’m sure none of our parents expected to give birth to pint-sized Paxman’s but this is what many of them got. “Do the trees make the wind?”, “Do they close the roads to switch on all the cats eyes?”, “where is my soul?”, and of course, “Where do babies come from?”. As children we’re naturally curious about the world around us, and less willing to accept things at face value.

The circle of why is a phenomenon that delights curious young minds and frustrates parents in equal measure. Yet at some point we learned to be less curious. “Why?” Because the very question became annoying and it stopped eliciting the responses that we liked.

Research shows that our questioning drops off dramatically after the age of five, suggesting that schools have a role to play here too. I remember from my own experience that school rewarded the children who knew the answer, not asked the best questions, and this pattern of rewarding answers over questions continues into our professional life.

So, what’s stopping us being more curious as adults? Potentially lots of things! Have you ever heard it quipped that there’s “no such thing as stupid questions, just stupid people”? Asking questions can cause us to be perceived as naive or ill-informed. Asking a question might feed our imposter syndrome, or we could risk letting our demigod masks slip in front of those who we want to see us as strong and all knowing – so they can trust us to lead them.

But without leaders asking why, what if, and how, we stifle our creativity and, at best, are doomed to tweak existing behaviours, programmes and ideas, and at worst repeat the mistakes of the past. If we’re to lead the change that we seek, then it’s critical that we think differently, and maintain a curious approach to everything we do, and everyone we do it with.

I started doing this a few years ago, particularly in relation to who I work with. It’s now habitual for me to be more curious soon after appointment to get to know my new colleagues more closely. I start with two questions. First I ask “what matters to you?”.

Beyond an interview environment and trying to impress the new boss, I aim to get to know my new colleagues more personally. I talk about what matters to me, and give the example of walking my dogs at lunch times, hoping to give them permission to share what matters to them and how we can fit work in to their life.

I also ask them to tell me about their favourite line-manager (or sometimes their least favourite – depending how mischievous I’m feeling). This gives me an idea of how they do/don’t like to be managed and supported. This curiosity is simple, but it has had a big impact on my relationships with colleagues and helps me to create an environment in which we can all thrive.

I’m also more curious in circumstances and conversations where I disagree. In the spirit of curiosity, I have become better at listening to understand, rather than listening ready to challenge with my own view.

What else could we relearn to be better leaders? My next blog will look at other child-like qualities we undervalue as adults.

Mark Kelvin is programme director at the Health and Social Care Alliance Scotland (the ALLIANCE) and a 2016 Clore Fellow.

What is transformation in health and social care? – Emma Goodlad

To me, to create true transformation in health and social care, transformation needs to be considered on an individual level as well as looking at the wider transformation landscape. This personal idea of transformation should be able to slot into the interactions people have with the health and social care professionals they come across throughout their life – but for this to happen there is a need for a shift in the way that the health and social care system across Scotland operates.  The introduction of Health and Social Care integration was promising and in theory makes absolute sense – however in practice will this turn out how we imagine it and truly benefit the individuals that it needs to?


On a personal level I think of transformation as the ability for me to live well with a long term condition, but also to be able to learn, adapt and develop as a person in response to this, with the support of those around me including health care professionals.  The support that I have received over the last two years from health professionals has been very hit and miss. I know I am very lucky to be receiving and have received the support I have thanks to our NHS – however this system is far from perfect and I have been victim to the postcode lottery which exists in mental health care support across Scotland. I did receive crisis support but not without a fight, but 9 months on from when I first presented to a GP in crisis I am still on a waiting list to see someone from the Primary Care Mental Health team. I have had to ensure that I am still on the correct waiting list as it seemed that one hand does not know what the other is doing. I am proactive and capable of advocating for myself which has prevented me falling through gaps – however, what about those who don’t, or those who like me have tried to advocate for themselves and seemed ‘too well’ to receive the appropriate support and treatment? It should not require an individual or their families and carers to have to fight and chase up services?


To be able to provide true transformation across health and social care in Scotland, there needs to be a shift in attitude towards person centred approaches – there is already evidence of this being demonstrated by the outcomes of projects funded through the Transforming Self Management in Scotland Fund.  Approaches like those that funded projects provide need to become more common place – putting people at the centre and working with them to design, deliver and evaluate services. The true worth of Health and Social Care Integration won’t be clear for a while, but to get the most out of it there must be true partnerships between statutory and third sector agencies, there must be a trust placed in the third sector that they already are and can continue to develop and provide a kind of support for people that is not currently available through statutory agencies and must stay where it is to protect the true nature of this work. Strong partnerships supporting these approaches are needed to move away from a postcode lottery and ensure that everyone who needs support can access it in a way which suits them and in a timely manner.  People are more likely to thrive, develop and therefore give more in return to society if approaches are person centred.  There are partnerships forming across Scotland between statutory agencies and third sector organisations which are effectively providing services and support for people in a way which is right for them, precisely because it has been designed and developed in conjunction with them.

Challenging the Five Provocations: Nurturing Transformation

In December 2015 the Academy published the Five Provocations for the Future of Health and Social Care, influenced by a think tank of leaders from health and social care and beyond. Since then we have tested them with a range of different audiences and deepened our understanding of what a transformed landscape would look.

This series of blogs, titled Challenging the Five Provocations, looks at this experience to dig a little deeper into the future and set out the opportunities for transformation as we see them.

Nurturing Transformation

Perhaps there is something in the word transformation itself that suggests a quick fix. But what it means is a thorough, radical and noticeable difference in health and social care and beyond. Suddenly the word transformation been adopted by every change project and even by systems change which is focused on one goal – cutting costs.

So perhaps there’s a need to qualify it right at the start. What we identify as transformation has to mean a positive, identifiable and radical shift in care where that change is needed. And transformation will embody the other provocations as well; it will cede power, it will reflect courageous leadership, it will be a change in culture and it will fundamentally emphasise and value humanity at all levels.

It is not a quick fix and so it needs to be supported and nurtured by a longer term vision and the courage and passion to work towards it; by supporting and navigating the involvement of people, the design of supportive systems and investment in them as well as the inevitable bumps in the road and the changes in political landscapes.

To nurture means to care for and encourage, this needs to be a fundamental part of the process of transformation and can’t only apply to one sector or profession but needs to be as evident in the informal communities of care as well as the formal.

Edgar S. Cahn – Scotland taking the worldwide lead in co-production

Edgar S. Cahn, founder of TimeBanking, former counsel and speech writer to Robert F. Kennedy and co-founder of the David A. Clarke School of Law at the University of the District of Columbia celebrates Co-production Week Scotland in this special blog:


In devoting an entire week to promoting co-production, Scotland is taking the lead worldwide. Congratulations. You are transforming what it means ‘to help others’ from a well-intended service delivery role to being a catalyst that enlists those being helped as partners and co-producers of real change, for themselves and others.

TimeBanks USA is undertaking to bring co-production into our higher education system – both for undergraduates at the University of the District of Columbia and my law school. The law faculty will shortly authorise a course in Becoming a Changemaker which introduces law students to co-production that reframes providing legal services to clients from a service delivery role to a transaction that enlists those clients as co-producers advancing System Change.

This past week, at the Annual Conference of our National Legal Aid and Defender Association (NLADA), TimeBanks USA, my law school, and the NLADA conferred a formal Client Contribution award to clients who had advanced social justice.

As we look at the recent election, we can see that we may be learning that the well-meaning effort of all our NGO’s to ‘do good’ may have relegated those recipients to being passive and disenfranchised – a status they did not appreciate. This election may have been their expression of dissatisfaction with that role and status. My hope is that co-production will be the way to restore us to the core values on which this nation was founded. Empowering the disempowered and disenfranchise is the mission to which I have committed myself since 1963 when I served as a Special Counsel and speech writer for Attorney General Robert Kennedy. I’m  not turning back – and you in Scotland have provided a model for us all.

Edgar recently gave a special lecture at our event Health, Human Rights and Co-production. Read the #LetsCoPro Storify here.


My Imaginary Illness

I feel like I’m in a dream. Everything seems to be in slow motion and I’m fighting to keep myself from passing out. Every touch makes me jump and almost lash out at the person who came near me. Sounds and lights seem louder, harsher and overwhelming. My legs struggle to move, like I’m walking through thick sludge. I’m existing, but just barely.

Despite having frequent episodes of these horrible, debilitating symptoms, sometimes lasting months, there are still people who question that I am actually ill at all. Neurotic and hypochondriac are the two favoured words, and have fast become my most hated vocabulary.

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“None of us is better than all of us”.

At the ‘2 Million Expert Voices’ ALLIANCE conference on 23rd May the afternoon brought a panel and Q&A session based on the Five Provocations for the Future of Health and Social Care. These have been generated through cross-sectoral discussion groups tasked to consider what is needed to transform Scottish society so that all citizens are able to thrive. The provocations are: courageous leadership; nurturing transformation; target culture; emphasising humanity and ceding power (see The three panel members each focused on a different provocation in their talks.

Jackie Maceira, convener of the Scottish Disability Equality Forum, illustrated the importance of emphasising humanity when he described his experience of applying for self-directed support not for personal care but for a personal assistant so that he could remain involved and active in the community. He was taking an approach that was considered somewhat novel, trying to do things in a flexible way to achieve what was meaningful. Barriers that arose around which category to ‘put’ him in, or “but we don’t do it that way” were subsequently overcome, a social worker represented his request to the panel and ultimately he received the personal assistance. Jackie’s message of hope was that life-changing outcomes can be achieved when there is an emphasis on humanity.

Judith Robertson, Chair of the Scottish Human Rights Commission, addressed the issue of nurturing transformation, pointing out that people need to know what their rights are in order to assert them and hold duty bearers to account; something we need to work on in Scotland. Judith reflected that often there are individuals within services doing things as we want them to be done, but in order for this to spread and become the norm it is vital that those people and their positive practices are truly valued and nurtured. As Eleanor Roosevelt said “Where, after all, do universal human rights begin? In small places, close to home…”.

Oliver Escobar, Director of What Works Scotland, took both courageous leadership and ceding power as the prompts for his talk, although he highlighted that ‘ceding’ power might also be seen as ‘sharing’ power… or even creating power by involving 2 million experts. Oliver emphasised the need for a shift from an ethos of individual, ‘heroic’ leadership to recognition that the best leadership is collective, with facilitators bringing together people who need to have difficult conversations. Grassroots community work alone is not enough, he stressed; those at strategic level need to be engaged in order to influence investment, aid decision-making and effect transformational change on a large scale. Oliver advocated devolution to a local level and not only the participation of lobbies but actively seeking the voice of the seldom heard. An overarching theme was the need to move from seeing health and social care integration as a question of services to seeing it as a matter of power, politics and democracy.

Questions from the attendees stimulated discussion and comments about the politics of partnership, the importance of those providing a service having knowledge about human rights, and the view from Oliver that sometimes those collaborations which involve constructive conflict can actually be the most productive. The role of advocacy for individuals was a recurrent theme in people’s stories, with one person’s reminder that even those who are empowered and capable of defending their human rights can be just exhausted by it. Tokenism and overuse of jargon were cited as barriers to participation, while positive examples from as far afield as Melbourne and West Dunbartonshire were presented to illustrate willingness to cede power and do things in a different way.

Take-home messages for me? Particular challenges may include the necessary culture shift described by Judith – maintaining accountability but moving away from a culture of blame and defensive practice and towards a culture of looking for learning. I would argue that much work can be done in the early years, in schools and in parenting support to nurture such a culture. Opportunities for doing things differently are ripe in Scotland right now, with developments such as the new Mental Health Strategy and the work of the Integration Joint Boards. Above all, I was reminded of the power of collective action by Jackie’s “None of us is better than all of us”.

Publication: Nurturing Transformation Case Study

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Nurturing Transformation: A Community-Focussed Social Impact Bond in Perth and Kinross

The next in our series of case studies on our Five Provocations is Nurturing Transformation. It highlights Perth and District YMCA’s Living the Balance project, which was funded and delivered as a social impact bond. This is a model which is becoming more widespread in the funding of preventative projects, but Living the Balance is Scotland’s only social impact bond as yet. Jill McGrath, CEO of Perth and District YMCA, spoke at our recent event on the Power of Prevention, and explained how their project pushed the boundaries of the innovative model by involving small, local funding partners, many of whom invested more than simply capital in the project.

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Publication: Five Provocations for the Future of Health and Social Care

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Following the Academy’s inaugural Think Tank in October 2015, we are pleased to be able to launch our latest publication, Five Provocations for the Future of Health and Social Care. This paper explores each of the themes that emerged from the Think Tank and provides context and a narrative for how change in each of these areas could transform health and social care in Scotland. These provocations will shape the Academy’s future work, as we aim to incite conversation, debate, new ideas and action around these themes. Read More “Publication: Five Provocations for the Future of Health and Social Care”

The Power of Prevention: Money doesn’t grow on trees…

The latest event in the Academy’s Integration Series, The Power of Prevention, took place on Monday 25th January. A diverse range of delegates from across sectors came together at the Serenity Cafe in Edinburgh and fuelled by some delicious haggis, neeps and tatties (it was Burns’ Night after all) we set about exploring the cost effectiveness of preventative approaches to health and wellbeing.

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