Tracy Allen, "What is your leadership for?"

Tracy Allen is Chief Executive of Derbyshire Community Health Services NHS Foundation Trust (DCHS), a primary care trust with 4,000 staff. Tracy was recruited to the NHS Management Scheme straight out of university and, apart from a brief spell in academia, has worked for the NHS throughout her career, close to 30 years. For the first 20 years she worked mainly for secondary (acute) trusts but for the past 10 years she has specialised in primary (community) healthcare.She established DCHS in 2011 as the Chief Executive and has been there ever since – that is quite a stint as an NHS Chief Executive. The Care Quality Commission (CQC) has recently rated the Trust as Outstanding overall and Outstanding for well led. Tracy attributes this to “great people who want to do a great job, a really clear set of shared values and a common purpose… and a golden thread that connects the way we go about our jobs every day back to those common values and purpose.” And this was evident to the CQC.In the next episode of The Compassionate Leadership Interview, Chris is intending to interview Professor Michael West, author of the report ‘Caring to Change: How Compassionate Leadership Can Stimulate Innovation in Healthcare.’ The Trust has given a lot of thought to providing people with the autonomy and space to innovate. This has meant, inter alia, thinking hard about how to handle assurance and governance in a less time-consuming way.An example of innovation at the Trust is the introduction of health coaching, an approach based on the notion that healthcare is co-created between patient and clinician, rather than dispensed by the clinician. Using this approach the Trust has significantly improved outcomes for leg ulcer patients, for example. Health coaching improves the patient experience, enhances overall community health and wellbeing, delivers best value and is more fulfilling for the professionals involved.Tracy views her leadership philosophy as closely related to her philosophy about being a good human being. “It’s a people business … it’s the interactions between each one of us every day that determine the quality of the services we are going to provide.” Kindness, respect, teamwork, and feeling comfortable to bring your whole self to work are critical.The body of evidence that the CQC has built up has established a strong correlation between quality of health outcomes and how people in the healthcare provider feel they are treated, especially minorities. “Looked after people look after people. Hurt people hurt people.” The Trust is trying to create a culture where everyone feels supported and engaged, they all understand what is expected of them, and they truly believe they are all there to care for one another as well as to care for their patients.Tracy acknowledges the “inexorable” pressures within the NHS – rising demand, resource constraints, workforce challenges. And innovating, working with ambiguity, and empowerment within the context of a system under pressure places ever increasing demands on leaders. One of the lessons in leadership that Tracy has learnt from experience is the imperative to have difficult conversations with colleagues at an early juncture. Conversations at the right time are kinder than having to work round an individual and postponing the point at which things come to a head. If matters are dealt with well, an individual can be supported to find the right role rather than leaving under a cloud, and everyone benefits. “The compassionate thing to do is to step up and have the conversation. It’s about how you have it.”One of the people that has inspired Tracy is Professor Donna Hall, formerly Chief Executive of Wigan Council, now Chair of Bolton Foundation NHS Trust and also Chair of The Local Government Network. She introduced ‘The Wigan Deal’, a multi-agency service delivery approach founded on the strengths of individual...