Unleashing the power of reflection, action and collaboration in health care improvement

Treating people in a safe environment, including protecting them from avoidable harm, and improving the quality of both care and leadership are the top priorities for the NHS since the tragedies and high profile cases of recent years (Berwick, 2013; Francis, 2013; Keogh, 2013).
My research describes the value of an action-based approach to research and learning in North West London (NWL) NHS organisations, in response to the challenges and recommendations of the Berwick review (2013). This proposed that the NHS should become a system in which leaders create and support capability for continual learning and improvement.
The research is in the form of a first-person inquiry (into my life as the researcher – Reason & Torbet, 2001) and a second-person inquiry (with others, into issues of mutual concern – Reason & Bradbury, 2008) including learning and sharing with others beyond NWL.
This thesis illustrates my experience – as a practitioner inquirer with lived personal experience of being a patient receiving critical care and in active collaboration with other co-inquirers (NWL practitioners and patient representatives) – of working in the complex system that is the NHS: a collective, human, living organism that is non-linear, unpredictable, dynamic and networked over multiple organizational boundaries.
My doctoral research has made a contribution to academic literature and professional practice by evidencing what it takes to operate through relational leadership in the NHS. I offer my view from the inside, capturing the emotional rollercoaster of anxiety, excitement, struggle, messiness and warmth involved and describing the dynamics we experienced. It includes exploration of the less obvious thread that connects race, voice and power to leadership practices, which was a critical part of my personal leadership experience.
My doctoral research demonstrates that nurturing effective use of the voice and power of practitioners and patients not only improves patient safety at an individual level, but also promotes the safety of the wider healthcare system. It does this through enhancing a self-reflective approach in leadership practices and thereby fostering sustainable cultural change.