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GenerationQ is not just about leadership and quality improvement theories. It’s about leaders as individuals and the day-to-day conversations and actions which they chose to engage in and perform. It’s about the complexity of how it all fits together, in both theory and practice.

I started my GenerationQ journey in April 2010, reasonably proud of my leadership achievements as a medical director of a primary care organisation and of an innovative social enterprise, which had opened four new ‘Darzi’ GP practices in just nine months. In my application I wrote that I wanted to develop the ‘technical know-how … to achieve more in time-pressured environments’.

While the programme has certainly given me lots of technical know-how, in both improvement methodologies and change management, more important (for me) have been the gentle prompts and coaching for me to understand ME, and the ways in which I relate to those I seek to lead. Quoting from our core texts: leadership 'is what happens between people in a particular moment or situation' and asking 'How am I making sense of my own and others' participation?'.

As I developed skills and enthusiasm for personal reflection and studied theories of organisational development, I reached a defining moment of realisation about myself that enabled me to quite fundamentally rethink what I was best equipped to offer to our organisation, and therefore what my role should be.

While my instincts for exploration and innovation were valuable in setting up our social enterprise, a colleague who could bring more stability to the team of GPs was better placed to lead them through a period of consolidation. My colleagues agreed and I switched my role to a non-executive one and have since been seeking to encourage other board members to similarly develop their leadership through self-reflection.

Our Action Learning Sets (ALS), which consist of six fellows and a faculty member, have given us the opportunity to bring issues and problems to the group, to be ‘listened to, supported and challenged to think [about] issues from new perspectives, to pay attention to [our] own part in the problem and come up with fresh ways of approaching the problem’. Reflecting on our first year together, almost all of the issues raised have involved relationship difficulties that we have been dealing with as leaders, many very personal to us.

Following our recent ALS meeting and in writing my penultimate assignment, I’ve been reflecting on how poor the level of personal connection often is between senior leaders in our organisations. How can we possibly hope to improve the quality of NHS services if leaders don’t respect and trust each other more?

My reflections on our ALS meeting, alongside conversations with other colleagues, have led me to a further defining moment in my leadership journey. Having started to research ‘relationship theory’ I’ve been impacted by the teachings of Hedy Schleifer. While most of Hedy and her husband Yumi’s work is focused on couple therapy, they also apply their theories to help organisations alter their culture ‘to create an atmosphere of emotional safety for you and your staff’.

Central to Hedy and Yumi’s work is the concept that in order to better connect we need to suspend our own emotions and ‘cross the bridge’ to the other person’s world. They draw attention to the emotions in the ‘space’ that we share with colleagues, which can lead to conflict (explosions) or withdrawal. As I work on my current GenerationQ assignment examining my relational leadership skills, I’m noticing opportunities for me to cross the bridge whether chairing a meeting, coaching a colleague or engaged in a conflict situation.

I heartily commend GenerationQ to those interested in taking the time to reflect on their own leadership contribution. For example, GPs who are accepting the government’s invitation to help lead the NHS (post reform) will find the teaching and coaching invaluable in understanding why so many might wish to resist GPs taking such a significant role.

Tim is a GP with special interest in urgent care and substance misuse, a director of Hope Citadel Healthcare Community Interest Company, and a GenerationQ Fellow.

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