Failing to ask a question

In June 2015, I wrote a blog about the importance of asking the ‘right’ questions as advocated by Dr Atul Gawande. He writes in the context of medicine. Recently, failing to ask a key question cost me several hundred pounds and gave me an insight into the potential consequences of separation of functions in a large company. 

Foolishly, in hindsight, I wanted to avoid a small fee for moving my broadband and landline with the same provider to my new house. The sales consultant found a way to do this. I failed to consider that my move might be delayed. He did not explain the costs should this occur. In the event, I moved out nine weeks before I completed on the new house. The answer to the question would have been that I would be billed all the usual costs, despite no longer owning that house. 

This result became apparent 6 months later when hundreds of pounds were direct debited from my account. I did not see an statement or invoice. At least six phone calls later, at my cost,  I understood better what had happened. A key factor was the apparent complete lack of communication between the sales team and the billing team. The billing team continued to charge me for four months when, under their rules, I was no longer liable. I did achieve some refund but no manager agreed to speak with me despite my registering a complaint. 

My analysis of this scenario is the lack of communication and understanding between the sales team who set up new lines/broadband and those responsible for invoicing may have significant financial consequences let alone reputational risk. Some management theorists call this relationships that of ‘internal customers and suppliers’. This telecommunications company would benefit, in my view, from investment in the relationships and communication with internal suppliers/customers. I have learnt that seeking to save a relatively small amount of money can lead to a much bigger loss, if I do not understand the whole picture. I will work harder to ask the ‘right’ questions in future.

Recognition of the impact of understanding the values, priorities and needs of other roles and teams in an organisation from your own improves the working of systems and processes as well as professional relationships. This in turn supports the achievement of agreed outcomes. For example, as a university Head of Division, I quickly realized the value and importance of working collaboratively with the Admissions Team, the Finance Team and with colleagues in Human Resources. Taking time to understand their perspectives and responding promptly to requests led to the best relationships possible with my ‘internal suppliers’. 

This message also applies to the Hospice UK ‘Hospice Trustee: what you need to know’ one day masterclasses for trustees, which I lead. The understanding between the Board of Trustees, who undertake their governance role and the Chief Executive and the senior team, who have responsibility to manage the hospice is key to working together successfully to achieve the aims and objectives of the hospice. It is part of the consultancy role in organisation development.

 

On January 9 2017, The Prime Minister pledged that every secondary school in England will get free mental health training, over three years, and improved support from local health services. 

This mental health training will be delivered by Mental Health First Aid UK. It will aim to ‘make school staff better at spotting signs of mental health problems in pupils.’ Her speech at the Charity Commission recognised that “help and support for children and young people with mental health problems would be needed to prevent untreated conditions blighting lives”. On 17 January, the education secretary, Justine Greening, writing in The Times, said the government also wanted to see schools get “the best support” from their local mental health services, “so children needing help can get the right treatment as quickly as possible”. Steps to ensure this promise did not include additional funding. It will be backed by the Care Quality Commission and Ofsted” and will also include new trials to strengthen links between schools and local NHS mental health staff. In addition, Ministers have pledged a review of child and adolescent mental health services across the country, which will take place in the spring and inform a new strategy due to launch later this year.

The crucial need for funding was highlighted by Russell Hobby, the general secretary of the National Association of Head Teachers, who ‘welcomed the focus on children’s mental wellbeing, but said it would “fall short” without proper funding, especially in the face of cuts to school budgets.’ 

This pledge meets a recommendation in the Children’s Rights Alliance for England (CRAE) recent publication State of Children’s Rights 2016 which assesses progress towards meeting the concerns and ‘Concluding Observations’ of The UN Committee on the Rights of the Child when they examined the compliance of the UK Government to the Convention on the Rights of the Child in 2016. Recommendation 4 in Briefing 7, Health, of this report is: Training about mental health for staff working in schools should be improved to better equip them in responding to the needs of students facing mental health and emotional problems.’

CRAE states: ‘It’s crucial that the Government uses the State of Children’s Rights 2016, alongside the UN Committee's Concluding Observations, to urgently identify what actions it will take so that all children can have a happy and fulfilling childhood and the best start in life.’ (Briefing 1, Executive Summary, p3)  It will also be used to inform strategy development, campaigns and funding bids by organisations working with children and young people.

Despite the commitment of the last three governments to attaining parity of recognition and funding between physical and mental health needs, the UN Committee highlighted that the promised investment of £1.4 billion (until 2020) in CAMHS (Child and Adolescent Mental Health Services) is being delayed and failing to reach the frontline services where it is badly needed. CRAE recommends that this sum is ring fenced for local authorities. The year on year cuts to local authority funding have contributed to a ‘postcode lottery’ in mental health provision for children and young people. Young people’s rights are not being met consistently across the UK. ‘28% of children referred to CAMHS in 2015 were turned away – increasing to 75% in some areas. Nearly 60% of children were on a waiting list, with many forced to wait an average of 100 days.’ (Briefing 1, Executive Summary, p 9) 

My personal interest, in addition to my professional commitment,  in the rights of children and young people, has been raised and sharpened by the very recent arrival of my first grandchild, who is also the first of his generation in my wider family. A visceral emotional response has been added to logical, thoughtful research and discussion as this new relationship begins to affect the rest of my life. I will keep a keen look out for the new strategy for child and adolescent mental health services due out later this year following the review of CAHMS.