I was at a North London hospital yesterday accompanying a friend. We signed in at reception, she was called in to her appointment, I could see some patients returned back to the waiting area for a while after a prep session.
So I asked at reception whether I should stay-put to give smiling support to my friend, or go down to the café.
The receptionist answered:
“Oh, I couldn’t tell you about that. We’re not them.”
“Well, how long might she be?”
“No, we’re not them, they’re different and we’re separate.”
It was a Lewis Carroll conversation: the person you are looking to for help is explaining not only that they can’t help you but that they shouldn’t, because they are not part of the group that would be able to help you.
She defined her lack of help through NOT belonging to the department my friend was seeing. She reinforced the internal structures:
“They just lease the space from us.”
Uh? It’s all one NHS hospital, we weren’t in a private wing or external company.
“We’re Surgical. We do day surgery. A whole lot of top specialists doing lots of different things. ‘They’ just do one thing.”
And finally, NON accountability.
She was not accountable for looking after the patients of ‘Them’ beyond signing-in. So, you see, she couldn’t possibly help me.
The problem for this member of staff was sharing a reception service with another department which used to be separate. Though her job is to serve Reception for both units, she feels she ‘belongs’ to the surgical, not the investigative, team. So she refused to do anything beyond the basics.
She was dressed in claret-coloured kit, ‘raspberry scrubs’. (A staff sign said this was required dress code for surgical teams: you get the importance of this now.)
“You need to ask someone in blue” she said grabbing a lady in blue.
“Hello” said the lady in blue
“I’m Esther. How can I help you?”
Esther was straightforward. She told me how long it might take, where to wait (the next room, not hard to point to), to get tea for me but nothing for my friend because Esther was in charge of that.
That’s because Esther is a recovery nurse. She is not a receptionist. It is not her job to look after patients’ anxious friends and families. She is not accountable for this. But she does it anyway, because it makes a difference to her that people feel comfortable about the procedure they are coming in for and the support around them.
The raspberry-scrubs receptionist could have told me all that, in less sentences than the confusing stuff about her Not Belonging to the other team.
OK, it’s not a big deal. Organising people in reception has low level risk.
But it’s a neon-highlighter for how a sense of ‘Not Belonging’ can trounce personal accountability.
In another context, what if Not Belonging, and Not Being Accountable, spreads to an ethical judgement or a safety risk? We’ve seen catastrophic risks in many sectors.
Belonging leads to commitment; commitment means accountability.
Commitment means doing more than basic tasks.
Commitment means relationship more than transactions.
Commitment means looking at consequences of actions.
Commitment means connecting up with other teams.
Commitment means being willing to go further, accepting accountability for follow-through.
But it all begins with Belonging.
“We’re not them, they’re different, we’re separate” sums up why organisations need a clear sense of belonging.
Most organisations are complex, many-layered, a mix of mergers, acquisitions and sub-contracting, old and new departments, specialist teams.
In the minefield of belonging to different territory, the lines of accountability can get mangled.
Each break in belonging is a potential breakdown of accountability, or failure-point for ethics, safety and strategy.
Wherever you fit in, you’re still part of the same goals. Your team, and its particular specialism, interconnects with others. ‘We’re’ all ‘Us’.
And that means having a sense of belonging, a shared ethos on which to base commitment, and clear accountability to uphold it.
Show everybody in the organisation how it all connects, the principles that bind all its communities into one, as well as the particular focus of each team.
In a complex organisation like a hospital, it is interdependence not independence that makes it all work.
In this way, belonging brings the cohesion to achieve effectiveness as well as efficiency.
I asked Esther if it was a good hospital to work in. She answered firmly:
“It is. But do not look at these new buildings and say it is a good hospital. Look at the work, look at the people doing the work. Look at how they work with each other. Then you’ll see: is it a good hospital? It is a good hospital. But that doesn’t mean that everybody in it is good.”
She’s right, and about a lot more than hospitals.
Do your teams feel they belong to the same organisation?
Do your people share accountability?
Talk to us about how to create a sense of Belonging.