Changing the conversation

Julie Gardner argues that transforming the way we talk to each other could have dramatic improvements for health and social care and more importantly, people.

Let me start by introducing myself. My name is Julie Gardner and I am on secondment with the Training and Consultancy team here at Thistle. Specifically I am part of the ‘Personal Outcomes Partnership’ which is a partnership between Thistle, the Joint Improvement Team and the Health and Social Care Alliance. When I was thinking about how to explain what I do (and what I am passionate about) the phrase that kept coming into my head was ‘changing the conversation’.

Most of us are probably really familiar with the challenges that face health and social care in Scotland: an ageing population, increasing demand with decreasing resources – the perfect storm. We know that we can’t just batten down the hatches and try to keep on course by continuing to do more of the same with less, but in the face of real pressures we tend to do just that – default to what we know, keep on keeping on, and so on. But the cracks are really beginning to show and the realisation is growing that keeping our heads down and waiting for the storm to pass just isn’t going to be the answer. So what is?

My belief is that a key part of the answer is learning to look differently at our situation – learning to ask different questions. It’s about changing the conversations we have with each other as colleagues, and with the people we support. So what does that mean? 

Often our current approach (and by ‘our’ I am talking health and social care across Scotland) is one where we engage with people around what’s wrong – what’s the matter – what they can’t do and our role is to use our expertise to ‘fix’ it. So the conversations we have with people focus on ‘what are you struggling with?’ and ‘how can we help you?’ This puts us into the role of ‘fixers’ in people’s lives and they become the ‘service users’, the ‘clients’, the ‘patients’. The expectation is that we will then deliver a service, an intervention that makes things better, and so more services and support can often be put forward as the answer when they just aren’t. People become passive recipients rather than active participants in this process.

But what happens when we see the person not as someone just with problems, a diagnosis or struggles but as an individual with knowledge, skills, experience, motivation and hopes? What happens when you change the conversation to focus on ‘what matters to you?’ rather than ‘what’s the matter with you?’ What happens when we see our role not as ‘fixers’ but as ‘facilitators’ who will help people to explore what matters to them, and to explore the resources they already have in their lives (their knowledge, skills, experience, community etc.), both within themselves and around them?

The answer is that changing the conversation and with it, the questions we ask unlocks so much more resource, as it allows people to explore what really matters and how resourceful they already are. So then whatever support or intervention we may need to offer is a contribution to people’s lives and not the ‘solution’, leaving the person in control.

For us as practitioners, when we change the conversation there is often a sense of liberation that we don’t need to have all the answers, and also a sense of fulfilment as we see people build confidence and self-belief in their own resourcefulness and in their own solutions.

For us as colleagues, changing the conversations we have with each other can mean that we support each other to explore, recognise and build on our own resilience as we work to strengthen our own sense of being in control and influencing the future development of services in which we work.

The work of the Personal Outcomes Partnership is facilitating conversations across Scotland about these ‘good conversations’ – walking the talk. So here’s an invitation: next time you are talking with a colleague, or someone you support, or a friend or family member see what happens when you ask ‘what matters to you?’ or ‘what are you hoping for?’ – it might just change the conversation in a really interesting way!

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