If I were to ask you this question directly, your knee jerk reaction may be, ‘Of course, why else would I work with them?’.  But for many of us, this question raises some uncomfortable truths.

Yes, I may have ‘competency-based trust’ in my colleagues. I know they are capable of practicing safely, have good clinical knowledge and go above and beyond in the care of patients. I also know they are honest, good upstanding citizens and unlikely to nick my car…

But do I really trust that I can speak up, raise difficult issues with them, give them some feedback about the way they behaved in that meeting, challenge a decision they have made about a patient or disagree with something they have done? AND that our relationship will be totally fine afterwards?

Do I know that they always assume I have a good intention towards them? Do I know they will forgive me if I get it wrong or fail at something – even if I should have known better?

This is a different level of trust – vulnerability-based trust.  It is what makes teams work – or not. It is a key ingredient of psychological safety – essentially a climate in which people, ‘are comfortable expressing and being themselves…in which they are comfortable sharing concerns and mistakes without fear of embarrassment and retribution and…they are confident that they can speak up and won’t be humiliated, ignored or blamed.’ Amy Edmondson, The Fearless Organisation.

Unless we have this sort of trust within our teams, we are effectively trying to drive a high-performance car in first gear. The team won’t even be the sum of its parts, and certainly won’t be able to conflict and disagree well, which will lead to artificial harmony, lack of commitment, accountability and ultimately poor results.

One of the major reasons why PCN Directors and other leaders in healthcare struggle to get projects off the ground is an absence of trust in the team between the individuals from the different practices or organisations.

Teams with high levels of trust and good psychological safety have less medical errors, better outcomes, more engaged staff and better performance, so building trust in your team should be a priority for any PCN Director. The problem is that so often we focus on tasks and processes rather than building relationships and trust. Whilst doing a task together is a good way of beginning to build trust (if you do it right!), neglecting to work on the relationships can have dire consequences and can de-rail the whole thing.

So how do you build trust within your teams?

• Really get to know one another. This doesn’t actually take too long. It is possible to make a deep connection in less than a minute if you ask the right questions. Show genuine interest in the other person (and then remember their answers!). Find some ‘uncommon commonality’ (perhaps you have children at the same school, or you’re both origami enthusiasts) or something about their past that shaped them and affected them deeply. Don’t forget to create times where you can have informal interactions (admittedly much harder online – it can be done but you’ll have to plan it more).
• Model vulnerability. Tell people when you’re worried about something, share where you’ve made mistakes and ask for help. Self-disclosure is a powerful way of building a deep connection with people and it shows you trust them if you’re asking for help.
• Assume good intent from others. Assuming that someone has your best interests at heart and that they are saying that thing because they are genuinely concerned, want to learn from mistakes, make things better and that they care about you too is a powerful mindset and the basis of psychological safety. It will allow teams to address all sorts of things in a non-judgemental, open and curious manner. It will help people speak up, recognise problems and challenges before they happen and save a whole load of hassle and heartache.
• Seek first to understand before giving your opinion. Not only will you build trust but you’ll come across as wise too.

Leading teams in healthcare is ultimately about people, not about process. Focus on building trust within the teams in which you work and you’ll reap the rewards several times over.

For more about how to build trust when working across teams in practices and networks, check out the brand new BONUS spotlight course from Ben Gowland and Rachel Morris  ‘How to work together across practices and networks: 6 mistakes leaders in healthcare make and how to avoid them’ available free to you when you join the Resilient Team Academy – a membership for busy leaders providing monthly Deep Dive Masterclasses, ‘done for you’ team resilience building activities, teaching you how to use the Shapes Toolkit coaching and productivity tools with your teams and giving you a likeminded community of peers. Find out more here.