Book your course with confidence

Wednesday, 12th January, 2022

Peace of mind

Doctors are feeling the impacts from the pandemic’s Omicron wave in a variety of ways. It all means that your working patterns and family responsibilities are prone to change at short notice. At the same time, the skills and behaviours we develop through our courses are essential for getting us through the immediate difficulties and for moving forward. So education must continue and we want to make sure you can book your course with confidence.

What if I have to change my booking?

If you are unable to attend a course for any reason related to the pandemic, then we will transfer your booking to another date, free of charge. We will do this even when this is at short notice, as long as you contact us beforehand. This over-rides our normal Transfer & Cancellation Policy section of our Terms & Conditions until the end of February 2022.

What safeguards are in place when I attend a course?

Virtual Training Room courses:

The majority of our courses are currently scheduled for our Virtual Training Room. This means you can participate and interact with your tutor and other doctors for the safety of your own home. We have redesigned many of our courses activities and significantly reduced delegate numbers to ensure you have an engaging, enjoyable and worthwhile learning experience.

In-person courses

Over the coming months, we have number of in-person courses scheduled for London, Birmingham, Manchester and Glasgow. We ask all delegates attending these events to wear a mask when moving around. We also ask everyone to observe good hygiene and social distancing at all times. To make this realistic, we have reduced maximum delegate numbers and redesigned the course activities.

If circumstances change and mean this is no longer viable, then we will change the course to run in our Virtual Training Room. This will be a last resort as we realise anyone choosing in-person has a preference to learn that way. We will contact you at the earliest opportunity if we have to make such a change. You will have the choice of attending the Virtual Training Room, changing to a different date or having a refund.

Online Courses

Our broad range of online courses offer you the chance to learn on your own, at your own pace. You can revisit the material as often as you like over the duration of your subscription. This means they are unaffected by any uncertainties over availability for dates, travel or meeting other people. We’ve also recently revamped our Online Career Development Collections. These enable you to make considerable savings when purchasing multiple courses while broaden your learning experience.

Next update

We will update this page during the first week of February 2022 or if there are any further developments before then.

What are the long-term risks of chaos?

Warning triangle

The immediate impact of the current chaos is fairly obvious. It means best practice is often no longer realistic. Even good practice is challenging. In fact, doctors are often functioning in the world of novel practice, having to create new solutions to new challenges. Unfortunately, this plays into the hands of the mavericks and feeds the problematic subcultures identified by the GMC pre-pandemic. The divas take centre stage. Conflict leads to factions forming. Those who are liked or revered are often excused or even enabled in their shortcomings. And it’s not difficult to find groups who are embattled or becoming increasingly insular.

Falling short of standards and results expected by yourself and others is stressful. This increases the risks of individual errors, burnout and system failures. In turn, they feed absence rates and people leaving the healthcare professions, resulting in an ever growing vicious circle. Leadership typically becomes more directive, more top-down, meaning the smaller voices go increasingly unheard. And that’s just the short term impacts.

But what about the long term risks?

A recent podcast by the KingsFund discussed the risk of doctors losing sense of what good care looks like. It’s a common human reaction that when we fall short or keep being disappointed, we start to expect less. The longer this goes on, the more it becomes the norm. So, we could be on a path toward accepting lower standards and shortcuts.

We form a new habit when we repeat a behaviour often enough that it becomes our default response to a situation. As time goes goes on and we continue to repeat the pattern further, our habits becomes more and more deeply entrenched. They even take a firm hold when they conflict with our desires and values. This process is accelerated when we are surrounded by others who are experiencing the same situation and reacting in the same way. Although we may be aware of this for a while, we can easily slip into “unconscious incompetence”. Habitual behaviours are triggered by an endless array of cues – some obvious and some not. When they take root, they can persist long after the original driver for the behaviour is gone.

Now consider the doctors who have taken on their new roles during the pandemic. Many of them will never have had the opportunity to experience high standards and best practice in the first place. How will they know what good practice looks like?

From emergency to recovery

It’s going to be tough for everyone to move forward from the repetitive strains resulting from this latest pandemic wave. So, good leadership will be essential to get through the coming months. It can be argued that it will be even more important for getting through the pandemic’s aftermath and for achieving stability. All healthcare professionals will have a role to play in this and can’t start preparing early enough.

The pressure and creativity of the emergency phase will inevitably be followed by confusion and regression. We can’t take for granted that we will easily recover to regain and improve on previous standards. The journey from novel practice, through emerging practice, then good practice, re-defining and re-establishing best practice will take deliberate effort. The leadership styles correctly employed in the emergency may become yet another bad habit. But people behave differently in different contexts. So, versatility in approach will be essential. Good planning and organisational skills will also be required, as will good teamwork.

What steps are you taking to be ready to participate in the journey out of the chaos?

Stephen McGuire – Managing Director

How can you lead if you don’t have the answers?

“Everyone’s looking to me. They expect me to know what to do. But I’ve never been in this situation before. They must think I’m a fraud. Why should they trust me with anything? Why would they listen to me or do what I ask them to. I’m not good at this……”

We’ve all been there. We have a moment of uncertainty. Imposter syndrome rears it’s ugly head and our confidence wobbles. Sometimes, these feelings last a few moments, then we move on to other challenges and regain our composure. At other times, we carry our anxieties over one awkward situation to the next. When this happens, it’s all too easy to slip into a problematic downward spiral of self-doubt.

Lessons from sport

Here’s a hypothetical question. If you were the world’s best footballer, tennis player or sprinter, how do you improve from there?  If you’re Usain Bolt and have ran faster than any other human being on record, how can anyone tell you how to get even better?

The worlds top athletes typically depend on other people for help with this challenge. They surround themselves with and listen to coaches and mentors who help them think. Consider, for example, Serena Williams, Lionel Messi or Simone Biles. Their coaches and mentors could never come anywhere close to replicating their amazing achievements. But what they do have is the ability to help these superstars figure things out for themselves.

Relating this back to your world as a doctor, you don’t need all the answers to be able to lead others. You don’t need to be the best at everything. You only need to know how to help others perform at their best.

The challenge for Medical Leadership

Psychologist and author Dr Merete Wedell-Wedellsborg has described how the best leaders are “willing to tolerate frustration and not knowing, and accept and handle uncertainties.” They “create energy from inventing the future and experimenting and finding the answers together. This requires a shift in leadership style from crisis management, which calls for a fast, top-down, unequivocal style, to explorative leadership, which is more open, inclusive, and nuanced.”

It’s true that an emergency situation benefits from an expert who can direct everyone with clarity and confidence. That comes from experience. But, as a doctor, the endless possibilities of context, individual patient presentations and reactions to interventions mean that no-one can prepare you with all the answers in advance. What they can do is to equip you with the ability to think for yourself, to know when and how to interact with your colleagues.

Modern healthcare is delivered in teams of professionals with diverse skillsets. So – rather than being the oracle who knows what everyone should do in every situation – the real challenge for medical leadership is to enable others to become capable, independent critical-thinkers. The challenge is to become skilled in engaging people in learning conversations.

What steps are you taking to improve your coaching and mentoring skills?

Stephen McGuire – Managing Director

Who is your mentor?

Take a moment to think of the journey you are on. Where have you come from, where have you been and where are you going? Think of the bumps, the tough climbs and the wrong turns. Think of your achievements, discoveries and realisations. Now, who helped you on your way? Who has been your mentor? Perhaps you are or would like to become a mentor to others and support them on their journey?

Doctors should always be on a journey of learning, growth and improvement. Yet, you can only learn so much in lecture halls or in books. So, everyone benefits from having a mentor to help them on their way. But such a multi-dimensional journey of growth covers numerous domains of knowledge, skill and practice. That means we should probably amend our question. Who have been and who are your mentors?

Now, did they all approach the challenge of supporting you in the same way, or were there significant differences? If your answer is the latter – and you either want to be a mentor, or a better mentor than you currently are – then you really need to be able to answer another question.

What actually is a mentor anyway?

When we ask delegates on our courses to describe their mentors we regularly receive a broad range of very different responses. Some share their experiences of the teacher who has willingly shared their knowledge. Some talk about the person who provoked them and challenged them to figure things out for themselves. Others recall the more experienced person who gave them opportunities and were on hand to intervene whenever necessary. And some fondly remember the experienced person who was always available to answer their questions and share their own stories. We hear about formally appointed mentors and structured programmes. We also hear about the mentors who are simply willing, helpful colleagues and have been on a similar journey.

Who’s right? Well, they all are of course, and that’s part of the problem. All too often, descriptions and explorations of being a mentor go into the subject without a clear, tangible definition. Even when they do, they often focus in depth on one approach to mentoring without paying attention to the potential breadth.

That’s why we’ve based our new Mentoring Skills Online Course for Doctors on a multi-faceted model which is easy to remember and to use.

So, whether you want to become a mentor, or you want to be a better mentor, what do you mean by that? How are you going to make that happen?

Stephen McGuire – Managing Director

How political should a doctor be?

Doctors have been more visible on the UK’s political stage over the past year than ever before. We have all regularly tuned in to broadcasts with Chris Whitty and Jonathan Van Tam in the full glare of the television spotlight. News media carried endless reports of challenging conversations taking place behind closed doors. Meanwhile, various members of SAGE have popped up across a whole range of topical discussion programmes. Senior healthcare leaders have played an essential role in addressing the pandemic. But, as we slowly return to normality, just how political should a doctor be?

What do we mean by “political”?

When we think of politics, it’s easy to think of the big parliamentary parties. They are all about to enter the annual pantomime phase of their conference season. In an ideal world, this would be where their various members gather together to debate the big issues of the day, reach a consensus and define policies for the way ahead. Sadly, these meetings have typically become major stage-managed events. Speakers aim to deliver headline-grabbing soundbites which are more for the general public than discussion with the audience in the hall. They’ve become forums for publicity rather than debate. In keeping with the general population, involvement in such events is probably only for those doctors who feel strong allegiance to one of these parties.

But let’s consider “politics” in the broader sense. Consider it as the set of activities associated with decision making where individuals or groups have different interests. These decisions relate to defining priorities, timelines, ways of working, distribution of resources and much, much more. In that sense, we all have political interests.

Political hot topics for doctors

Scanning current general news media reveals a broad range of topics affecting doctors. Digging into the medical press then brings these issues into sharper focus. There are numerous decisions to be made. Inevitably, some are more emotive or tangible than others.

Take, for example, the case of tobacco giant Philip Morris International who are currently trying to buy a pharmaceutical company who make inhalers for £1.1bn. Is it ok that we could have a huge organisation making massive profits from both selling the products which inflict harm and treatments for the resulting disease? is it ok that the NHS will end up paying a tobacco company for treatment. Many readers will hope our Government intervene in some way. Yet this may feel like an issue that is a bit distant from your daily practice. It’s an emotive situation, but for high-level decision makers to deal with.

Potentially much closer to home is fact that the BMA has recently adopted a neutral stance to assisted dying. It’s a big shift in position and one that’s been made to reflect the differing opinions of its members. Legislative change here could have a huge impact for you, your patients and their carers. Alternatively, you may feel the current status quo is unacceptable. So, you may want to make sure your voice is heard in that debate.

Then, there’s our challenge of finding a way out of the pandemic to a new normal. How will we re-organise our systems and make good use of the recent increase in funding? How will healthcare and social-care actually integrate? Who will make these decisions? This requires decisions at every level, from the top of Government to the teams you work with. So who will make them? How can you realistically become involved in shaping the future?

Getting involved

The start point is to be well informed, then stay informed and up to date. Next, it’s about recognising how and where you can make a difference.

In simple terms, our NHS and social care systems are made up of groups of people who serve groups of people. Each of these groups are made up of individuals. Decision makers need to hear opinions and ideas from the individuals involved and people affected. So, we all need to ensure our voices are heard in the right way at the right time by the right people. You may not get your own way, but at least you will have tried. Better that than being a passive passenger, swept along and at risk of finding yourself adrift. At the end of the day, that’s politics.

What are you doing to ensure you are informed and that you voice is heard?

Stephen McGuire – Managing Director

Why bother with organisation values?

UK health and social care organisations now all typically boast their own defined set of values. They proudly list them on their websites, stationary and notice boards. Leaders refer to them during presentations, in newsletters and other communications. They tell us how good and caring these organisations are. But now consider them against the backdrop of numerous news stories, independent reports and the daily reality of being an employee or patient. Bullying; sexism; burnout; problematic sub-cultures; patient complaints. Take your pick from these issues, and more, because they all make regular appearances in these blog posts and beyond. David Oliver makes some very good points in his recent column in the BMJ: “When organisations’ behaviours betray their value statements.

The problem with organisational values

As human beings, we each develop our own unique moral code and guiding principles. They are informed by our personal life-experiences and beliefs. For some of us, this might not go much further than experiencing a simple gut feeling or niggling voice in the back of our minds when things aren’t right. For others, who have taken the time to consider the matter, this could be a set of written values. In the best cases, these are consciously used to inform decisions or to review actions. But we are all unique.

Organisations and teams benefit in many ways when members commit to common ideas. So the obvious step toward improvement is to define values as guiding principles and communicate expectations. If we know what we want to be then we can check our behaviours against this. We can also hold each other accountable and celebrate what we do well. These are fundamental elements of functioning as an effective team. It sounds like it should be straightforward – but how do you take the individual nuances in beliefs of numerous people and create something that is meaningful to everyone?

The reality is that we often end up with words which are a weak dilution of anything meaningful. David Oliver describes how these value statements often end up as “generic platitudes that no one could disagree with as principles.” “We act with dignity”; “are collaborative”; “inclusive compassionate” and “based on individual needs.” But, given the challenges and constraints which employees face on a daily basis, are these expectations realistic ? And what’s the point of spending time defining values if behaviour that’s at odds with the stated principles regularly goes unchallenged? In addition, each and every one of us can interpret the same set of words in our own personal way.

So are values statements a waste of time?

Well, if organisations create them to tick a box, or if people don’t even try to live up to them, then the answer has to be “yes”. But David Oliver’s closing paragraphs point the direction toward making them well worthwhile:

I’d challenge all readers—myself included—to go back to the organisations or health economies they work in, look at their value statements, look at the NHS constitution, and ask themselves, “Do we even believe in what we’ve signed up to? How much of this do we really live up to in practice? And how could we get a bit closer to delivering on it?”

David Oliver – BMJ, September 2021

And it’s that last question which is perhaps the most important one. None of us are perfect. When we each define our personal values, they are aspirational. They are what we want to be now, and in the future, regardless of the challenges we face. When we fall short, we remind ourselves of this and take steps to redress or do better in future. In this respect, organisation or team values are no different.

When well-considered, well-written and utilised, they are effectively goals which tell us what we want to be and provide direction. They should be used to inform decisions, to challenge and to hold each other accountable – even if they are inevitably generic to some extent.

How do you use your team and organisation’s values on a daily basis?

Stephen McGuire – Managing Director

Imposition or investment?

“A big political moment.” That’s how the BBC’s Laura Kuenssberg described the lead up to the recent announcements about changes to funding the NHS and social care. The systems are now being given a significant headline grabbing cash boost. Considering the scale of challenges we are facing, there are very few voices who oppose that. But public systems are ultimately paid for by taxes and decisions related to our tax system always divide opinion. Yes, we should all pay our fair share. But, when it comes down to it, what’s fair?

The complexities of public funding

Income tax, National Insurance, VAT and Capital Gains are just a few of the methods our government uses to collect cash to spend. As an NHS doctor, the fact that you pay into the public purse and, at the same time, are paid by it can heighten the conflicting emotions connected to these questions. It feels great when you and your colleagues are awarded a salary increase you deserve. But you then find you are to be taxed more in order to fund NHS pay-rises and additional staff, along with improved facilities and treatments. At the same time, you may see cuts to other public services which you care about and want more to be done in those areas.

Big questions

Our democratic model means we empower our government to make decisions on our behalf. That’s fine when things go the way we want them to. On the other hand, it can be infuriating if and when our collectively elected representatives hold different views to your own. Ultimately, regardless of political persuasion, we have to answer some big questions. For example:

  • How much are we willing to spend on our public services in general?
  • How much of that do we want to spend on health and social care?
  • What’s the balance between each person paying for our individual needs versus supporting our relatives, friends and neighbours?
  • Should we all contribute the same or should those who can afford it pay more?
  • How do you work out who can afford what?
  • If there’s a limit to what we can or are willing to contribute, then what do we spend less on if we want to spend more on health and social care?

And then there’s perhaps the biggest question on this subject of all. Are taxes an imposition or an investment?

Having an impact

Like many things in life, making decisions about taxation, public spending and government policy related to accessing services is likely to be beyond your control. But that’s not to say that you have no influence beyond your occasional opportunity to cast your vote. Your opinion matters. Everyone’s does. But, as a doctor, your opinion can count for more. People will take heed of your opinion as long as it is informed, considered and aligned with your everyday actions. A society’s collective opinion is shaped by individuals.

If you are to be a proactive participant, then it’s important that you have a good grasp on who’s who in terms of the various organisations which collectively make up the health and social care systems. You will understand how the money flows in a general and be aware of the conflicting demands which come into play. You will be able to engage in discussions around topics such as the pros and cons of big surgical hubs versus providing access to care which is close to a patient’s home. And you will be able to not only recognise waste or inconsistency, but to work with others to address this. Influence and genuine change comes around through numerous moments of everyday medical leadership.

What steps are you taking to learn about the system and the part which you can play in it?

Stephen McGuire – Managing Director

New teams, new faces, new places?

It’s that time of year again. The sun is shining; the flowers are flowering – and, all across the UK, teams of doctors are in a state of flux. You may be fresh from university and taking up your first post. You may be moving to join a new team in a new location to start your next rotation. Or you may be settled in your role but surrounded by new faces. It’s an annual ritual and a challenging experience for all concerned. But the past couple of years have been unique in countless ways. So, will this August and the following months be a fresh start? Or will they be just another iteration of the cycle where age old problems are repeated?

The same old problems?

The normal stresses and strains for doctors have been dramatically amplified by the pandemic. Unfortunately, stresses and strains affect our moods, behaviours and our communication. Our behaviours and communications then have direct impact on the people around us. In any given year, you never have to look far to find the latest reports about bullying, toxic bickering or burnout in the medical professions. So, should we expect more of the same? Should we expect worse? Or do the changes to teams, faces and places create opportunity to break this cycle?

It’s worth pausing to consider a key message from Dame Clare Marx’s recent resignation letter from her post as Chair of the General Medical Council.

“When I look back on my career, I remember how I was treated. In my happiest moments, I felt respected, valued and listened to. I felt I belonged.

In a service short on time and short on resource, there is no excuse for being short on kindness and politeness. We are in control of how we treat each other. Our behaviours determine the success of our working relationships, with both colleagues and patients.”

Dame Clare Marx, Chair of the General Medical Council

The big question is, how to break free from the past and make this fresh start?

The solution?

As human beings, communication is at the heart of everything we do. Whether good or bad, it defines our social experience, our identity in the eyes of others and often makes the difference between success and failure. Good communication is also a fundamental ingredient for developing a successful team. So, we can’t afford to let it be taken for granted. Regularly taking a pause to reflect with fresh input is as essential for this skill as it is for any other clinical knowledge or abilities.

What are you doing to improve your team communication skills?

Stephen McGuire – Managing Director

What to do about the ever-changing team?

It’s fairly common for teams of doctors to be in an almost constant state of flux. It won’t be long before the next cohort of students leave university and join the workforce. That coincides with the regular rotations for doctors in training. Summer also (hopefully) means time off for holidays. Then there are vacancies created by ongoing career progression movements. Any temporary gaps created are filled by locums, who may be with your team for days, weeks or months.

These changes create challenges for both the doctors taking up new posts and the teams they are joining. There’s a lot to learn, meaning it typically takes time for new personnel to get up to speed. So, efficiency drops. Then there’s the question, “How do I trust people I don’t know?” It’s a stressful time for all concerned. Experiencing this again and again can feel like you are going round in circles. It’s hard enough trying to maintain standards and performance. Even harder making improvements. In fact, such constant transition risks creating a downward spiral if you don’t manage it properly.

Increased stability may seem desirable. However, these regular transitions are the reality of our system. So, the question is, how to turn these interruptions to our advantage?

Preparing for team changes

First of all, it helps to acknowledge the fact that none of this is easy. Giving someone a well structured welcome to your team takes dedicated effort and time. You know it’s important, but there are many conflicting demands. So, it can be tempting and quicker to simply do a task yourself. That’s easier than taking time to provide the information or support for the new joiner. But that means you’re working harder and under even more pressure. In addition, they will take longer to get up to speed and to play an active role. Everyone benefits if you learn how to prioritise and to delegate well. These fundamental skills help you make decisions – what to do yourself and what to pass on? – and ensure you make your choice for the right reasons.

An opportunity mindset

Next, it’s useful to adopt a mindset where you see both leavers and joiners as opportunities. At the very least, it’s your opportunity to ensure you do it better than the last time someone joined or left!

With the person leaving, you can review their experience in the team through honest conversation. What do we do well? Where do we need to improve? What should we stop, start and continue? Listening to their opinions is likely to help you clarify where you need to focus your energies.

Now, let’s turn our attention to the person joining your team. Consider what they need to become an effective team member. We explore this on both our Essentials of Medical Leadership & Management and our Advanced Team Communication Skills courses. What information do they need? What resources? How will we ensure it’s all available to them? Who do they need to know? Pondering these questions often reveals changes or clarifications which would also benefit your current team members.

Then, once you have new new team member in place, there’s another useful headline question to explore.

What can we learn from the new team member?

A new team member should provide you with a fresh perspective. This can be the case whatever their level of level of experience. So, you can take advantage of this. What are they noticing about working in your team? What have they observed in terms of patient care? How easy is it to work with the systems and processes that are in place?

Empowering your new joiner with ownership of their welcome plan encourages a proactive attitude toward becoming an effective contributor. Discussions around their observations and needs can then take place both formally and informally. This means everyone getting involved in creating the latest version of the team and building for the future. Such an approach creates solid foundations for an ongoing improvement spiral – spiral where joining your team becomes increasingly easy. And that accelerates the process for your future new colleagues becoming effective team members.

What steps are you taking to make it easier for doctors to join your team?

Stephen McGuire – Managing Director

If not now, when?

Let’s expand this blog post’s heading a little. “If not us, who? If not now, when?” Sound familiar? This phrase has seeped into popular consciousness over the years. Who asked this first? Ivanka Trump? Obama? Robert Kennedy? Hillel the Elder? Well, it doesn’t really matter. We should consider these questions now, more than ever.

Our experiences of the global pandemic forced us to take a critical look at our systems. We’ve recognised both strengths and flaws of our health system’s structures, their processes and the multitude of people who constitute the workforce. We can see things more clearly than ever before. We all want an efficient, properly joined-up healthcare system which is truly integrated with social care.

The initial stages of the crisis initiated an incredible burst of energy, creativity and flexibility. We have all revisited our values and priorities, everyone from politicians to healthcare professionals and the general public. It’s been a sobering and exhausting experience.

Here’s another useful quote to add to the mix:

Never let a good crisis go to waste.

Again, it doesn’t matter whether it was Kissinger, Churchill or Machiavelli who said this first. These are wise words. The open-mindedness and momentum generated by high pressure situations often create opportunity. So, great leaders grasp such moments and channel peoples’ energies toward constructive, sustainable change.

However, there’s a predictable stumbling block that we encounter. People cannot function at such high intensity, at maximum and over-stretched capacity indefinitely. Our bright ideas often turn out out to be overly simplistic when points we haven’t considered begin to surface. Knee-jerk reactions and quick-fix plans often turn out to have serious flaws when they face the test of time.

This means that crisis is typically followed by feelings of regression. Yes, we want the new normal, to get to that better place. Yet exhaustion, disappointment and complexity start taking hold and tighten their grip. So, recent headlines such as “Exhausted doctors seek respite before further NHS reforms” are not unexpected. These reports follow the BMA’s response to the Queen’s Speech to parliament, the annual event outlining the Government’s agenda for the forthcoming year. Plans for major reforms of health and social care systems were included this year.

The politicians have a tricky balance to strike here. No-one wants sweeping change at a time when they are struggling. But, at the same time, there is real risk that we lose the momentum and drive required to make the improvements that should be in everyone’s interests.

Closer to home

It’s unlikely that you have much influence over restructures – unless you are in a very senior position, or politically active. It will be a while before there are any direct ramifications for you. So, let’s consider your recent experiences and current situation. Think of your own role and your own team. What have you learned over the past year? What needs changed?

If you don’t take action on these points then you risk losing traction. However you cannot drive change without considering the people who work with and for you. Merete Wedell-Wedellsborg has described how emergency and regression are followed by recovery. Great leaders need to take people with them, supporting people through the journey or emergency, regression and recovery. So it’s essential to learn and refresh the skills required for this. Effective, sustainable change also requires solid management of projects which are both well designed and well executed. Are you prepared for this challenge?

So, if you can see the need for change, pause and consider:

If not us, who? If not now, when? Don’t let a crisis go to waste!

Stephen McGuire – Managing Director