goals

Grand ideas

I recently filled in an application to speak at an event about children in Care. The form asked me to summarise in a limited number of characters what I would bring to the table as a speaker. I wrote:

We have collected BERRI data on the psychological needs of over a thousand children in residential children’s homes over the last five years, and surveyed and trained over a thousand residential care staff to provide care that is tailored to those needs. We can present what this data shows us, and how we have used it to improve the services that are offered, and commissioning decisions made about children. For example, we have learnt that the level of challenge presented varies remarkably little by age or gender, though the types of needs are slightly different. Some types of needs (eg behaviour, risk) are affected much more by proximal stressors (eg exclusions from school, gang involvement, substance misuse, sexual exploitation) whilst others (eg relationships) are affected more by historic adversity and the nature of early attachment experiences. We can present how staff variables (demographic factors, burnout, empathy, ability to formulate) affect the care they deliver, and how the price and types of services commissioned relate to the needs of the child and the impact they make on the life of the child – if at all!

The government spend a billion pounds a year on these 7000 children, and we have good evidence that by better targeting the psychological needs of individual children they can improve outcomes whilst saving costs.

It struck me when I looked at that paragraph that this was simultaneously a grandiose claim and underselling the potential of the systems we have developed*. I think that tension between over and under-selling what we can do reflects one of the big challenges of being an entrepreneur – seeing the potential, whilst being realistic about the frustratingly slow steps it takes to achieve it. I can see so much that we can achieve, and the way that collecting the right data can help put children’s needs in the heart of commissioning decisions, improving outcomes whilst saving substantial amounts of money but it is very hard to get this information in front of the right people. I’ve tried to speak to politicians, policy makers, experts in the field, commissioners, clinicians, funders and the media. I’ve spoken at conferences, written a book, contributed to policy documents, delivered service improvement programmes in major providers in the sector, I’ve even given evidence before a select committee. But because I try to answer the questions that are asked, I don’t always get the chance to promote the products and services that we provide. And it isn’t my personality to aggressively sell what we do.

Looking back, I think that I believed that if you work out a better way to do something, a technique that saves time or money or improves outcomes for people, then once people knew about it then it would start to gain traction until it became the established way of doing things. I figured that was how we had progressed from horse-drawn carts to steam engines, cars and now electric vehicles, or from papyrus to paper to typewriters to computers to the plethora of voice-activated, photo-capturing, text and graphic app laden smartphones – finding iteratively better ways to solve problems. I knew that sometimes there were two simultaneous steps forward that competed (like VHS and Betamax) and that variables like marketing, networks and budget could influence the choice, but I generally thought that the best solutions would win through. Maybe it is my left-leaning political bias or my hippy upbringing, but I think in my heart I have held onto a naive idea of fairness in which everyone should be motivated to solve social problems, and people should be rewarded for their effort and insight.

I suppose the concept that we live in something of a meritocracy is quite a widespread belief, and entrenched in western cultures, that good ideas will surface and the best people will rise to positions of power. That’s taken a bit of a crushing for me over recent years, as I’ve seen the covert influence of the super-rich and we’ve had several prominent examples of terrible people rising to the top of systems that have failed to keep up with social and technological change, but somehow I am still hoping for the system to right itself, because it feels like society should be a functional meritocracy.

I think it is particularly well articulated in the USA, because they started as a nation of immigrants who created their own society. To quote the American Declaration of Independence, “all men are created equal”, are entitled to “the pursuit of happiness” and will rise to their natural position in society. That sounds like a fair way to run a country, but of course the reality has never quite matched the headlines, given the theft of land and resources from native peoples, the decimation of the natural environment and the evils of the slave trade. But somehow the myth of the American Dream has persisted. First described by James Truslow Adams in 1931, it describes a culture where anyone, regardless of where they were born or what class they were born into, can attain their own version of success in a society where upward mobility is possible for everyone. The American Dream is achieved through sacrifice, risk-taking, and hard work, rather than by chance or the privilege of your pre-existing connections. In Adams’ words it is:

a dream of social order in which each man and each woman shall be able to attain to the fullest stature of which they are innately capable, and be recognized by others for what they are, regardless of the fortuitous circumstances of birth or position

Whilst I can see so many places where people are not starting the race from the same starting line, because of geography, race, gender, religion, socio-economic adversity, sexuality, age, or so many other variables I have clung on to my optimism that if you can work out a solution to a big social problem, or have an idea that can really work to make life easier (and/or make lots of money), then it should be possible to gain traction with it, get key people to support you, and get it to happen. The reality is that so many people who think of themselves as examples of a working meritocracy have in fact been handed a huge head start by their privilege. As we joked the other day on Twitter, all the wrong people have imposter syndrome because it is mutually exclusive with entitlement. It seems that private schools in particular train people to expect to be leaders and wielders of power, as we see in the preponderance of Prime Ministers educated in Eton (and in the irritating arrogance of Lottie Lion and Ryan-Mark in the recent series of the Apprentice). Having attended an ordinary comprehensive, and never having been aware of any negative repercussions of my gender or heritage, it has been quite eye-opening to see that maybe the playing field isn’t as level as it appears, even for someone ostensibly white and middle class**.

One figure that has stayed with me is that of all the money invested into fledgling businesses in the UK, 89% is given to all male founder groups, 10% to founder groups containing men and women, and just 1% to all female founders. I couldn’t find any UK numbers, but the figures look even worse if we consider race, with black women only receiving 0.0006% of the of the $424.7 billion that has been invested into startups globally between 2009 and 2017 by venture capitalists. Those white men probably think they simply have better ideas, but the evidence doesn’t support that, whilst the statistics say they are 89 times more likely to be funded than all female groups, whilst a white male entrepreneur is thousands of times more likely to be funded than a black woman, and will have the confidence to ask for much larger sums of money. Only 34 black women have raised more than a million dollars of investment in the last decade. This doesn’t reflect the quality of the idea or the work ethic of the individuals involved (as meaningfully empowered women on boards increase corporate social responsibility and may have a positive impact on the profitability of the business, and diversity increases profitability). It reflects the stereotype of what the (predominantly white male) funders think successful entrepreneurs look like – and they imagine young geeks from silicon valley who are predominantly white and almost always male. And that sucks.

It might also explain why men in suits with glossy patter are able to sell systems they have pulled out of the air for eight times what we charge for properly evidenced tools that do the same job better. Or maybe that’s just a coincidence. But whether or not the playing field is flat isn’t something I can solve alone, and it is unlikely to be resolved within the timescale that is critical for me to make a success of my business and to maximise the impact I can make on the lives of vulnerable children. That means that, despite how discouraging it is to realise that we are not living in a meritocracy where the strength of the idea is enough to sell it to those who matter, I need to find ways to shout louder, communicate what we do better, and get our message in front of the right people.

Because we are tantalisingly close to having all the data we need to understand the critical variables at play in the psychological wellbeing of children and young people in Care, and which placements and services can help to address them. We have an exciting partnership growing with a group of local authority commissioners that will couple our data with commissioning data, and we are applying for grants to help us to gather and analyse that data across much wider samples. We are also scaling up the previous project we did looking at whether BERRI can help to identify suitable candidates to “step down” from high tariff residential settings into family placements with individualised packages of support. These larger scale projects mean that we will be able to show that the model works, at both the human and financial levels. And with a little bit more momentum we can start making the difference I know we are capable of. The trick is hanging onto the vision of what is possible and celebrating what we have already achieved, whilst having the realism to put in the graft that will get us there. I need to keep pushing upwards for longer than I ever imagined, in the hope of reaching the fabled sunlight of easier progress – even if so many variables skew us away from the meritocracy that I imagined.

 

*I think that’s why I used the pronoun “we” and shared credit with my team, even when I was asked to describe myself as a speaker, rather than taking full credit on my own. This transpires to be a common female trait, and part of the double bind for women where being assertive is seen as aggressive whilst being collaborative is seen as lacking leadership. In fact, many words are used exclusively towards women and highlight how pervasive these biases about women in leadership roles are.

**albeit a second generation immigrant to the UK, with Jewish heritage

Reaching the summit?

For a long time, I’ve had a metaphor in my mind about how it feels to run a small business aiming to change children’s social care. The image is of me rolling a massive boulder up a hill. Progress is slow, it is hard work and I often find it tiring. Even when I rest I have to do so holding the rock in place. At times I feel like I might be reaching the summit, only to see that there is another climb ahead. I sometimes wonder why I’ve taken on this mammoth task, or whether my goals are even possible, but I am stubbornly determined that now I’m so far up the hill I don’t want to give it up. Maybe that is about sunk cost. But I’ve chipped off the worst of the bumps from the rock and got my rolling technique worked out, so I keep telling myself that if anyone can get this thing to the top of the hill, I can. Over the years of my journey I’ve tried to encourage other people to help me to push, so I am not bearing all the weight, but whilst I’ve had good company at times and plenty of encouragement, it has always seemed like the task is mine alone. That has been reinforced by numerous people telling me how I’m uniquely skilled at rock-rolling, even though I know that I was no better than many other people at the start of my journey. In fact I’m pretty sure anyone with some pretty basic skills who rolled a rock for this long could be standing in my shoes.

Of course, that bypasses the fact that I had to be willing to spend a lot of time on this, be resilient in the face of obstacles, and give up other easier opportunities to stick with it. And the fact I had the intellectual, social and personal characteristics to work out how to do this, choose a viable route and make improvements along the way. And it also omits to mention that had I known the real scope of the task would take me over a decade I might not have taken it on at the beginning. On the other hand, perhaps the fact it was difficult enough for nobody else to take on was why I did it. I think those who know me might point out it isn’t the first time I’ve jumped in at the deep end, and that I don’t do things in half measures. I don’t like taking the easy route in life, and if I set myself a challenge I like doing the task properly. I’ve always thought about what I can do to make the most impact, rather than to have the easiest life or earn the most money. I prefer to cut my own path, than to take one that is already well-trodden, and to find a way to enjoy the challenges of the journey.

So here I am, pushing my boulder and feeling like I’ve come quite a long way over the years. I might be deluding myself, but the gradient appears less steep these days. In fact, it feels tantalisingly close to reaching level ground, and I am starting to imagine what it might be like to roll my boulder down the other side of the hill. I’m trying not to be complacent that I’ve reached a point at which the boulder is stable enough not to roll back the way we came up, but people are starting to talk about how this boulder is not just on the level, but given one more push might gain enough momentum to create a landslide that will divert the river to irrigate the lands the local population need to farm. That would be beyond my wildest dreams. I mean, the motivation behind all this is to improve the lives of people who are having a tough time, but to think that it could have impact on the scale some people are now anticipating is mind-blowing. That would mean my big gamble of investing so much time and effort into this project could pay off in terms of impact. In a way that’s the great thing about indirect interventions – that they can make change that ripples out on a much bigger scale. In my boulder metaphor I’m trying to make change not by trying to teach them new farming skills one by one, but by trying to address some of the systemic barriers that impair their life chances, so that they have the opportunity to find their own ways to thrive.

So this blog is a marker of me standing at what I hope might be the top of the hill, and crossing my fingers the gaining momentum part happens. The mixture of hope and uncertainty is stressful to balance. When it’s a bit more concrete I’ll write a bit more, and hopefully I’ll not need a metaphor to couch my cautious optimism in, and can tell you about the actual project and the steps I’ve taken to progress it.

Pushing upwards

When I was an undergraduate psychology student, I found parts of the course curriculum kind of boring. I was interested in human behaviour and experiences, because I wanted to understand how to alleviate distress and increase wellbeing. Unfortunately I was not so interested in the neurochemistry or neuroanatomy that is the underlying mechanics for those emotions and behaviours. I was interested in behavioural ecology, like the evolutionary/survival value of altruism to vampire bats, and its parallels in human behaviour (eg why we have developed a system of rules and punishments to enforce the social contract). But I wasn’t so interested in animal perception and cognition. I found some of the early psychological experiments on both animals and humans to be really cruel and distressing, though I was aware that they helped to progress our understanding of brain and behaviour, and helped us to recognise the need for the ethical considerations we apply to experiments now.

Because I didn’t love the whole course, during the second year of the course I began to wonder whether I had selected the subject on autopilot, because my Mum is also a clinical psychologist (now retired).  A few other life events compounded this lost feeling by lowering my mood generally* and I developed an increasing existential doubt about whether I was making the right choices in my life.  I also wanted to test out my values and the options available to me, so my focus drifted to my social relationships and activities outside of psychology. I became less motivated and didn’t attend all of my lectures, and (despite having previously been quite successful in educational assessments) I got a 2:2 for one module that I hadn’t enjoyed. It was a mark that fairly reflected my effort/interest level, and in any other context it wouldn’t have been a big deal. However, I was gutted because I felt like the whole course would be pointless if I didn’t excel academically, as I was aware of how competitive the path into clinical psychology was. I considered changing course or dropping out, but I couldn’t think of anything I would rather do.

One of the images that helped pull me through that time, was from the I Ching – an ancient Chinese book of wisdom, also known as the book of changes. The basic gist is that you throw coins to point you to one of 64 readings, which can be generated with various variations and additional comments, and (like a horoscope or cold reading or fortune cookie, but perhaps with a bit more zen wisdom) the resulting text is ambiguous and non-specific enough for you to draw relevance to your life situation. The page that I was sent to was called “pushing upwards” and the hexagram was of wood below the earth. The image it described was of a seed below the surface, using all of its stores of energy to push a shoot upwards in the hope that it would reach the light and conditions in which it could grow and thrive. The text explained that to do this is an effortful process, in which you are gambling that this investment of energy will be worthwhile in reaching a goal that might still be out of sight. It describes the heaping up of small efforts to create the conditions in which future success is possible. The seed takes time to unfold into the tree: Although the results are not immediately visible and gratifying, “that which pushes upwards does not come back”. The reading tells you to put in a sustained effort if you want to achieve great things. It reassures you that if you are driven by a deeper sense of purpose (rather than wealth or glory) and willing to learn from wise people around you, you should not fear the path ahead. It implies that in time favourable conditions will help you along. In this way, it says, a person can rise from obscurity and lowliness to power and influence, provided that you make your efforts in a humble, flexible and authentic way.

This was a good metaphor for needing to put in more effort to achieve my goals, and it also reminded me of my core values and my drive to in some way make the world a better place, by improving the experience of other humans who had been dealt a tougher hand in life. Thankfully, as I entered my third year I got together with my husband (who has continued to be a supportive and stabilising influence for more than two decades since) and entered a much happier phase in my life. I also found the modules in the final year of undergraduate much more relevant to my interests, because they were much more closely tied in to the theory and practice of clinical psychology. As a result I started to put in more effort and get higher marks. I also started to gather work experience, and to seek out advice from qualified CPs. Gradually, those efforts paid dividends – I secured an AP post on a research project straight after graduating** and then worked incredibly hard to do that job, write up papers for publication and complete a masters degree by research at the same time, before gaining wider experience in a more clinical role with a different client group and then securing my place on clinical training.

From the moment I entered that third year with that mindset, I enjoyed the rest of my journey into clinical psychology. No matter what the client group or type of work, I felt like I was doing something worthwhile and I was also constantly learning and being challenged. I had some inspiring supervisors, both as an AP and as a trainee. I didn’t love every placement (they were all good learning experiences, but my enjoyment varied depending on my interest in the client group, the style and context of the work, and the amount of travel involved to get there). Likewise I didn’t click with every supervisor equally, but I did learn a lot from each of them. In my first AP role my supervisor was a role model of the true scientist practitioner, who secured grant funding to push forward the evidence base of the clinical work, and constantly published papers and disseminated findings. She pushed me to participate in that world, and with her support I co-wrote six peer reviewed journal articles during those two years! She is still my role model of embodying the link between research and practice in psychology, and I would love to emulate Esme’s energy and influence in my own field of work. I then worked in a project that trained student social workers, and assisted with expert reports on parenting – something I continue to have an interest in to this day. It gave me a much more practical grounding, and an awareness of social care systems that I have subsequently built on.

As a trainee I gained a basic grounding in brief CBT-based interventions in an adult service, and learnt more about the structure of mental health services and working as part of a multidisciplinary team. I also worked in services for people with intellectual disability, where I learnt about the value of indirect work, and gave more explicit consideration to issues of capacity and consent. I loved my core child and family placement, and the warmth, pragmatism and commitment of my supervisor, Patricia, set the tone for the kind of psychologist I wanted to become. I returned to her for a specialist placement to pick up the cases that were more complex, transgenerational or involved child protection issues that I had avoided the first time around. I was lucky enough during that second specialist placement to also have the opportunity to work one session a week into an NCH Action for Children project for child and young adult survivors of sexual abuse. There I was reminded of the value of human connections over any academic knowledge, as well as having the opportunity to use Cognitive Analytic Therapy for the first time. I also did a specialist placement in a child development service, with some work into a sexual abuse team – including working with children who had survived abuse and co-facilitating a group for mothers whose partners had sexually abused their children. I learnt more about complexity and systems, and some healthy cynicism about organisational change. I still remember the chart for the new tiered model of services pinned up on my supervisor’s wall, with ovals that widened at lower tiers, entitled “the shape of future services” to which he had added a handwritten subtitle “is pear-shaped”.

When I qualified I was torn between a post with the favourite supervisor I had spent two placements with and one that several people warned me was “burnout waiting to happen” working in child protection. After a long discussion with a good friend I concluded I wanted to continue to challenge myself, and also to put myself where I was most needed. I therefore took the latter post, and worked in a split post across CAMHS and child protection. I learnt from a fantastic supervisor how to work in complex systems and services. David also taught me how to be an expert witness for the family court. The balance between being down-to-earth, approachable and yet grounded in knowledge and theory, as well as the clear communication under pressure gave me another role model of the type of psychologist I wanted to become. He taught me to ask the uncomfortable questions, and to balance holding empathy for parents with speaking up for the best interests of the child. Then in my longest standing post, I learnt from another fantastic head of service to think about process in supervision, how to bring fun and creativity into my work, and also to pick my battles! I also did a lot more collaborative work, and got involved in service development and audit, as well as gradually stepping up to greater supervisory and management responsibility. In that post I had the benefit of working with an inspiring social work team manager who had been doing really innovative work to increase access to permanent placements for older and more complex children. I also went out to America for a couple of weeks to train with Dan Hughes, where I learnt about the power of being present in the intersubjective space, and became more willing to show my own vulnerability and emotional reactions.

I have also learnt from less positive experiences – the times where I got it completely wrong, or unintentionally triggered negative responses in others. For example, I remember an AP I supervised feeding back disliking that I had introduced her to colleagues as “my AP”, intending that to be as supportive as I had perceived it being when I had been an AP myself, rather than as indicative of any claim of ownership. I remember crying when criticised in a multi-agency meeting about the autism pathway, and realising too late that it had been a bad decision to come into work that day whilst my house was flooded and I didn’t have enough emotional resources for work. I still cringe looking back on one time I tried to be supportive to a junior colleague who had to give evidence in court, but ended up making myself look stupid and inhibiting her ability to impart her observations in a useful way. I recall the challenges of having to raise concerns about how a colleague’s homophobia might have a negative impact on service users, and how they justified this being part of their cultural and religious identity. I remember the camaraderie, but also the pressure of working within a big system, feeling responsible for protecting more junior colleagues from organisational changes, worrying about waiting lists, and defensively managing referrals.

Most of all, when I think about negative experiences, I remember how gutted I was when my wonderful employing organisation lost the competitive tender for our service, and how horrible the initial meeting with the new service directors and managers at our new employing trust was. It started with a gloating talk from the new clinical director, and him taking digs at our senior staff about how some people in the room might think they know how to run CAMH services, but clearly he new better as they had won the tender. The jokes about how nobody need worry about their job security, except the consultant grade psychologists, as “you are quite expensive and we haven’t figured out what to do with you yet”. And the patronising response of the service director to my questions about whether the plan for my service section in their tender specification was fixed: “If you think you can do better, cheaper, love, knock yourself out”. I remember the pressure to rewrite the service specification and job plans for my team whilst my kids were in neonatal intensive care, and to take on various tasks to compensate for the fact they hadn’t appointed a locum to cover my absence. I remember my team being left out of the accommodation plan entirely whilst I was on maternity leave, and after protesting, returning to an undecorated, unfurnished office without internet or telephone points (or mobile reception) that could only be accessed by swiping out the fire exit across two flights of stairs, then swiping into another wing of the building and going down to the furthest end of the corridor. I remember being told to income generate or face temporary staff on my team being made redundant, and then being told that I was allowed to neither quote nor invoice as I wasn’t a budget holder. I remember being promised time off in lieu for all that I did during my maternity leave, but then being denied this on my return as “we can’t pay you full-time pay for part time work, no matter what you did in the previous financial year”.

I remember the day I walked out of a meeting with an operational manager, out of the building, out of the car park and down the road, and felt like I could keep walking forever and never go back. In the end I walked across town to my previous base and talked to the directorate manager there, who made it feel less personal. Over the following weeks I sought out some personal therapy through Occupational Health, and picked apart what was me and what was the toxic system around me. Then I decided to take a career break and spoke to HR to confirm that I would be able to continue my self-employed activities during a career break without this being considered “taking up alternative employment” and blocking my right to return. I also wanted confirmation that I would return on the same grade to the same client group. I always joke that the HR lady I spoke to should never play poker, because as I told her my reasons for leaving her face gave away too much. I watched her non-verbally say something along the lines of “oh shit, we’re in trouble here, pretend we’re not, pretend we’re not” before casually raising the option of redundancy and a gagging contract***.

So I had to uproot and push upwards into new an unfamiliar soil. Initially I applied for other NHS jobs, but ended up withdrawing before interview for one and declining a job offer for another, because I wasn’t prepared to work in another toxic culture. In the end I used my expert witness work as my parachute, and figured I would work it out as I went along. I changed from being a sole trader to a limited company so that I could employ an AP. I felt like I had been gradually dehydrated by the conditions I had worked in until I was just a husk of myself, and as I started doing my own thing I found some rain I started to find my own shape again. At first I used my own business to try to achieve what I had hoped to in my NHS career independently. As I have said in previous blogs, I helped set up a parenting charity, but felt the political agenda of the founder wasn’t consistent with the clinical goals. I secured funding for, designed, managed and evaluated a service to support people with diabetes, but ultimately it wasn’t commissioned. I set up a psychology service within a social care provider, and trained staff all across the country, but whilst I enjoyed the work I didn’t enjoy spending so much time away from my home and kids.

The challenges have continued, as I have had to foster my entrepreneurial side and learn the skills to run a business, hold a budget and manage staff. I’ve found new ways to disseminate knowledge – through being on committees, doing policy work, and writing for different audiences in my book, practice journals and on social media and this blog. I’ve developed ways to use technology to improve services, and I’ve returned to doing research. I’ve had to be flexible enough to try new things until I’ve been able to find a way to work that feels authentic. This blog documents much of that journey.

Through it all I have never been bored or complacent about my work. I’ve always enjoyed finding new challenges, and new ways to apply psychological knowledge. I have always found that my work provides moments of flow – that sense of deep and satisfying immersion in the present moment to the exclusion of everything else, that you get when you have sufficient agency and skills to meet a challenge, and feel a sense of reward from doing something well or contributing to something worthwhile. By comparison with so many people who do repetitive, boring or physically challenging work, I feel a great deal of gratitude that I earn my living doing something that is so varied, with so much autonomy and opportunity for enjoyment. Thankfully I have always been able to find sufficient challenge and novelty in how I work, along with sufficient freedom to satisfy me. And there have always been new human puzzles that intrigue me, and the varied settings and ways of working that I have experienced each involve looking at what I have to offer afresh and customising what I do for the new context.

 

So here I am, running my small business and trying to establish the use of structured needs assessments and outcome measurements in children’s social care. Once again, those themes of pushing upwards are back, as I have been putting in a big investment of time and effort to nurture this project over many years in the hope that it grows into something productive. Now that I am more established and have a mortgage to pay, plus rent on my office and employee salaries it feels like a bigger gamble than early on in my career where I had little to lose. But I have that same feeling of clarity about where I want to make my impact in the world that I did when I decided clinical psychology was for me after wavering as an undergraduate. I also have the same faith that my cumulative efforts will eventually be repaid with positive outcomes and a move into easier progress. If I go back to the image of the seed growing underground, I’d like to think that the journey through the earth has been completed and the new shoots are now reaching up into the sunlight where they can be replenished by energy from the external elements. I know as a gardener that with good planning and regular nurture the slow growth of seeds sown over winter can quickly turn into the rapid growth of spring and summer. I can only hope that I’ve done enough to establish my new plants and all this effort comes to fruition soon!

*My landlady decided to sell the house I was renting (despite having agreed I could stay on there in my third year), so I had to find an alternative place to live. My Dad was tested for prostate cancer. And I experienced the second incident in this past blog about rape culture in which I felt at risk of rape.
** Before you say “it must have been easier back then” I would note that I got that post against 110 other applicants. So even in 1995 things were pretty competitive, and probably more effortful as we had to find job adverts in the BPS appointments memorandum booklet that was posted out with the Psychologist magazine, phone up for an application pack, and then post in a hand written application, as NHS jobs didn’t exist and internet based application systems had not been invented yet. Which makes me feel very old.
*** A legal “compromise agreement” that included terms saying I would not tell people why I was leaving or speak negatively about the trust from which I departed, and could not take legal action against them – terms I understand are pretty common in that situation, but the government has subsequently outlawed after bad publicity, as they can be seen as an attempt to silence whistle-blowers.