Oliver Townsend, Head of Partnerships and Practice at Platfform and Head of PTS and New System Alliance in Wales, explores the topic of professionalism and the experience of implementing the first PTS Coaching team in Wales.

Professionalism is not a Bad ThingTM, but sometimes professionalisation can be. What is the difference? There’s a lot of research published on this distinction, too much to go into here. But there is a broadly accepted idea that professionalism is how to be efficient, effective, and skilled in your profession – an idea that holds true largely to a similar extent across medical, educational, and social fields.

 A volume of research

Professionalisation appears to be much more contested as an idea, with there being echoes of “control”, or trying to fit people in various professions into centrally set boxes. Although there are often strong arguments made for increased professionalisation, there are also concerns about who is pushing for it, for what reasons, and some of the unintended consequences (1). When engaging with medical students, Phillips and Dalgarno (2) discovered that there was a real tension between professionalization as the “development of physician identity”, and the wish to remain emotionally connected to patients. They note:

“What emerged was participants’ drive to become detached clinicians who set aside emotional responses and interactions that could impede and be incompatible with professionalization. However, participants also recognized and lamented what was lost in such a transformation.”

This is a blog, not a study about professionalisation, but I wanted to demonstrate that there is a significant volume of research out there, discussing these very issues and that this discussion cannot take place in a vacuum.

The Person-led, Transitional, Strength-based (PTS) Response and the challenge to professionalisation

One of the many reasons I am an advocate for the PTS Response is the focus on what people want. PTS Coaches have a relentless focus on the person in everything they do, and it is refreshing to see. In conversations about how to change systems, how to work better, how to make a difference, their mantra is always to listen to the person, to see what they want, what their goals and wishes are, and to do what we can to make that a reality. It often means that traditional tools of professionalisation such as reductive outcomes, disconnected targets, impersonal frameworks (and more!) are stripped away.

It also means (linking back to some of the “control” ideas found in the research), that practitioners, known as PTS Coaches, with the PTS Response are asked to become activists in the system. When I think about PTS Coaches, I always remember this quote from Matt Haig:

“The world is increasingly designed to depress us. Happiness isn’t very good for the economy. If we were happy with what we had, why would we need more? How do you sell an anti-aging moisturiser? You make someone worry about aging. How do you get people to vote for a political party? You make them worry about immigration. How do you get them to buy insurance? By making them worry about everything. How do you get them to have plastic surgery? By highlighting their physical flaws. How do you get them to watch a TV show? By making them worry about missing out. How do you get them to buy a new smartphone? By making them feel like they are being left behind. To be calm becomes a kind of revolutionary act. To be happy with your own non-upgraded existence. To be comfortable with our messy, human selves, would not be good for business.”

This is not to say that PTS Coaches are agents set up to overthrow capitalism (ooh, or are they?), but instead that PTS Coaches are there to be radical activists that aim to make our structures (hollowed out and centralised under the guide of professionalisation) human and messy – empathic and kind.

And this is where professionalism comes in. Because in a world where unrealistic targets are set, or where services are set up to prove effectiveness by almost teaching-to-the-test, where almost all the structures of a system are designed to reduce people to catch-all brackets or categories, you need both a radical, activist’s heart – alongside skill, knowledge and a willingness to learn (and unlearn). It is why I have started calling our PTS Coaches in Platfform “radical activist practitioners” – not all the time, obviously, it’s a mouthful. But I do that because it recognises the high degree of skill, integrity and passion they have in their work to change the system.

How do we create radical activist practitioners without professionalising away the humanity?

For us, we worked hard initially to provide internal training to our PTS Coaches. I am not saying that training alone will create radical activist practitioners – but the way we did it was to give a toolbox of skills and approaches to our Coaches, without mandating anything other than the following:

  • Be kind
  • Be PTS-led
  • Be an activist

By following those three pillars, and using the skills they have, and having access to a range of coaching methods, for example, we gave our PTS Coaches the confidence they needed to work differently.

We also made sure that we provided funding and support for them to access the PTS Qualification through Mayday Trust and Coventry University. I shadowed the Qualification as well, so I knew what was said and so I could support the team of Coaches. This Qualification does several things: it helps people unlearn the old system; it helps people find like-minded activists, so they don’t feel alone, and it provides a structured way to begin exploring the challenges of a new way of working.

We put all our Coaches through this Qualification, and although it can be difficult to balance the workload, it is having a positive impact on the team. It reduces the isolation that you can feel when you are one organisation striving to deliver change – it can provide you with the confidence to forge your own path – and it can give you the knowledge needed to keep yourself going on your change journey.

How have we supported our PTS Coaches and what have we learned?

It is very clear to us at Platfform that our work to change systems needs skilled practitioners – but human ones. To do that, we had to really look at the way we listened to our PTS Coaches. Part of that came in the training mentioned above. But there are also ways we have worked directly with the Coaches that try to create the right space and conditions to gather feedback and challenges from them.

  • Reflective Spaces: We make sure we hold a reflective space every two weeks for the Coaches, with myself and the other Heads of Service, to listen and share experiences as a group, and ask for advice from each other. This is vital in creating the right ingredients for change – sometimes people need a morale boost, or to check-in that they are working in the right way, sometimes they just need to vent about how frustrating the system is. We have all worked very hard to create this as an honest, open space – which has meant me trying not to be proud and stuffy, and to encourage people to disagree. In this way, I often talk about “an expectation to challenge” with our coaches, so they know it isn’t encouraged, or supported, or allowed – it is expected.
  • Light-touch oversight and focused goals: We don’t tell Coaches how exactly they should work, and what tools to use when they listen to people. We trust them to listen and act in a compassionate, human way. But we also stay very focused about the purpose of what we are doing, something Mayday Trust has espoused from the beginning – stay focused on the reasons we are there, on the need to sustain system change. Sometimes that means we all have to be comfortable with some challenge.
  • Kindness: Kindness has become a buzzword, but in this instance, it is much needed. We are all going on a journey, we all need to show kindness towards each other. But it is important to note that kindness doesn’t mean wishy-washy stuff. It means that people can raise challenges kindly, it means we can remind coaches (and they can remind managers!) that our primary aim is to change the system, rewriting the rules so that people’s experience of services is first and foremost, kind. I am sometimes reminded of the “cruel to be kind”, phrase. It has been overused a lot, often as an excuse for some awful behaviour towards someone, and I would never advocate cruelty. However, “honest to be kind”, works better. You cannot have a kindness-led system without honesty and trust at all levels.

These are just three key areas we have worked on, and the PTS Qualification has helped give focus to this work. I am really pleased that we supported this for our team. And I see it as a crucial part of the journey we are making away from the centralised, reductive boxes that professionalisation creates for us all, into smashing them apart and putting radical, activist people who are skilled and ready to walk alongside people when, or if, they are needed.