Edition 16 Heath Operations Playbook: The Conversation You Keep Putting Off!


The conversation you keep putting off

If you lead a team in health, you already know the one.

The staff member whose behaviour has been sliding for months. The clinician everyone quietly works around. The pattern that has become “just how they are.”

You have probably had the conversation in your head a hundred times. You just haven’t had it out loud.

That gap is where culture erodes.

In the GRIP Framework, People sits across everything. Your governance, your resources and your insights all depend on people who feel safe enough to speak up, and trusted enough to be told the truth. Culture isn’t set in a values workshop. It is built one conversation at a time.

Most of those conversations are easy.

The ones that matter most are the ones we avoid.

Why we leave it too long

Here is the uncomfortable part. Usually you are having this conversation with someone who has never had it before.

The behaviour has gone on for years. Manager after manager has walked past it. Then you arrive, or you finally find the courage, and you name it. And it lands as a shock, because no one ever given them the feedback before.

Meanwhile, the team has been watching. They know who isn’t pulling their weight. They know whose behaviour makes the ward feel uncomfortable. What you walk past, you permit. And your best people notice that most of all.

Leaving it isn’t kind. It just moves the cost onto everyone else.

Before you open your mouth

The conversation goes better when the thinking happens first.

Three questions before you walk in:

  • What am I actually trying to achieve here? Pick one or two things. Not ten.
  • Who am I meeting? A peer, someone junior, or someone more senior than me? That changes how I prepare.
  • What might be going on underneath? People rarely behave badly for no reason. Hold curiosity first.

Purpose, outcome, and the person in front of you. Get those clear and half the work is done.

How you open sets the tone

One of my leaders uses a line I love. “This is a difficult conversation for me to have, because I respect you.”

It does something clever. It names that this is hard, it signals you are not here to point fingers, and it holds the relationship steady before you have said anything difficult at all.

Be deliberate with your words. And keep the tissues handy. People cry, and you can’t always pick who.

A framework for the conversation itself

If you want something to hold onto when the conversation gets off track, use the BUILD model.

  • B: Behaviour. Name what you saw. Not who they are.
  • U: Understanding. What is going on underneath it?
  • I: Impact. On the team, the consumer, the service.
  • L: Learning. What is the insight for them to take away?
  • D: Do differently. What changes from here?

It keeps the conversation on the behaviour, not the person. That is the whole game.

This framework was recently shared with me and I found it really helpful.

Bring it back to values

This is what stops it feeling personal.

You are not sharing your opinion of them. You are holding the line the team agreed to. Some services run an “above and below the line” exercise, where the team names what good teamwork looks like, and what falls short, and develop a team charter.

When behaviour drops below the line, you are not the villain. You are pointing at a standard everyone signed up to.

“This is how we work here” is a far easier sentence to say, and to hear, than “I have a problem with you.”

The move this week

Nip it in the bud early. The small, kind conversation this week is the one that saves you a formal process next year.

Aim to close without wrecking the relationship. Do no harm. The point isn’t to win. It is to give someone insight into their behaviour so they can change it.

So think of the one conversation you have been carrying around. Prepare your opener. Have it this week.

You will feel lighter for it. So will your team.

Jo Glover
Leadership Coach & Operational Expert in Health
Empowering Health Leaders to Believe, Lead & Achieve
🔗 LinkedIn
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Jo glover

I’m Jo Glover — a senior health executive and leadership coach. I help health operations leaders move from firefighting to confident, calm execution using simple systems for governance, performance, people leadership, and operational rhythm. Expect practical tools you can use this week. What subscribers can expect - * The Health Operations Playbook: field-tested leadership moves for the operational middle, Operating rhythms for Quality & Safety, Access & Flow, Workforce and Finance, Short coaching prompts to strengthen influence, clarity, and decision-making. Templates, agendas, and checklists you can drop straight into your week. Subscribe for practical leadership systems that make health operations feel lighter — and work better.

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