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Read the latest blog from Jagtar Singh, Trust Chair

Going Virtual – ‘no going back in the cave...' – reflections of an NHS Trust Chair.

Tuesday 21 April 2020

The impact of the Covid-19 crisis and how Trust Boards have adopted technology to face the challenges of how they continue to function effectively. 

Hindsight is a wonderful thing, so I won’t apologise for using it. Many organisations will have dusted down their emergency plans from previous health crises as an initial defence to the challenges that COVID-19 brought. However not many would or could have anticipated the challenges that the lockdown would present, in particular the lack of familiarity with digital technology. In this article I discuss how the ability to cope with these challenges allows Trusts to navigate their way through an unprecedented crisis but also presents a disruptive opportunity to change the way we work forever.

We have all faced emergencies and situations that test our leadership and our systems in the past but nothing like COVID-19. The national lockdown was an abrupt hard cut-off of how I worked and how my natural style best works face to face with people. Within days I found that most of my meetings had to be conducted virtually. Technology apps that many took for granted became an essential new language within the NHS. At a pace I have never witnessed in my time in the Fire Service or the NHS, adoption of new skills became compulsory and having to adapt rapidly to new ways of working became a survive or die situation. The board’s responsibility of duty of care has never before been tested in the way COVID-19 has challenged. The need to reach every single member of the Trust with clarity, to provide assurance and build confidence, and to ensure their wellbeing and ability to do their job, was never more important.

This is the first of a series of articles that will track my journey during the period of lockdown and beyond. This article provides a personal insight into my experience of going virtual and what this means for future working, as well as some tips on how to cope and help you make the transition. My story demonstrates how quickly individuals need to switch to new ways of working due to external pressures, in this case COVID19. My experience over the last few weeks shows how virtual meetings can be challenging and rewarding in equal measure. However this new world order is now a fundamental way of how we get things done – and is here to stay.

When we are over COVID19 it is my belief that we will not be able to go back to the old ways of working.  As one member of my staff said to me ‘we cannot go back into the cave.’  Virtual meetings will increasingly complement the traditional face to face roundtable meetings and so we must embrace the opportunities that this sadly tragic situation offers. It will be even more tragic if in the end NHS Trusts revert back to how they worked pre COVID-19.  I hope never again will a GP make you wait seven days for an appointment. During the current lockdown, everyone I have spoken to has had a call back from a GP in hours not days. What a great improvement and transformation.

So here are my personal insights into my journey over the last few weeks of how I managed to adapt and cope. They include, after a few false starts, the things I have done to improve my and others’ experiences and to help make meetings more effective, inclusive and efficient. I am sure many of you are on a similar or the same journey of discovery and change. What I have suggested below is therefore not definitive. In fact I would welcome you to share your experiences so please feel free to send them me at and I will update this article and share our collective thinking.

  1. Personalised checklist. This will help you avoid some of the basic pitfalls of virtual meetings. I have highlighted my starter-for-ten below – please help me make this richer by sharing your coping mechanisms. 

  2. Formality and purpose. I have found that it works better if each meeting has some element of formality and structure through agendas, objectives and decisions/outcomes. You may be at home, but remember you are in a workplace meeting. Dress comfortably but appropriately and try not to offer any distractions through your surroundings/background.

  3. Prepare then test, test and test.  I cannot stress this point enough. Being totally reliant on technology there are several things that must be considered before embarking on your first and subsequent virtual meetings until they become second nature.  Even then making the basic checks will help ensure a smooth, efficient and effective meeting.

  4. Be clear and take the lead if you are chairing or facilitating. Not all apps are the same. The way in which invitations and joining instructions are communicated is different in each case. Breaking language down and using ‘Noddy’ joining instructions and navigation guidance, whilst seemingly patronising, does work. Speak to people in advance to instil and ensure confidence.   

  5. Listen and be heard. Body language and other physical signs you can pick up in a face to face meeting will not be evident in the same way. Therefore the need and ability to listen more intently and communicating clearly and concisely is imperative. Remember, if you are using video, your facial gestures will be prevalent more than normal. 

My top tips for effective, inclusive and efficient virtual meetings with multiple attendees:

  • Before the Day.

  • Make sure everyone has the same app and link for the meeting and it works on their device

  • Provide sufficient help and support to ensure the technology works for your attendees

  • Check the link and the technology works on your device

  • Give people clear and simple instructions on how to join the meeting

  • Encourage participants to join the meeting a few minutes before the scheduled start

  • On the Day.

  • If you are the chair or facilitator join early and have your phone close by

  • Make time for introductions (unless it’s a broadcast communications exercise)

  • Clarify the agenda and purpose for the meeting

  • Outline the key protocols of making comments or asking questions

  • Consider appointing a facilitator to keep an eye on chat box conversations and manage Q&As

  • Good practice

  • Be an active listener and show verbal empathy throughout the meeting

  • Ask participants to mute their microphones when not talking

  • Don’t be tempted to fill the gaps of silence

  • Encourage participants to give physical signs of acknowledgement (eg thumbs up)

  • Use the chat box facility to seek agreement/confirmation and/or to raise questions

  • Give everyone attending the opportunity to contribute and input

  • Ensure you have practiced good governance and received good assurance on the key issues and objectives

  • For longer meetings ensure you schedule break points

  • At the end of the meeting summarise the key points, decisions and actions

  • After the meeting provide a summary record of the meeting to all attendees

  • Try to avoid

  • Don’t be too task or agenda led – allow the meeting to flow and people opportunity to speak

  • Don’t run meetings for more than one hour without scheduling a break

  • Long ‘speeches’ from participants or the same participants dominating agenda items 

  • Keep presentations short and digestible

  • Distractions in the background

Finally, on a personal note, I have had to make the necessary adjustments that the COVID-19 challenge has created and I now feel healthier for having to travel less. As a nation, we are lighter on the environment with less fuel consumption and alive to the many benefits of a different way of working. We now have the opportunity to embrace the change that necessity has forced upon us, but is also bringing about a realisation that we can be far more efficient. Only time will tell but I genuinely feel our decision making process is also beginning to become even better and faster.

I do not believe that we should, or that our staff will allow us, to go back to the old ways of working, or as one member of staff said, ‘go back into that cave’

Embrace the change and don’t return to the cave!


Jagtar Singh, OBE, Trust Chair


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