Posts Tagged 'NHS leadership'

CQC – Safety is in the hands of real leaders!

Mike Attwood has spent 26 years as an NHS Leader and is an accredited coach and editorial advisor for the Journals of Integrated Care and International Leadership in Public Services. He is also a member of the LeaderShape NHS specialist faculty.

He responds to the latest Care Quality Commission (CQC) report here:
imagesThe CQC report shows safety is still a major concern with 13% of hospitals, 10% of adult social care services and 6% of GP services rated as inadequate.

Importantly, the body identifies a need for creative, selfless leadership (rather than more technical expertise and knowledge-based solutions) and outlines three key factors that play a critical role in shaping quality services:-

1) Engaged leaders building a shared ownership of quality and safety

2) Staff planning that goes beyond simple numbers

3) Working together to address cross-sector priorities

The report places a major focus on the culture of engagement that leaders need to create far more than it stresses the formal governance processes to underpin systemic, high quality care – vital though those are, of course. This aligns with LeaderShape’s long held belief that great leaders reach out selflessly beyond their own expertise and egos to acknowledge fears and uncertainty (particularly facing today’s public services.) Leaders act as catalysts to harness the creativity and new ideas that intractable environments desperately need, to break out of the old controlling, failure-based action plans.

NHS “turnaround” regimes have been alive – but not well – since at least 2000, under many different guises. The response to CQC inadequate ratings needs a new, engaging, collaborative approach – local organisations must work together locally and the “centre” itself should seek to move beyond its critical role of judge and jury towards something more empowering.

All too often as leaders we can come from a place where we confuse true engagement with sharing our own expert message and communicating what teams need to do to improve. We can fall into the trap of merely broadcasting rather than “listening to hear” the real concerns of patients, front-line teams and partner organisations. Only by striving to listen will we unlock the new creativity and ideas that undoubtedly exist beyond ourselves.

For too long we also have tended to appoint NHS leaders to run their own institutions, leaving them to struggle and fall when the challenges they face are really whole system issues.

Perhaps now we are seeing a new wave of bravery in places like Cornwall and Greater Manchester where leaders have gained a new emotional and psychological understanding, beyond their undoubted intellectual prowess. They see that collaboration between organisations and citizens requires them to value deeply the very fact that they don’t have a monopoly on expertise; a world of ideas is out there for them to draw on.

Professor Keith Grint’s work on Tame and Wicked problems is illuminating. Wicked problems are intractable, multi faceted, riven with disagreement and not amenable to linear problem solving.

A clear example of a wicked problem is safety of care. Should we publish clear standards manuals and audit compliance? Should we accept that we will simply overspend and ramp up staffing levels? How can we expand staffing if not enough nurses are being trained? How can we openly acknowledge that safety is a problem whilst persuading the press we need proportionate, challenging journalism, not universal doom and gloom?

As the NHS Leadership Academy takes its new place within Health Education England, it too needs to consider deeply how more time, space and focus on creating selfless leadership can be built into its commissioned leadership programmes. Is it prepared to work ” out there” with real health and care systems like Cornwall on culture and collaboration?

Critically too work is needed at the centre to mirror selfless leadership beyond ego. What are the Civil Service College and others doing to support and challenge national leaders in the Department of Health, the CQC itself, NHS Improvement and NHS England? Will these institutions be brave enough to challenge their own cultures? Local NHS organisations and local authorities can helpfully resist an understandable temptation to criticise “up” and instead reach out to help the centre shift its perspective.

We sometimes do see signs of a desire for a more collaborative approach from the core but all too often we still see turnaround and “success” regimes imposed. In September 14% of NHS CEO jobs were either vacant or soon to become vacant.

The CQC lays down a considered leadership challenge. It is now time for them – and the NHS at national and local level – to find the selflessness to lead differently – and by example.

See LeaderShape Director, Duncan Enright’s original thought leadership commentary on the CQC report here

Thinking like a patient, acting like a taxpayer, behaving like an emotionally intelligent leader

THE NEW NHS England CEO, Simon Stevens, is a breath of fresh air. He is offering new perspectives on the challenge to leaders, and one key message, recognised by the Nuffield Trust, is the need for organisations to work across boundaries, and to abandon a top-down approach in favour of establishing new models of care that work locally.

This is demanding for board members – how can you get the right sort of change while devolving decisions about that change? The answer Simon Stevens offers, and he is right, is to develop “values-based leadership” to create a climate conducive to the right sort of change. This will take emotionally intelligent leaders, and a questioning and challenging board, working in the interests of the public and not within organisational silos.
See Simon Stevens’ speech to the NHS Confederation here

And we have provided the response from the Nuffield Trust also.

The LeaderShape Faculty has worked with many boards and directors in the NHS to develop leadership and build strategies, so please get in touch on if you would like to discuss these issues with us.


Duncan Enright, LeaderShape.


First for NHS 360 Degree Facilitation

Greg Young LeaderShapeLEADERSHAPE IS DELIGHTED to announce that Chief Executive, Greg Young, has been confirmed as a facilitator for the new NHS 360 leadership assessments – the first of a cohort of just 50 people who hold this new accreditation in the UK.


The NHS Leadership Academy website explains:
Bringing the Leadership Model to life and helping people use it in their everyday practice is enormously important. Research into 360° feedback has shown that the provision of quality feedback from a coach or facilitated session plays a crucial role in encouraging managers to accept results of their assessment and initiate behavioural change.

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The way we manage ourselves is a central part of being an effective, (and what LeaderShape would call a transpersonal) leader. It is vital to recognise that personal qualities like self-awareness, self-confidence, self-control, self-knowledge, personal reflection, resilience and determination are the foundation of how we behave. Being aware of your strengths and limitations in these areas will have a direct effect on how you behave and interact with others.

Whether you work directly with patients and service users or not, this can affect the care experience they have. Working positively on these personal qualities will lead to a focus on care and high-quality services for patients and service users, their carers and their families.

Continue reading ‘First for NHS 360 Degree Facilitation’

Developing a New Generation of Financial Leaders at the West Midlands Pension Fund

“Due to my heavy workload I would sometimes feel that I could not justify the day out of the office (for this leadership and culture change programme) however on each occasion I returned to work refreshed and positive.”120THE £9 BILLION WEST MIDLANDS PENSION FUND (WMPF) is the largest in the UK. It has over 257,000 members and 300 scheme employers. Its assets are primarily managed in-house by investment professionals. It is facing unprecedented change because of the planned reforms of the UK pension industry and because of the declining and increasingly competitive traditional market. LeaderShape was called in to help Chief Pensions Service Manager, Nadine Perrins, manage the restructure of the organisation and the performance and development of it people to meet these changing needs. WMPF had been very traditional in its directive style of leadership and career progression based on longevity and favour, rather than merit. A major gap existed between the leadership experience of the Senior Management Team (several of whom were in sight of retirement) and middle-managers who had mostly received development in technical and business skills. The leadership style and culture of the organisation needed to become more inclusive and engaged with its employees in order to improve performance in a rapidly changing market.

Read the full Case Study on this major, successful piece of work.

We are pleased to report that, when asked “would you recommend this programme to a colleague?” 93% of WMPF participants said “YES”

“This was an excellent development opportunity which should be offered across the Pension Service as it would enable managers and staff to learn more about the impact they have on peers and colleagues, which would contribute towards changing the culture of the organisation!”     Testimonial from in-house review.

Developing Public Health with County and District Councils

“A simple methodology to unlock possibilities and energy, when people are struggling with budgetary doom and gloom’’

by Cllr Michael Bamford and Cllr Diana Kersley

A few months ago, we wrote about the pilot between Suffolk County Council, Babergh and Mid Suffolk District Councils and the Suffolk Public Health team. We are delighted to provide an update on this very successful project, which offers a framework for other two tier areas.

Public Health in Suffolk made an early transfer to the County Council. Embedding Public Health in Local Government gave an opportunity to achieve greater collaboration and coordinate focus on health and wellbeing. It also allowed time to understand different contributions, including those of the District Councils.

We wanted to build a framework to make the most of what each organisation had to offer and reduce inequalities in health and wellbeing. Like all public services, the change came at a time when the service was also coping with significant reductions in capacity; finding a way to help communities do more for themselves

Continue reading ‘Developing Public Health with County and District Councils’