West Midlands Public Health Practitioner Development Scheme
Leadership and collaborative working to improve population health and wellbeing
Rachael Cox, Andrew Hood & Nicola Wright (Specialty Registrars in Public Health)

AIM: Overview of the application of management theory including leadership, individual and team development, change and performance management • Outline the various management models and theories • Critically discuss management techniques for the individual and team development and partnerships • Critically discuss the application of evaluation, audit and standard setting to improving quality • From feedback: address conflict resolution and day to day management issues and leadership experiences

1. Who are you?
Local Authority Other Other Local Authority Health Improvement NHS - Health Improvement Total responses = 12 Non Clinical Clinical Non Line Manager Line Manager

2. Awareness of management tools 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Myers Briggs Belbin Jung formally assessed taken part in aware never heard of

3. Your current duties and tasks 4 2 0 12 10 8 6
Total respondents = 12

4. Your interests for today....
Theories of leadership and management Practical methods for improving management and leadership Developing strategies for dealing with other people’s styles
0%
Managing workloads where partnerships/ different priorities exist
20% Least Interested 40% Interested 60% Quite Interested 80% Most Interested 100%

Feedback from the 2011 session

Methods for understanding your management and leadership style Working with teams: What makes a good team and performance management for improvement, conflict resolution Successful partnerships: opportunities and challenges and managing change

Styles and attributes of leaders and managers Exercise One: Famous Leaders

• Very quick and dirty: four questions • No indication of intelligence, suitability or potential

Four questions with two different descriptions of personality "preferences”.
Try to answer as you really are, not how you may wish you were, or have to be at work.
http://www.personalitytype.com/career_quiz

. Talk more than listen Think out loud Act, then think
E
Can sometimes be easily distracted Prefer to do lots of things at once Are outgoing & enthusiastic
Extraverts' energy is directed primarily outward, towards people and things outside of themselves
Listen more than talk Think quietly inside your head Think, then act
I
Have good powers of concentration Prefer focus on one thing at a time Are self-contained and reserved
Introverts' energy is primarily directed inward, towards their own thoughts, perceptions, and reactions.

Focus on details & specifics Admire practical solutions Notice details & remember facts
S
Like to use established skills Like step-by-step instructions Work at a steady pace
Sensors notice the facts, details, and realities of the world around them. They tend to be practical and literal people, who trust past experience and often have good common sense.
Focus on big picture & possibility Admire creative ideas Notice anything new or different
N
Prefer to learn new skills Like to figure things out themselves Work in bursts of energy
INtuitives are interested in connections between facts and their meanings. They tend to be creative, imaginative, theoretical people who trust their hunches.

Make decisions objectively Appear cool and reserved Convinced by rational arguments
T
Are good at seeing flaws Are motivated by achievement Argue or debate issues for fun
Thinkers make decisions based primarily on what makes the most sense and what is logical. They tend to be analytical, and are convinced by logical reasoning
Decide based on values & feelings Appear warm and friendly Are most convinced by how you feel
F
Are quick to compliment others Are motivated by appreciation Avoid arguments and conflicts
Feelers make decisions based primarily on their values and how they feel about the choices. They tend to be sensitive, empathetic and strive for harmony.

What environment makes you most comfortable?
Like to have things settled Take responsibilities seriously Pay attention to time, usually prompt Work first, play later Seek closure
J
See the need for most rules Like to make & stick with plans Find comfort in schedules
Judgers prefer a structured, and fairly predictable environment, where they can make decisions and be settled. They tend to be organised and productive .
Like to keep their options open Are playful and casual Less aware of time, may run late
P
Question the need for many rules Like to keep plans flexible Wants freedom to be spontaneous
Perceivers like to keep their options open and are comfortable adapting. They tend to be flexible, curious and
nonconforming.

ISTJ Inspector ISFJ Protector INFJ Counselor INTJ Mastermind ISTP Operator ISFP Composer INFP Healer INTP Architect ESTP Promoter ESFP Performer ENFP Champion ENTP Inventor ESTJ Supervisor ESFJ Provider ENFJ Teacher ENTJ Fieldmarshal

Bayley et al (2004) The good mentoring toolkit for healthcare

“The NHS needs people to think of themselves as leaders not because they are personally exceptional, senior or inspirational to others, but because they can see what needs doing and can work with others to do it” (Turnbull James, 2011)

The Good
• Components of a successful team • Diagnostic tool
The Bad
• Managing poor performance and conflict • Improving services

What do you want from:
• Team of directors • Your department • Your operational team How you behave: do you need to adapt to each team?

Developing an Understanding of how your Leadership affects Others

A (brief) introduction to avoiding conflict managing poor performance, and improving services Staff: Performance management Services: Audit

**** ADD ANDREWS SLIDES HERE****

Your organisation: Policies & procedures, training, HR Documentation: One to ones, agreements, job descriptions, letters and emails Your skills: professional, motivational, patience

Principles for Best Practice in Clinical Audit NICE (2002)

• Balanced scorecards • Key Performance indicators • Service Improvement Find out more: www.institute.nhs.uk

“Teamwork is the ability to work together toward a common vision. The ability to direct individual accomplishment toward organisational objectives. It is the fuel that allows common people to attain uncommon results” (Unknown)

Share some case studies....
• Opportunities and Challenges • Tips for managing change in successful partnerships

Health Services Management Centre - Uni of Birmingham Working with community groups, voluntary bodies, other public sector organisations, businesses, patients, members of the public or groups of staff
• Change or improvement is achieved through inclusive partnership working • The scale of achievement could not have been made without the contribution of partners • All organisations have made a significant contribution to the achievement of the aims of other partner organisations that has benefitted the local community

Co-operate: Partners may share information. No joint planning, resources are kept separate Co-ordinate: Partners will do some planning together. Sharing and responsibilities, resources and risks Collaborate: Organisational changes so that there is a higher degree of shared leadership, control, resources and risk sharing

NHS: lead organisation for the development of sexual assault services for victims together with the police

....and....

• Physical Activity Strategy due for renewal 2010 • Usually led by PH and the PCT • Originally asked to do the narrative • Actions and outcomes needed to come from the providers of service – what could be measured, what would be an improvement etc

• Quarterly meetings with floating attendance from 8 organisations • Attended either by lowest grade member of staff due to time commitments, or ‘the figurehead’ • Low grade staff – unable to influence and engage higher levels re strategy or data collection • The figurehead – never gained buy-in across the organisation as they were the ‘doer’ • 2 years later – still no actions/outcomes identified by provider organisations

• No one organisation can deliver the strategy • Needed buy in from all organisations • Group discussed operational rather than strategic issues • Repetitive minutes !!!
• Standing still between meetings • Cycle of non-attendance, repetition, nil action

• Common vision • Objectives are aligned  • Added value • Willing to make changes  ?
• Facilitate partnership working  

• Mutually accountable • Understand and respect differences  ?
• Deal with conflict and frustration  • Communications are sufficient & effective  • Sharing of contributions, risks & rewards  • Equal say 

Structure fits its purpose  Roles, responsibilities & contributions clearly defined  Objectives, targets & milestones are set and owned  Adequate resources  Project management and co-ordination ?

Continuously seek improvements Review the partnership Seek to learn from each other Use strengths and talents Manage the changes ?
 ?
 

• A good thing to do, but nobody’s priority • No decision maker (s) • No overall responsibility for partnership’s delivery • Being done for appearance’s sake • ? Used as a talking shop and ‘woe are we’ • A breather from the day job

Survey to:
• Identify strategic & operational leads from each organisation • Whether PAS is a priority for the organisations • What could be done differently/better • Results to go to Health and Wellbeing Board • Board to clarify if a priority • Potentially, this Board will then provide leadership and accountability focus.

Managing change through effective partnerships • Scale of change: NHS wide, local, team • Responses to change • Stakeholders: Public, colleagues, organisations • Signposting: Tools for managing change

Tools for Managing Change
Change Management Toolkit
• Force Field Analysis • Communications Plans • Stakeholder Analysis http://www.fsdnetwork.com/ “Thinking Differently” - range of practical approaches and tools to fundamentally rethink pathways of care and service delivery.

• Your style • Team • Partnership • Thank you • Evaluation forms

rachael.cox@nhs.net
nicola.wright6@nhs.net