Maggie Woods
Leadership Development Team, NHS South
Central
Programme Lead for Leadership, Oxford
Deanery
What we will cover today
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Context
Leadership
Teamwork and leadership
Leadership and change
Two approaches to leadership
So what?
• The NHS sees I million patients every 36
hours, spending 2 billion a week.
• The number of managers is 3.6 % of the
workforce
Source Kings Fund 2011
4
% patients
diagnosed with
dementia
whose care has
been reviewed
in the last 15
months, 200910
5
The number
of people
aged 85+ in
this country
will double in
the next 20
years
6
7
Constants
• Clinical Engagement, GP commissioning
• Relationship with patients, shared decision
making
• Outcome focused to drive delivery
• Independent sector, voluntary and private,
• QIPP challenge
Lets talk Leadership………
Leadership is the art of
motivating a group of people to
achieve a common goal
Kings Fund May 2011
The function of
leadership is to add value
The NHS Leadership Framework
• It includes 5 core dimensions, drawn from the MLCF/CLCF:
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Demonstrating Personal Qualities
Working with Others
Managing Services
Improving Services
Setting Direction
• There are two additional
dimensions
– Creating the vision
– Delivering the strategy
12
Management Matters!
Kings Fund May 2011
Interesting Reading
• Kings Fund report; May 2011
http://www.kingsfund.org.uk/publications/nhs_leadership.html
• The conclusions challenge some of the negative attitudes
towards managers, and questions current plans for major
reductions in management and administration costs.
• The commission believes that the NHS needs to move beyond
the outdated model of heroic leadership to recognise the
value of leadership that is shared, distributed and adaptive.
•
In the new model, leaders must focus on systems of care and
not just institutions and on engaging staff in delivering results.
PEOPLE
+
Outcomes, Activities,
Behaviours
RESOURCES
KNOWLEDGE
SKILLS
ABILITIES
VARIABLES
LEADERSHIP/
MANAGEMENT
ACHIEVE VISION
Poor leadership has a cost, Francis –
what he identified:
• Preventable deaths
• insufficient attention to professional
standards
• a weak professional voice in
management decisions
• acceptance of poor standards of
conduct
• low staff morale - demoralised
• a lack of any systematic approach to
coordinating care
• very poor communication
Team Working and
Leadership
110
108
106
104
102
100
98
96
94
92
90
% Staff Working in Teams
The link between the Management of People & Patient Mortality in Acute Hospitals
West M et al. Int J HR Management 2002 13:8 1299-1310
“Don’t tell people how to do it, tell them what
to do and wait for the results”
General Patton
Employee Engagement (NHS Staff Survey Findings)
Performance
Appraisal
Team Working
Job Design
Supervisors’ Support
Work Pressure
Having an interesting
job
Feeling valued by
colleagues
Employee Reactions
Overall Engagement
Health and Well-being
Stress
Presenteeism
Advocacy
Hospital Performance
Intrinsic Engagement
Quality of
Services
Involvement
Financial Performance
Absenteeism
Patient Mortality Rate
client Satisfaction
Benefits of Team Working
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•
Reduced hospitalisation and associated costs
Improved service provision
Improved levels of innovation in patient care
Reduced error rates
Lower patient mortality
Enhanced patient satisfaction
Increased staff motivation and mental well-being
West, M.A. & Borrill, C.S. (2005). The Influence of Team Working. In Cox, J., King,
J., Hutchinson, A. & McAvoy, P. (eds). Understanding Doctors’ Performance.
Oxford: Radcliffe Publishing.
Team functioning and patient satisfaction
3.3
3.2
Patient experiences
3.1
Clarity of objectives
3
Reflexivity
Support for innovation
2.9
2.8
2.7
Low
Moderate
Team functioning
High
Staff absenteeism
•
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5% more staff working in real teams associated with 0.27% in overall
absenteeism rate (p < .001)
For an “average” acute hospital, this represents a potential estimated saving of
over £1 million per year in direct salary alone
Questions for you?
• Does your team have clear goals/ objectives?
• Who is in your team?
• Do you have regular 121s and feedback
mechanisms?
Leadership and Change Management
Change as a Human Process
DENIAL
Anger
Self
Esteem
or
Morale
Shock
COMMITMENT
Internalising
Realisation
FUTURE
PAST
Depression
Search for meaning
Testing
RESISTANCE
Acceptance
& letting go
EXPLORATION
Time
Adapted from Adams, Hayes and Hopson : Transition, understanding and managing personal change; 1976
• Future, Engage , Deliver, Steve
Radcliffe
• Good To Great, Jim Collins
•Future
•Engage
•Deliver
Help people see the future, create a future that is
compelling, makes best use of their skills. Move from the present.
Engage with people: open & honest conversations. Feedback
Maintain a healthy emotional bank account. Listen and hear.
Be present. Autonomy. Cross sectors/ boundaries
Mobilise the team’s drive for improvement, provide
a sense of purpose, hold people to account, drive for
results and celebrate success so people feel they
have done something important . Make things happen
Good to Great, Level 5 Leaders
• All good to great companies had level Five leaders
• Level 5 = personal humility and professional will
• Modest and safe effacing, motivated to produce
sustainable results, plough horses
• Level 5 leaders; look out the window to attribute
success, in the mirror when things go wrong
• Many people have the potential to be level five leaders
• Most level five leaders come from within their
companies
• Level five leaders, get the right people on the bus…
and the wrong people off the bus, and then figured
out where to drive it
• When in doubt…..don’t hire - keep looking
• When you need to make people change- act
• Put your best people on your biggest opportunities,
not your problems
Create a climate..
• Lead with questions…not answers
• Engage in dialog and debate not coercion
• Conduct investigations without blame
• Build red flag mechanisms to identify essential
information that cannot be ignored
What actions do you need to take to
become the leader that you aspire to
be?
Thank you
maggie.woods@southcentral.nhs.uk