Jeremy Baskett

New challenges for NHS leaders

Thu 16 Jun 2016

The 2016 King’s Fund Leadership and Management Summit brought together current thinking on leadership and management in health and social care. MiP committee member Jeremy Baskett reports on a thought-provoking day.

The King’s Fund’s sixth annual leadership summit on 25 May brought together a good number of current leaders and managers across health and social care, and included a surprise question and answer session with the health secretary for England, Jeremy Hunt.

The new chief executive of Bart’s Trust, Alwen Williams, spoke about the three key elements any health organisation has to bring together: quality, money and performance. The key to success is to concentrate on all three elements, she said. If you only concentrate on one or two, there is a real chance it will end in disaster.

A common thread throughout the day was that it is essential to really engage staff and energise them into a team. For this, the leader must be visible and accessible, and must ‘hold the line’. In other words, have a plan and take it forward in a measured way and do not get pushed into making “knee jerk reactions”.

Another general theme throughout the day was the recent change in management styles, described by one speaker as a move from ‘hero’ managers, who tried to manage everything, to a ‘coaching’ style where you empower and lead others.

An interesting take was the lessons we can learn from the aircraft industry about managing quality in the NHS. The aircraft industry works with on real time data, and pilots often get a phone call on their return to question data received from their recent flight and are questioned on why they didn’t report any issues that arose. Pilots in industry accept this challenging practice.

Great praise was laid on the Western Sussex Hospitals NHS Foundation Trust, which is one of just three Trusts that have received an outstanding ranking from a CQC inspection. One of the key recommendations the CEO made to others seeking the secret of their success was to work to achieve a small number of between four and ten key metric targets. There are examples of some Trusts which have been struggling to manage as many as 223 targets.

Other key activities and approaches that brought success were:

•    Staff on the frontline know the issues and are the best people to sort them out.

•    Use the Plan-Study-Act improvement model to ensure continuous improvement

•    Keep all staff up to date on performance against the few key metrics

•    Ensure all the staff involved in an improvement plan are involved, including support functions such as finance, HR and IT.

•    Bring in patients and carers to get ‘nuggets’ of information to help develop services.

•    The CEO must be fully engaged and supportive of the process of change, or it will not work.

One helpful comment on brining change was ‘never waste a crisis’: we need to ensure that when the unexpected occurs we use it to bring about change for the better.

There were discussions on leadership for innovation, together with presentations on health care systems around the country, and from abroad –particularly interesting was the one from the CEO of a large American healthcare company on lessons we may be able learn and adapt to improve the NHS.

One of the more controversial and interesting discussions was led by a very dynamic leader who talked about changes required to our health and social care systems being “titanic”. With funding decreasing and public expectations rising, the old ways of resolving cross-organisational “wicked issues” – with practice changing by osmosis within organisations – are not fit for purpose. We need leadership from a single point which crosses organisation boundaries and brings about change within the “Place” to meet service needs.

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