maggie woods leadership development team, nhs south central programme lead for leadership, oxford...
TRANSCRIPT
Maggie Woods
Leadership Development Team, NHS South Central
Programme Lead for Leadership, Oxford Deanery
What we will cover today
• 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
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% patients diagnosed with dementia whose care has been reviewed in the last 15 months, 2009-10
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The number of people aged 85+ in this country will double in the next 20 years
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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
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The NHS Leadership Framework
• It includes 5 core dimensions, drawn from the MLCF/CLCF:
– Demonstrating Personal Qualities– Working with Others– Managing Services – Improving Services – Setting Direction
• There are two additional dimensions – Creating the vision – Delivering the strategy
Management Matters!
Kings Fund May 2011
Interesting Reading• Kings Fund report; May 2011http://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• The commission believes that the NHS needs to move beyond the outdated model of heroic leadership to recognise the value of leadership that is shared, distributed and adaptive.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
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RESOURCES
Outcomes, Activities, Behaviours
ACHIEVE VISION
KNOWLEDGE
SKILLS
ABILITIES
VARIABLES
LEADERSHIP/ MANAGEMENT
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
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% Staff Working in Teams
The link between the Management of People & Patient Mortality in Acute HospitalsWest 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 WorkingJob Design
Supervisors’ Support Work Pressure
Having an interesting job
Feeling valued by colleagues
Overall Engagement
Advocacy
Intrinsic Engagement
Involvement
Employee ReactionsHealth and Well-being
StressPresenteeism
Hospital Performance
Quality of Services
Financial PerformanceAbsenteeism
Patient Mortality Rateclient Satisfaction
Benefits of Team Working
• 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.
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3.1
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Low Moderate High
Team functioning
Patie
nt e
xper
ienc
es
Clarity of objectives
Reflexivity
Support for innovation
Team functioning and patient satisfaction
Staff absenteeism• 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
SelfEsteemorMorale
Realisation
Acceptance & letting go
Testing
Internalising
Time
Shock
Anger
Depression Search for meaning
Adapted from Adams, Hayes and Hopson : Transition, understanding and managing personal change; 1976
RESISTANCE
EXPLORATION
COMMITMENT
DENIAL
PAST FUTURE
• 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. FeedbackMaintain 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?
