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24th September 2012 

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In tune 

News and Comment from Roy Lilley
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I tipped you off last week. I said all I could. I knew it was going to be on the telly and I knew it was going to be good. I just hadn't realised how good. A real cockle-warmer; Gareth Malone creating a choir out of the discordant voices of the NHS.

The NHS; a hierarchy of the posh and the porters. A vertical organisation. Suits at the top and the cleaners-up-of-sick at the bottom.

Malone would have none of it. Every voice had to be heard, everyone earning a place; singing in tune. Even the stroppy consultant is realising, in the lives of the people the NHS serves, he is at least as important as a nurse, a receptionist or the speech therapist whose daughter is deaf. And yes, he has to sing a song he doesn't like.

I've been around the block; I'm annealed to life, I've seen it all. I admit; I wept. I really did. I wept. What a fantastic programme. In a world where the NHS throws away the word 'team', devalues it as a common currency, we were given a lesson in how fragile, hard to realise and treasured teams are.

If you haven't seen it, take a day off, go sick, or say the dog ate your knickers.  Claim you were kidnapped, or got locked in the lavatory. I don't care; just watch this.

Forget the Nuff's, the King's Fund, management consultants, the DH, the Carbuncle, the Snake Oil salesmen and the spivs. Look at this; play it to your people and have a bloody good think.

Football teams and the Army all spend longer training than they do, 'doing'. Choirs spend more time rehearsing than they do entertaining. We don't have the time. Is there a short-cut to 'every-day' teamwork? Yes!

Six people in room doesn't make a team. It is six people with their own budget, individual targets and six diverse reasons why they can't work together. Shared objective? No, that doesn't work. They'll lie about their own objectives.

Shared motivation works; it's the short cut to success.  Just like the choir; wanting to sing in tune, not let each other down and facing a mutual challenge - a performance.  What is your team's theme, the mutual challenge, the shared motivation, what are you singing together for?

If a workplace Team is permanent, it is a department and different rules apply.  For Teams there are nine imperatives:

1 No magic is required. There is no need to go on bonding weekends, cross a chasm with a cotton reel and a shoe lace, or head for the pub. All that's needed is respect for others, integrity, honesty, compassion and courage. Showing appreciation is a short-cut to all that. Each member will have unspoken expectations of each other. What are they?

2 Get the right people on the bus. Don't have passengers. Token members just for show, to do favours or fester organisational politics. Grafters only. Invest 95% in the people and 5% in the process.

3 Recognise that teams are flat structures. There can't be hierarchies; no gold card memberships. They must be egalitarian. Everyone able to make a contribution all the time, every time. Everyone empowered.

4 Teams are comprised of people who also have a day job. Make sure team meetings are time well spent.  Have the admin sorted, meetings run to time, have an agenda and produce productive decisions, activity and measured outcomes.

5 Remember, there will be people outside the team who will be impacted by team decisions. Avoid alienation; make sure they know what's going on. Don't turn a team into a clique.  That simply fosters resentment. Share decisions and demonstrate benefits.

6 Team leadership must be consensual, invite challenges.

7 Syndicate knowledge; no one should hold back on intelligence. Have a 'new knowledge' run-around-the-table before you start.

8 Make it easy for people to say they don't understand - particularly finance issues. Encourage ignorance. No one is an expert at everything.

9 Make it fun! Celebrate success; even if it's only finishing a team meeting on time!

The ideal team is a bolshie group who want better, are honest communicators and with a boss who gives them their head.

Get that right and your team will sing in tune. 

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Medicine for Managers
MaM Logo
Dr Paul Lambden
What and Why
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carter1 
Warehousing old people is not an option.
Peter Carter boss at the RCN writes exclusively for us with a hard hitting article on the care of older people.  Cuppa-builders and Hobnob time.  Must read.
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News and Stuff
News boy
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clegg sorry 
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secret 
Gossip
This is what I'm hearing.  
Unless you know better.
  Tell me
>> I'm hearing Tim Kelsey, IT Gnome, was at a dinner hosted by the Knight of HealthCare, Ian Carruthers.  He made some 'down to earth' comments about the Pharma industry and their transparency. Carruthers had been grooming pharma-partners for ages and it was a case of apologies all round - can that be right?  If you were there, tell me, in confidence, of course.
And here is our boy again.  This time Kelsey in the US trying to flog NHS data-sets to a company that says the Coalition is aiming to 'blow-up' the NHS. And, he's going to teach us all to write Apps, so we can understand our healthcare - or something like that?
>>  Healthy Start vitamins - I'm told the distribution arrangements are heading for chaos. DH stuff here.
>>  There is a lot of talk that the NHS should fund the full cost of Dilnot.  As the NHS is sitting on a surplus (See first story top of the page) you can see why!
>>  Francis (Mid-Staffs) report delay - a reader reminded me he has 'form' for delay.  He did the Michael Stone/Megan/Josie Russell enquiry in Kent.  It took nearly 4 years and as far as I can recall nothing was learned other than it cost a shed load of money and needed a wheelbarrow to cart it around. (One page summary here) The same will happen at Mid-Staffs if we're not careful. National Voices are fed-up, too. 
>>  Have CQC placed restrictions on Pinderfield's?
>>  Is it true; God's gift to the NHS Circlebrooke is to cut 46 nursing jobs?
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More from the fabulous 
Dr Jones
Stunning analysis of particular interest to Dermatologists, GPs and Commissioners.
Really interesting here and here, have a look.
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