If there is a word, to start off the week, it might be… longevity.
Elizabeth, The Queen. The longest serving monarch and someone, whose passing, was marked, around the world. The epitome of longevity.
On these pages we are principally concerned with the success of management and leadership and longevity plays a vital part in that.
The NHS and longevity. Goes hand-in-hand. If it were a brand, it would only have oil companies and banks for company, in the league table of longevity.
Unlike a company, whose customers exercise a choice and their loyalty keeps the organisation going, or doesn’t, the NHS is in a unique position.
The failure of companies is well studied and documented.
Spectacular falls, like Kodak, who invented the digital future but were unable to embrace it.
Blockbuster, who were simply swept aside by developments in technology. All very familiar.
The NHS occupies a legacy role and has, perhaps, a legacy mindset.
Is its successful past a mill-stone or a stepping stone into the future?
Here are six things to consider.
1 To survive, all organisations must have a relentless focus on understanding their customers.
Unlike businesses, the NHS does not have the luxury of understanding and serving a segmented market. Focussing on providing for a particular group; young fashion, family food, retirement living and so-on.
It has to be all things to all people, all the time. Young and old, rich and poor.
2 In many ways the NHS is way behind the public in the management of their lives by the use of information technology.
Lack of investment and poor decisions have left the Service in a technology no-man’s-land. Not knowing who to trust. Undecided how to move to a digital-first-future.
3 The NHS has the biggest carbon foot-print in Europe. Success in reducing it will depend on relationships with suppliers.
This relationship is mostly confrontational based on competition.
The seismic shift, to green-the blue, will need relationships based on partnership, collaboration and problem solving.
4 NHS management is largely introverted. Growing-our-own is fine. It generates loyalty and an understanding of a complex environment.
However, having no system to expose leaders to the world outside, loses the opportunity and benefits of making them multidimensional.
5 The NHS struggles to live its values. The threat of litigation, condemnation and ridicule, from regulators and the courts, means mistakes, errors and failings are defended, with a circle-the-wagons mentality.
Patients maybe at the centre of its thinking but when disaster arrives, the NHS closes the doors. There is no genuine desire, nor safe mechanisms to create regular opportunities to learn from mistakes.
6 We don't get the best from our Boards. Their performance is questionable because they are little more than the Deliveroo for a politically infused DH+.
They have no control or influence over the keystone of their organisations; staff recruitment, training and renumeration. Strategic planning... impossible.
Short-termism and political imperatives supplant any meaningful mastery they might have, over the affairs of their organisation.
The keys to the future may well be in the way the NHS is led. In 2020, longevity in leadership was researched by Manchester Uni. They published some chunky research on long-serving NHS CEOs.
There were six main findings.
Longevity was about:
Three phases, as CEOs developed their organisations: bedding down; moving from new incumbent, through to experienced CEO and on to trusted senior figure. Evolving personal leadership styles. This takes time.
Shaping a very experienced, stable executive team, with some turnover, to ensure a degree of freshness.
Prioritising external relations.
Very strong attachment to the mission of the NHS, and a fierce loyalty to their organisation.
High levels of; personal resilience, tenacity and energy, a spirit of optimism, living in the present, ability to overcome setbacks.
Continuous personal learning and development, and, for some, a coach or mentor, and membership of peer networks.
Rarely do these six principals emerge because at the first sign of trouble, NHSE avalanche CEOs with threats, comm’s are silenced and the CQC begin the beatings.
The research highlights the importance patience and of supporting new and not-so-new CEOs.
We should and we don’t… and it’s a miserable experience, because politics is impatient.
Longevity is important. It means stability. Stability requires patience. Its reward will be seeing the NHS come through a difficult time, where its own direction is unsure.
Very few NHS organisations fail, we just don't help them flourish.
Very few NHS leaders go bad. We just don’t give them enough time to get good.
>> I'm hearing - I've flagged up that the 22/23 pay award is pushing some Band 8c people into the next pension contribution rate. Meaning the will be a shortfall in their next pay-packet, when the difference in the pay award back pay has been deducted. NHSE have written to Trusts asking them to arrange a staged repayment. Trusts seem to be offering instalments over three months, including December, rather than taking it all in one hit. I can't see why it has to be three months? Why not six?
>> I'm hearing - efforts to publish weekly, Covid style dashboards of NHS success in hip, knees and similar operations, scans and tests are being stymied by a combination of DH and NHSE comms. If that is true, we are missing an opportunity to delver some good news and reassure the public something is happening, to get their granny to the front of the queue.
>> I'm hearing - Tizzie has been criticised for dismissing concerns from MPs about nurses using foodbanks. She accused the opposition of “talking down” the NHS.
>> I'm hearing - GP practices will see surpluses plummet by up to a third in 2022/23 unless they make significant cuts that could include reductions in clinical staff
