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Join Tim Kelsey in conversation with Roy Lilley at the Xmas Health-Chat

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Mike Richards 
News and Comment from Roy Lilley

Congratulations to Sam Jones; chief executive of the year! And well done the HSJ for helping to celebrate success. I've seen Jones in action at her West Herts, Watford Trust. I visited early-on in her tenure. I remember commenting; is it possible to find quality in a building site, can a centre of excellence be anywhere but in the metropolis, can localness deliver?


We know now; yes... but it takes leadership. Jones is a natural born leader. Leadership is a precious commodity that is being squeezed out of the NHS by people with inferior talent, who have never run anything of any size or importance and who justify their position upwards by finding fault, rather than looking out for success and celebrating it.


I was surprised, (Make that horrified) to discover the troubled Colchester Trust has had 3 chief executives, 3 chief nurses, lost its medical director last week, gone through 2 HR directors, 3 finance directors and 4 company secretaries. Still the inspectors turn up and drive the organisation further down a cul-de-sac with threatening letters like this. Note; no offer to help.


Leadership is rare and precious. You can study it, observe it and try to emulate it. It exists, in a few people, in the nine inches between their ears. For people who have 'got it' you can help to develop it but you can't make a tightrope walker out of a vertigo victim.


Leaders are visible, have a vision and share it often. That's all there is to it.


Leaders are brave but don't confuse bravery with leadership. The soldier who attacks a machine-gun nest with nothing but a tin opener, to draw fire from wounded colleagues, is brave beyond description but may not be a leader.


Leaders set boundaries but realise boundaries are there to be kicked over and be porous.


Leaders are teachers but understand the best learning comes when you trust people to do things.


Leaders lead by example but know; setting a direction everyone can be part of, is better.


Leaders need leaders around them and always encourage their independence.


Leaders deal with the issues no one else wants to or can't find a way into.


Leaders need time, encouragement and space.


Leaders are not perfect; they have foibles, blind spots and get things wrong. That is why if we want leaders in the bureaucratic swamp the NHS has become we must encourage individuality, help them see around corners and invite them to share the bad as the fastest route to the good and the only way to arrive at the best.


If it were possible for an organisation to get 'wrong' everything it does in the management of people, institutions and difficult situations, it is the NHS. What puzzles me is why sensible people are prepared to be part of the shrill.


There is no strategic management in the NHS only people whose job it is to find fault, complain about the minutia, create more tension and pile on unnecessary pressures. Tarzan heads up the only NHS organisation, the Carbuncle, that is looking for success. Success for the others depends on the failure of the rest.


NHS depends on its leaders and if leaders need leaders Tarzan needs to do more to protect the few leaders we have left. Last summer there were 20 CEO vacancies and the average tenure was 20 months. Yesterday morning, reporter from the HSJ, Ben Clover Tweeted; Tony Bell chief executive of Chelsea and Westminster has gone the same way as Mark Newbold... quit following a CQC inspection.  Problems insurmountable.


Taking on the role of Trust chief executive is no longer worth the carrot.


As the boss you have no control over the business model: compulsory frameworks that might be entirely inappropriate for where you work; fixed prices, targets and tariffs that create perversity; arbitrary regulatory rules; and required to do plenty more with plenty less.


The morning after the HJS Awards and Watford celebrated success, they had a visitor. To say well done? A pat on the back? Congratulations? No, the CQC arrived, unannounced, to find fault.


Forget finance, demand, politics and disaggregated systems; the most serious threat the NHS is facing is Mike Richards. 


  Contact Roy - please use this e-address


Know something I don't - email me in confidence.

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>>  I'm hearing - in the midst of the fracas about nurse pay rises, the NMC have awarded themselves a +2% pay rise.  Snouts in the trough doesn't quite cover it, does it?  By the way the chief executive earns �150k+.