Businessman Lord Rose recently described performance management in the NHS as “haphazard and weak”, adding that NHS staff were “drowning” in bureaucracy
He expressed particular concern about three areas: lack of vision, lack of management and leadership capability, and lack of direction in management.
Is there really a lack of leadership and management capability in the NHS? The service employs over 1.3 million people, so basic understanding of simple statistics tell us the must be some budding leaders and managers among so many people.
Perhaps the deficit is the result of the working environment that affects the ability of good leaders and managers. Is it surprising if proactive leadership and management finds it difficult to thrive among top-down metrics and a focus on who or what was to blame for performance?
If we create the right environment for staff to work in, we will bring to the fore everyone’s best management and leadership skills, despite their rank, age or length of service. If we deprive our staff of good and relevant information, either about what is expected of them or indeed how they are performing, it is incredibly hard to be the best leader or manager.
A few years ago a hospital, wanting to focus on waste management, launched a competition for departments to be the best at managing their waste. The part-time cleaner in the executive office wanted her department to win. She collected all the relevant segregated bins, sent the staff in the office information of what to put in each one. Every morning, when she came in at 6am to clean the office, she would check through all the desk bins, leaving post-it notes for executive directors highlighting where apple cores, banana skins, yogurt pots, etc should be deposited rather than the bin under their desk. The department won, due to her leadership and management of the most senior people in the hospital. There is a leader in us all if we have the right environment and the right information, which is relevant and meaningful to us as individuals.
In 2013 my daughter, who worked for Vodafone, spent the Christmas holiday at home with us. I was intrigued to see that each day she received a text with the “numbers” about her store’s performance: number of sales, performance against budget. Each morning on a call with her team the numbers were shared, and actions agreed to ensure the store hit its metrics.
After 16 years as a CEO in the NHS, I doubted my nursing teams knew their “daily numbers”. The only data they had was often out of date, and made up of metrics they had not chosen to collect. Data often comes from different sources and is not stored in one place, preventing teams from understanding some of the causes and effects related to delivering safe and efficient patient care.
Nurses who are not drowning in meaningless bureaucracy, but who own their “numbers”, will lead and transform great care for patients.
Jo Cubbon is chief strategy officer for Alamac and was previously a CEO in the NHS for 15 years.
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