Leadership: Doing the Right Thing on a Difficult Day Prof Aidan Halligan Ashleigh Knowles Clinical Lead Neuro-rehabilitation Services PCFT & Leading Transformational Cultural Change Programme 2015/16

Leadership Journey Wanting to be clinically effective & show impact had taken place – made a change Introduced to LEO – new insight into essential nature of interpersonal skills LEAN landed – process effectiveness & management directive NHS Leadership Programme – tools! Conflict noted between management directive & clinical effectiveness

Leadership Journey Duty of Care - Must be of a reasonable standard – safe; appropriate environment; appropriate staff number & skill mix to meet treatment needs Difference between doing things right & doing the right thing Importance of end in mind Importance of direction & image Objective & systematic process to inform innovation & change

NHS Change Challenges: No shared vision & values: ‘Our aim is to continuously improve our services & the experience of people coming into contact with them. Everyone working within the Trust, no matter what their role, has a part to play in delivering this aim’ Poor alignment: the structure and system of the organisation do not serve & reinforce the ‘end in mind’

NHS Change Challenges: Wrong style: Limited leadership. No amount of management expertise can keep an organisation from failing (Bristol/Mid Staffordshire) Poor skills: style does not match skills, or skill is lacking to achieve the ‘end in mind’ Low trust: staff have low trust, a depleted emotional bank account, and that low trust results in closed communication, little problem solving & poor cooperation & teamwork

NHS Change Challenges: No self integrity: values do not equal habits; there is no correlation between what I value and believe and what I do

Journey Outcomes Introduced ratio of direct & indirect clinical hours Secured WBL (clinical programme) time as fixed priority Customer service – Ghandi quote at all contact points IPDR objectives aligned to ‘end in mind’ DoC & developed a clinical risk tool to support clinical prioritisation of referrals End in mind & created clinical impact ‘Invited myself to the table’

Outcomes Continued Principles of Care & invited board level members (executive & non-executive) to tour the team Patient compliments to CEO ‘Closed the loop’ in all communications Taking on roles in networks FoI requests 1:1 supervision with Executive Director Sponsor Influenced organisational change outcomes

Key Aspects Principled Culture – it’s a habit It is doing the right thing Balanced behaviour Accountability Requires courage Self awareness/reflection Evolving Enriched by our experiences & & lessons learned & still learning

Leadership Tip Start with yourself & be principled When you do not have hierarchical power keep doing the right thing in the right way. Seek to understand first & ask wise questions. You will get a different view with more ideas. Opens opportunity for something different. Something better.

Covey & Organisational Leadership ‘The only competitive advantage your organisation has is its culture, and your culture is ultimately created by the behaviour of your leaders. The very best leaders bring both great character (personal and interpersonal effectiveness) and competence (ability to achieve results) to their leadership style, at whatever level of the organization they work in.’

Thank you.