Management within the public organisation setting Leadership and collaborative working to improve population health and wellbeing West Midlands Public Health Practitioner Development Scheme Rachael Cox, Andrew Hood & Nicola Wright (Specialty Registrars in Public Health)

AIM: Overview of the application of management theory including leadership, individual and team development, change and performance management Outline the various management models and theories Critically discuss management techniques for the individual and team development and partnerships Critically discuss the application of evaluation, audit and standard setting to improving quality From feedback: address conflict resolution and day to day management issues and leadership experiences Learning Objectives

Agenda

1. Who are you? Total responses = 12

2. Awareness of management tools

3. Your current duties and tasks Total respondents = 12

4. Your interests for today.... Theories of leadership and management Practical methods for improving management and leadership Developing strategies for dealing with other people’s styles Managing workloads where partnerships/ different priorities exist

Feedback from the 2011 session

Methods for understanding your management and leadership style Working with teams: What makes a good team and performance management for improvement, conflict resolution Successful partnerships: opportunities and challenges and managing change Agenda

Styles and attributes of leaders and managers Exercise One: Famous Leaders Understanding your Management Style

QUOTE FROM DRUCKER ON L AND M?? AH

Myers Briggs Health Warning Very quick and dirty: four questions Assess the PREFERRED ways of thinking and behaving No indication of intelligence, suitability or potential

Four questions with two different descriptions of personality "preferences”. Each question: Read both sets of descriptions and decide which list describes you better Try to answer as you really are, not how you may wish you were, or have to be at work. Instructions Myers Briggs

Introverts' energy is primarily directed inward, towards their own thoughts, perceptions, and reactions. Extraverts' energy is directed primarily outward, towards people and things outside of themselves. Talk more than listen Think out loud Act, then think Like to be around people a lot Prefer a public role Can sometimes be easily distracted Prefer to do lots of things at once Are outgoing & enthusiastic Listen more than talk Think quietly inside your head Think, then act Feel comfortable being alone Prefer to work "behind-the-scenes" Have good powers of concentration Prefer focus on one thing at a time Are self-contained and reserved Where is your energy directed? EI

INtuitives are interested in connections between facts and their meanings. They tend to be creative, imaginative, theoretical people who trust their hunches. Sensors notice the facts, details, and realities of the world around them. They tend to be practical and literal people, who trust past experience and often have good common sense. Focus on details & specifics Admire practical solutions Notice details & remember facts Are pragmatic - see what is Live in the here-and-now Trust actual experience Like to use established skills Like step-by-step instructions Work at a steady pace Focus on big picture & possibility Admire creative ideas Notice anything new or different Are inventive - see what could be Think about future implications Trust their gut instincts Prefer to learn new skills Like to figure things out themselves Work in bursts of energy What kind of information do you use? SN

Feelers make decisions based primarily on their values and how they feel about the choices. They tend to be sensitive, empathetic and strive for harmony. Thinkers make decisions based primarily on what makes the most sense and what is logical. They tend to be analytical, and are convinced by logical reasoning Make decisions objectively Appear cool and reserved Convinced by rational arguments Are honest and direct Value honesty and fairness Take few things personally Are good at seeing flaws Are motivated by achievement Argue or debate issues for fun Decide based on values & feelings Appear warm and friendly Are most convinced by how you feel Are diplomatic and tactful Value harmony and compassion Take many things personally Are quick to compliment others Are motivated by appreciation Avoid arguments and conflicts How do you make decisions? T F

Perceivers like to keep their options open and are comfortable adapting. They tend to be flexible, curious and nonconforming. Judgers prefer a structured, and fairly predictable environment, where they can make decisions and be settled. They tend to be organised and productive. Like to have things settled Take responsibilities seriously Pay attention to time, usually prompt Prefer to finish projects Work first, play later Seek closure See the need for most rules Like to make & stick with plans Find comfort in schedules Like to keep their options open Are playful and casual Less aware of time, may run late Prefer to start projects Play first, work later Difficulty making some decisions Question the need for many rules Like to keep plans flexible Wants freedom to be spontaneous What environment makes you most comfortable? J P

What is your type….? ISTJ InspectorISFJ ProtectorINFJ CounselorINTJ Mastermind ISTP OperatorISFP ComposerINFP HealerINTP Architect ESTP PromoterESFP PerformerENFP ChampionENTP Inventor ESTJ SupervisorESFJ ProviderENFJ Teacher ENTJ Fieldmarshal

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The 16 MBTI® Types ISTJ Quiet, serious, earn success by thoroughness and dependability. Practical, matter-of-fact, realistic, and responsible. Decide logically what should be done and work toward it steadily, regardless of distractions. Take pleasure in making everything orderly and organized – their work, their home, their life. Value traditions and loyalty. ISFJ Quiet, friendly, responsible, and conscientious. Committed and steady in meeting their obligations. Thorough, painstaking, and accurate. Loyal, considerate, notice and remember specifics about people who are important to them, concerned with how others feel. Strive to create an orderly and harmonious environment at work and at home. INFJ Seek meaning and connection in ideas, relationships, and material possessions. Want to understand what motivates people and are insightful about others. Conscientious and committed to their firm values. Develop a clear vision about how best to serve the common good. Organized and decisive in implementing their vision. INTJ Have original minds and great drive for implementing their ideas and achieving their goals. Quickly see patterns in external events and develop long-range explanatory perspectives. When committed, organize a job and carry it through. Skeptical and independent, have high standards of competence and performance – for themselves and others. ISTP Tolerant and flexible, quiet observers until a problem appears, then act quickly to find workable solutions. Analyze what makes things work and readily get through large amounts of data to isolate the core of practical problems. Interested in cause and effect, organize facts using logical principles, value efficiency. ISFP Quiet, friendly, sensitive, and kind. Enjoy the present moment, what’s going on around them. Like to have their own space and to work within their own time frame. Loyal and committed to their values and to people who are important to them. Dislike disagreements and conflicts, do not force their opinions or values on others. INFP Idealistic, loyal to their values and to people who are important to them. Want an external life that is congruent with their values. Curious, quick to see possibilities, can be catalysts for implementing ideas. Seek to understand people and to help them fulfill their potential. Adaptable, flexible, and accepting unless a value is threatened. INTP Seek to develop logical explanations for everything that interests them. Theoretical and abstract, interested more in ideas than in social interaction. Quiet, contained, flexible, and adaptable. Have unusual ability to focus in depth to solve problems in their area of interest. Skeptical, sometimes critical, always analytical. ESTP Flexible and tolerant, they take a pragmatic approach focused on immediate results. Theories and conceptual explanations bore them – they want to act energetically to solve the problem. Focus on the here-and-now, spontaneous, enjoy each moment that they can be active with others. Enjoy material comforts and style. Learn best through doing. ESFP Outgoing, friendly, and accepting. Exuberant lovers of life, people, and material comforts. Enjoy working with others to make things happen. Bring common sense and a realistic approach to their work, and make work fun. Flexible and spontaneous, adapt readily to new people and environments. Learn best by trying a new skill with other people. ENFP Warmly enthusiastic and imaginative. See life as full of possibilities. Make connections between events and information very quickly, and confidently proceed based on the patterns they see. Want a lot of affirmation from others, and readily give appreciation and support. Spontaneous and flexible, often rely on their ability to improvise and their verbal fluency. ENTP Quick, ingenious, stimulating, alert, and outspoken. Resourceful in solving new and challenging problems. Adept at generating conceptual possibilities and then analyzing them strategically. Good at reading other people. Bored by routine, will seldom do the same thing the same way, apt to turn to one new interest after another. ESTJ Practical, realistic, matter-of-fact. Decisive, quickly move to implement decisions. Organize projects and people to get things done, focus on getting results in the most efficient way possible. Take care of routine details. Have a clear set of logical standards, systematically follow them and want others to also. Forceful in implementing their plans. ESFJ Warmhearted, conscientious, and cooperative. Want harmony in their environment, work with determination to establish it. Like to work with others to complete tasks accurately and on time. Loyal, follow through even in small matters. Notice what others need in their day-by-day lives and try to provide it. Want to be appreciated for who they are and for what they contribute. ENFJ Warm, empathetic, responsive, and responsible. Highly attuned to the emotions, needs, and motivations of others. Find potential in everyone, want to help others fulfill their potential. May act as catalysts for individual and group growth. Loyal, responsive to praise and criticism. Sociable, facilitate others in a group, and provide inspiring leadership. ENTJ Frank, decisive, assume leadership readily. Quickly see illogical and inefficient procedures and policies, develop and implement comprehensive systems to solve organizational problems. Enjoy long-term planning and goal setting. Usually well informed, well read, enjoy expanding their knowledge and passing it on to others. Forceful in presenting their ideas.

Practical steps Mentor PDP 360° LQF Impartial Good Listener Supportive Non-judgemental Skilled in feedback Interested Bayley et al (2004) The good mentoring toolkit for healthcare

45 mins …. “The NHS needs people to think of themselves as leaders not because they are personally exceptional, senior or inspirational to others, but because they can see what needs doing and can work with others to do it” (Turnbull James, 2011)

WORKING WITH TEAMS

Working with Teams The Good Components of a successful team Diagnostic tool The Bad Managing poor performance and conflict Improving services

Your experiences.... What do you want from: Team of directors Your department Your operational team How you behave: do you need to adapt to each team?

Diagnostics Developing an Understanding of how your Leadership affects Others

Managing the bad A (brief) introduction to avoiding conflict managing poor performance, and improving services Staff: Performance management Services: Audit

Conflict Resolution **** ADD ANDREWS SLIDES HERE****

Performance Management Your organisation: Policies & procedures, training, HR Documentation: One to ones, agreements, job descriptions, letters and s Your skills: professional, motivational, patience

Audit Principles for Best Practice in Clinical Audit NICE (2002)

Also…. Balanced scorecards Key Performance indicators Service Improvement Find out more:

15 mins …. “Teamwork is the ability to work together toward a common vision. The ability to direct individual accomplishment toward organisational objectives. It is the fuel that allows common people to attain uncommon results” (Unknown)

WORKING WITH PARTNERS

Working with Partners Share some case studies.... Opportunities and Challenges Tips for managing change in successful partnerships

Working with community groups, voluntary bodies, other public sector organisations, businesses, patients, members of the public or groups of staff Change or improvement is achieved through inclusive partnership working The scale of achievement could not have been made without the contribution of partners All organisations have made a significant contribution to the achievement of the aims of other partner organisations that has benefitted the local community Health Services Management Centre - Uni of Birmingham

Types of partnership Co-operate: Partners may share information. No joint planning, resources are kept separate Co-ordinate: Partners will do some planning together. Sharing and responsibilities, resources and risks Collaborate: Organisational changes so that there is a higher degree of shared leadership, control, resources and risk sharing

Developing a West Mercia SARC NHS: lead organisation for the development of sexual assault services for victims together with the police

....and....

Physical Activity Strategy

Background to Partnership Physical Activity Strategy due for renewal 2010 Usually led by PH and the PCT Originally asked to do the narrative Actions and outcomes needed to come from the providers of service – what could be measured, what would be an improvement etc

Quarterly meetings with floating attendance from 8 organisations Attended either by lowest grade member of staff due to time commitments, or ‘the figurehead’ Low grade staff – unable to influence and engage higher levels re strategy or data collection The figurehead – never gained buy-in across the organisation as they were the ‘doer’ 2 years later – still no actions/outcomes identified by provider organisations Physical Activity Strategy - before

No one organisation can deliver the strategy Needed buy in from all organisations Group discussed operational rather than strategic issues Repetitive minutes !!! Standing still between meetings Cycle of non-attendance, repetition, nil action Physical Activity Strategy - before

Leadership Issues Common vision Added value Willing to make changes ? Facilitate partnership working  Objectives are aligned 

Mutually accountable Understand and respect differences ? Deal with conflict and frustration Communications are sufficient & effective  Sharing of contributions, risks & rewards  Equal say  Trust Issues

Managing Performance Issues Structure fits its purpose  Roles, responsibilities & contributions clearly defined  Objectives, targets & milestones are set and owned  Adequate resources  Project management and co-ordination ?

Continuously seek improvements ? Review the partnership Seek to learn from each other ? Use strengths and talents  Manage the changes  Learning Issues

A Bad Partnership A good thing to do, but nobody’s priority No decision maker (s) No overall responsibility for partnership’s delivery Being done for appearance’s sake ? Used as a talking shop and ‘woe are we’ A breather from the day job

Next Steps Survey to: Identify strategic & operational leads from each organisation Whether PAS is a priority for the organisations What could be done differently/better Results to go to Health and Wellbeing Board Board to clarify if a priority Potentially, this Board will then provide leadership and accountability focus.

Scale of change: NHS wide, local, team Responses to change Stakeholders: Public, colleagues, organisations Signposting: Tools for managing change Managing change through effective partnerships

The Process of Transition

Tools for Managing Change Change Management Toolkit Force Field Analysis Communications Plans Stakeholder Analysis “Thinking Differently” - range of practical approaches and tools to fundamentally rethink pathways of care and service delivery.

Stakeholder Analysis

Summary Your style Team Partnership Thank you Evaluation forms

Further Information....

Plan your changes well…..

…. And don’t forget your partners