1. Maggie Woods Leadership Development Team, NHS South Central
Programme Lead for Leadership, Oxford Deanery

2. What we will cover today
Context
Leadership
Teamwork and leadership
Leadership and change
Two approaches to leadership
So what?

3. The NHS sees I million patients every 36 hours, spending 2 billion a week.
The number of managers is 3.6 % of the workforce
Source Kings Fund 2011

5. % patients diagnosed with dementia whose care has been reviewed in the last 15 months, 2009-10

6. The number of people aged 85+ in this country will double in the next 20 years

7. 4% efficiency saving for 4 years = 20 billion

8. Constants Clinical Engagement, GP commissioning
Relationship with patients, shared decision making
Outcome focused to drive delivery
Independent sector, voluntary and private,
QIPP challenge

9. Lets talk Leadership………

10. Leadership is the art of motivating a group of people to achieve a common goal
Kings Fund May 2011

11. The function of leadership is to add value

12. The NHS Leadership Framework
It includes 5 core dimensions, drawn from the MLCF/CLCF:
Demonstrating Personal Qualities
Working with Others
Managing Services
Improving Services
Setting Direction
There are two additional
dimensions
Creating the vision
Delivering the strategy

13. Management Matters!
Kings Fund May 2011

14. Interesting Reading Kings Fund report; May 2011
The conclusions challenge some of the negative attitudes towards managers, and questions current plans for major reductions in management and administration costs.
The commission believes that the NHS needs to move beyond the outdated model of heroic leadership to recognise the value of leadership that is shared, distributed and adaptive.
In the new model, leaders must focus on systems of care and not just institutions and on engaging staff in delivering results.

15. Outcomes, Activities, Behaviours
PEOPLE +
RESOURCES
Outcomes, Activities, Behaviours
ACHIEVE VISION
KNOWLEDGE
SKILLS
ABILITIES
VARIABLES
LEADERSHIP/ MANAGEMENT

16. Poor leadership has a cost, Francis – what he identified:
Preventable deaths
insufficient attention to professional standards
a weak professional voice in management decisions
acceptance of poor standards of conduct
low staff morale - demoralised
a lack of any systematic approach to coordinating care
very poor communication

17. Team Working and Leadership

18. % Staff Working in Teams
The link between the Management of People & Patient Mortality in Acute Hospitals West M et al. Int J HR Management :

19. “Don’t tell people how to do it, tell them what to do and wait for the results”
General Patton

21. Employee Engagement (NHS Staff Survey Findings)
Performance Appraisal
Team Working
Job Design
Supervisors’ Support
Work Pressure
Having an interesting job
Feeling valued by colleagues
Overall Engagement
Advocacy
Intrinsic Engagement
Involvement
Employee Reactions
Health and Well-being
Stress
Presenteeism
Hospital Performance
Quality of Services
Financial Performance
Absenteeism
Patient Mortality Rate
client Satisfaction

22. Benefits of Team Working
Reduced hospitalisation and associated costs
Improved service provision
Improved levels of innovation in patient care
Reduced error rates
Lower patient mortality
Enhanced patient satisfaction
Increased staff motivation and mental well-being
West, M.A. & Borrill, C.S. (2005). The Influence of Team Working. In Cox, J., King, J., Hutchinson, A. & McAvoy, P. (eds). Understanding Doctors’ Performance. Oxford: Radcliffe Publishing.

23. Team functioning and patient satisfaction
3.3
3.2
3.1
Clarity of objectives 3
Reflexivity
Patient experiences
Support for innovation
2.9
2.8
2.7
Low
Moderate
High
Team functioning

24. Staff absenteeism
5% more staff working in real teams associated with 0.27% in overall absenteeism rate (p < .001)
For an “average” acute hospital, this represents a potential estimated saving of over £1 million per year in direct salary alone

25. Does your team have clear goals/ objectives? Who is in your team?
Questions for you?
Does your team have clear goals/ objectives?
Who is in your team?
Do you have regular 121s and feedback mechanisms?
M West research indicated that in a 1/3rd of GP surgeries at least 2 of the GPs don’t talk to ach other.

26. Leadership and Change Management

27. It takes 18 months for a change to become effective.

28. Change as a Human Process
DENIAL
Anger
COMMITMENT
Internalising
Realisation
Shock
Self
Esteem or
Morale
PAST
FUTURE
Search for meaning
Depression
Testing
RESISTANCE
Acceptance
& letting go
EXPLORATION
Time
Adapted from Adams, Hayes and Hopson : Transition, understanding and managing personal change; 1976

29. Future, Engage , Deliver, Steve Radcliffe
Good To Great, Jim Collins

30. Help people see the future, create a future that is
compelling, makes best use of their skills. Move from the present.
Future
Engage
Deliver
Engage with people: open & honest conversations. Feedback
Maintain a healthy emotional bank account. Listen and hear.
Be present. Autonomy. Cross sectors/ boundaries
Mobilise the team’s drive for improvement, provide
a sense of purpose, hold people to account, drive for
results and celebrate success so people feel they
have done something important . Make things happen
Leaders may vary in the three areas, FED, try not to focus on the ones you like,
Good leaders are up to something!
Feedback, give and receive, lift spirits, empower, challenge, identify the possibilities,
Ask the question, how am I doing as a leaders.
Be present, notice things,
Don ignore the most difficult,
Engage , cascade, plan a campaign, who is the most difficult

31. Good to Great, Level 5 Leaders
All good to great companies had level Five leaders
Level 5 = personal humility and professional will
Modest and safe effacing, motivated to produce sustainable results, plough horses
Level 5 leaders; look out the window to attribute success, in the mirror when things go wrong
Many people have the potential to be level five leaders
Most level five leaders come from within their companies

32. Level five leaders, get the right people on the bus… and the wrong people off the bus, and then figured out where to drive it
When in doubt…..don’t hire - keep looking
When you need to make people change- act
Put your best people on your biggest opportunities, not your problems

33. Create a climate.. Lead with questions…not answers
Engage in dialog and debate not coercion
Conduct investigations without blame
Build red flag mechanisms to identify essential information that cannot be ignored

34. What actions do you need to take to become the leader that you aspire to be?

35. Thank you