Health and Social Care Leadership, Organisational Design

Where does the future of the NHS lie – competition or collaboration?

Ever since the first purchaser/ provider split in the 1990s, patients and the NHS have been told that competition is the best way to drive up quality.  This has led to different systems over the years such as payment by results (the tariff based funding system) that have created incentives resulting in providers often competing with each other to provide patient care. All with the aim of driving up quality to attract more patients.  So far, so logical.

These principles worked to a degree when the problem was long waiting times (although arguably to the detriment of those services still on block contracts such as mental health and community); however the problem has changed.

Today demand has increased due to the advances in modern healthcare helping people live longer and survive premature birth and severe illness where previously this was sadly not the case.  This is at a time when social care has seen unprecedented reductions in funding, with 900,000 fewer people in receipt of social care than 2010 coupled with funding in the NHS not keeping pace with demand.

Patients have more complex needs due to chronic long term conditions and co-morbidity and so the logical solution can no longer be applied.  A more sophisticated funding mechanism that can cope with complexity is required.

In today’s world it is clear the pseudo-market economy logic and mechanism no longer works.  It’s yesterday’s solution.  Too often patients fall through the cracks of bureaucratic systems; clinicians are forced to find workarounds every day and managers are trying to make a square peg fit into a round hole so to balance the triumvirate of finance; quality and safety.

Another policy to cement competition was the creation of businesses or Foundation Trusts.  When this idea was first conceived in around 2004, the aim was to establish them as public benefit corporations.  Although a great idea in principle, Foundation Trusts ended up becoming legal business entities meaning that not only did they fall under the Enterprises Act 2002 and become subject to competition law but legally the first duty of the Board is to the organisation.  Great for competition, potentially not so great for creating a cohesive health and care system.

It is feasible that if health and care organisations had a first duty to their population, as a public benefit corporation suggests, then collaboration would not only be far simpler, but absolutely essential to deliver the right level of care to the population served.

All in all, it seems the competitive approach has served its purpose and now we need to move to a new world which sews back together fraying seams and in some cases, great gaping holes of the health and care system.  The needle we need to use is collaboration.

Sustainability and Transformation Plans (STPs) are going some way to address this conundrum and could start to pave the way for much greater collaboration if the incentives are aligned and executives are not forced to put their own organisations before the benefit of the wider STP.  It is crucial that the STPs give the proper time and attention to building the relationships and designing the clinical models that will become the bedrock of the new health and care system.  Tempting as it is, rushing into a new organisational form before this work has been thought through could actually worsen the situation.

In a previous blog post in 2015 I explored whether or not organisational form was seen as the silver bullet for the NHS.  It is dangerous to underestimate the impact of a restructure as often an organisation’s value is found in the informal structures created through internal relationships, shared history and the stories that are retold within the organisation, rather than the formal structures.  The risk becomes that in creating something new, the value is unwittingly destroyed.

Form follows function and therefore it is crucial to spend time creating shared purpose, building partnerships and strong relationships both at the top of organisations and also through bringing clinical teams together to ensure the clinical models are right.  The final step is to design the right organisational form to wrap around these new arrangements to cement in the new ways of working.  In this way we will find new organisational forms that are better able to solve the complex issues emerging today.

In order to ensure the NHS can not only survive this decade but thrive in the next decade of its existence, we need to find a way to manage the complexity in which we find ourselves in.  The only way to do this is through seeing the system as a whole and starting to form the relationships we need to design not only new ways of delivering care supported by new structures that make it easy to do the right thing, but most importantly, we need to find new ways of being so we can change things for the better.

As the old African proverb says; if you want to go fast, go alone. If you want to go far, go together.
Guy’s & St Thomas’ partnership statute outside St Thomas’ hospital 


About the author
Sarah Morgan is the Director of Organisational Development and the Programme Director for the Acute Care Collaboration Vanguard Programme (developing one of the first hospital Groups in the NHS) for Guy’s and St Thomas’ NHS Foundation Trust.

Sarah was previously the Head of the Dalton Review which examined organisational form options for providers in the NHS

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culture of compassion, Diversity, Leadership, NHS Leadership, Organisational development, staff engagement, wellbeing

Staff engagement – a matter of life and death part 2

The world of work is changing and our expectations of organisations and how we experience the 40 hours or more we spend working every week is changing.  Organisations that do not create environments where people can bring their whole selves to work will quickly find themselves without a workforce as people will make different choices.

Creating environments in which people feel their purpose is fulfilled, their passion is ignited and are proud to work in is the role of leadership in the 21st century.

My last blog post described the importance of staff engagement for the health of an organisation.  For an organisation like the NHS, it vital to have happy, proud, empowered staff as the levels of connectedness that staff feel in a healthcare organisation has been linked to the mortality of patients.

The happiness of our people is something that we work on every day however my personal belief is that the term ‘staff engagement’ is a passive term and instead we should talk about how we nuture our people to ensure that our staff feel involved, empowered and proud to be part of of our oganisation.

The 2016 NHS staff survey results are due to be published on 7 March 2017 and last year we took the approach that despite being the top in our category of acute and community provider, we were restless to improve our scores and so as well as celebrating and amplifying what went well we also acknowledged that there were 3 key areas that we scored in the bottom 20% on that we wanted to make a difference in, which were:

  1. Equal opportunities to career progression
  2. Staff experiencing discrimination from staff or patients
  3. Staff working long hours

We identified ways to support this at both a Trust-wide level as well as within the individual directorates.  Each directorate came up with their top 5 actions to support improving in the areas that their own staff had identified and as an organisation we have focussed on the top 3 listed above.  Througout the year we introduced the following:

Equal opportunities to career progression

  • managers to have ‘career coaching conversations’ with their team members during appraisals or other suitable times
  • Realising Your Potential conference for a cross section of staff with our partner trusts
  • Surveyed and ran focus groups with different generation groups (Baby Boomers; Generation X; Millennials and Digital Natives) to find out what is important to them to inform training and development (with more to come on this next year)

Staff experiencing discrimination from staff or patients

  • Leadership masterclasses on inclusion and unconscious bias
  • Unconscious bias training introduced into different training courses across the Trust
  • Violence and aggression campaign run in conjunction with the Metropolitan Police to support keeping our staff safe

Staff working long hours

  • Reduce our email usage culture and encourage ’email free Fridays’ and managers spending time out about in clinical areas with their staff
  • The Model Ward (Nightingale Project) which is rolling out standardised practice on the wards for the first hour and last hour of the day with a safety huddle in the middle of the day to ensure all staff start and leave their shifts on time.

A couple of weeks ago I took part in a webinar for the UK Improvement Alliance along with Caroline Corrigan from NHS England, talking about how to engage staff in change.  This webinar and introductory video focussed on some of the things that we have put in place to ensure that Guy’s and St Thomas’ is a place where staff feel proud to work.  If you missed it you can catch up here.

I hope that some of the things that we have experimented with this year have made a difference to our staff and to test this we have made sure we are full census for the next three years to ensure every one of our staff has a voice.  Watch this space for the feedback!

About the author

Sarah Morgan is the Director of Organisational Development for Guy’s and St Thomas’ NHS Foundation Trust.  An organisation in the English NHS with 15,000 staff that cares for patients in the London Boroughs of Southwark and Lambeth, across the South of England and both nationally and internationally.

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Authentic Leadership, culture of compassion, Leadership, Motivation, NHS Leadership, Organisational development, Resilience, wellbeing

2017 – My year of Focus

I was asked at the beginning of the year what my word for 2017 is and I decided it is ‘Focus’.

Just before Christmas I found myself in a complete state of overwhelm and was working inefficiently, flitting from task to task; meeting to meeting and trying to juggle too many variables at the same time.

Over the break I took time out to reflect and think about what I wanted to do differently in 2017 and came to the conclusion that less is more and I needed to re-prioritise.

I realised that in order to stay resilient I need to be more discerning and disciplined with my time, to not give it away too easily and spend more time on the things that energise me and make me happy in life including my spiritual and physical wellbeing. Most importantly I need to prioritise my time with my friends and family and ensure that I’m not taking them for granted.

I have decided to prioritise to five key things to focus on, which are:

1. The creation of a diary management system to prioritise both my work and social to have a much better use of time. This includes saying no more often and builds in protected time to think; write and research to ensure we stay ahead of the curve in leadership; OD and new models of care. This will ensure I can dedicate the right amount of time to the three major programmes that I am currently leading. I’ve designed a colour coding system so I know what is a must-do and what I can delegate or drop if necessary.

2. Limiting my social activities to only having one to two nights a week when I’m going on to an event after work. Prioritising things that I’m really passionate about. I became a Fellow of the Royal Society of Arts in November last year and am keen to connect with their Reinventing Work network as is connects with my passion of creating more love in the workplace – the theme of my 2016 blogging year.

3. Leaving work on time to go to the gym and making time to get enough exercise. Particularly reconnecting with the activities I love such as yoga; climbing and recently I’ve gone back to High-Intensity Interval Training (HIIT) . Even after a few short weeks it’s making a real difference to how I’m feeling.

4. Improving my sleep as before Christmas I was only getting 5 hours a night and I was finding it was affecting my decision-making and judgement. I’m experimenting with making sure that I’m winding down and in bed for between 10pm and 11pm to make sure I’m getting enough sleep aiming for between 7 and 8 hours a night to try and maintain my ability to stay focussed

5. Writing To Do lists is something that I have to really discipline myself to do. I’ve been lucky enough to have been able to rely on my memory for keeping me on top of my workload for my working career. However I noticed that as I became more overwhelmed, coupled with getting less sleep I found that I was starting to forget to do things until the last minute, which is very out of character. I find writing a To Do list quite cathartic and am using magic white board paper on the wall to write things down as well as using a To Do List book and a daily ‘plan of attack’ to make sure I prioritise every day. I find the discipline hard but rewarding when I do it.

I’m hoping that by putting in place these simple changes I’ll stay resilient; passionate; achieve more in my working day and have a greater sense of wellbeing. I’m starting to see the shoots of improvement and I’m encouraged to stick with it for now.

I hope you’ll stay focussed with me in 2017!

 

About the author

Sarah Morgan is the Director of Organisational Development for Guy’s and St Thomas’ NHS Foundation Trust

Sarah’s blog was nominated in 2016 for a UK Blog Award – healthcare

Sarah is passionate about getting more love into the workplace which was the theme of her 2016 blog series and nominated for the UK Blog Award

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Authentic Leadership, culture of compassion, Leadership, NHS Leadership, Organisational development

Move away from fear – how to get more love in the workplace – part 6

Earlier this week research showed that there are high levels of perceived bullying in the NHS workplace.  According to the research by NHS Employers 20% of NHS staff report that they have been bullied by other staff and 29.9% indicated that they had some element of psychological distress. Managers and supervisors were perceived to be the most common source (51%).

This is quite a shocking statistic and one that begs the question ‘why?’. What drives, seemingly normal people, who work in a compassionate profession and are probably lovely outside of work, to behave in a bullying manner in the workplace?

My guess is that it is based in fear.

Fear of missing the target; fear of the ramifications of spending too much money; fear of losing job/ reputation/ career that you’ve spend decades building; fear of rocking the boat or speaking up. What fuels these fears?

Fear is toxic; it creates a unconscious psychological response in our amygdala or ‘reptile brain’ which is fight; flight; freeze. This is helpful when a sabre toothed tiger is bearing down on you but has no place in today’s healthcare environment except in extreme circumstances. We are starting to see some of the unintended consequences such as a recent CQC report awarding a requires improvement rating citing ‘learned helplessness’ as one of the cultural indicators created by the senior leadership team.

So, how can we support our leaders to move away from fear and start to create the right conditions for staff to be able to operate to their full potential?

As we know culture is the shadow of the leadership and if the shadow that is being cast is one of fear; perceived lack of ability to control or influence; driving for results no matter what the cost and an inability to listen to ideas or thoughts that differ from the cultural norms; then the conditions that are being created for staff to work in are oppressive; toxic and limiting.

Having grip and telling staff what to do can work for a short period of time, particularly in a crisis. However, over a longer period will lead to reduced results and a culture of escalation to the organisation as paralysis will seep in and staff will start to fear making the wrong decision and therefore will make no decisions.

To move away from fear takes a huge amount of courage and the ability to trust in others. Although the current regulatory environment means that there needs to be an Accountable Officer so it is clear where the buck stops, this does not mean that this person has to do everything; quite the opposite.

The key to that opposite approach is enabling the Executive Team to feel it is safe to let go. A recent interesting article by the Harvard Business Review (1) on exactly this, highlighted the rules of ‘self organisation’ the main element of which is communicating intent. This is a very different approach to delegation. One which establishes a set of principles and a clear framework from within which all staff are able to take decisions.

Many of the organisations featured in Fredric La Loux’s inspiring ‘Reinventing Organizations’ (2) have in common a clearly set out vision and principles and enable their staff to make decisions based within the simple framework that they have established. All of the organisations have established approaches to dealing with performance issues and with those people who do not make decisions according to the agreed doctrine, quickly and simply. This clear and simple approach appears to be yielding amazing results the world over.

It is often argued that this is much easier in organisations such as Google and Amazon and in healthcare organisations such as Buurtzorg in the Netherlands (3) as they are all start up companies and had the opportunity to set things up right from the beginning.

So how easy is it to introduce this new way of working into a well established; heavily regulated environment such as the NHS where everything that is paid attention to, measured and rewarded is the opposite? Well the answer is that it is not easy – but rarely is anything worth having easy to achieve. If it was we would have done it already!

Collaboration is the key. Today’s healthcare environment is too complex to rely upon the leadership approaches that worked for complicated problems. Complicated problems can be solved through processes and linear solutions. Complex problems are worsened if this thinking is applied as there are too many factors and variables and therefore a more emergent approach is necessary.

The fear many leaders will have to face is that their ‘tried and tested’ methodologies that worked for yesterday’s problems no longer work and they have no more tools in their toolkit to rely upon. This can often be the root of fear that drives the ‘tell’ culture and often leaders struggle to understand why these methods, previously so successful don’t work in today’s technology driven, disrupted environment. They interpret the lack of results as due to the way the staff are implementing their instructions rather than it being the wrong approach and so give further, more detailed instructions.  Thus creating a vicious circle of decline.

The simple truth is we need a new toolkit and manual for ‘letting go’. Bringing together clinicians and giving them the tools and techniques to enable them to improve how they deliver care and trusting them to come up with the answers, is the first stage to truly transforming the culture in the NHS.

We need leaders that can:

  • lead from behind, rather than in front
  • pose questions rather than offers solutions as they recognise wicked problems require emergent solutions
  • truly collaborate with the workforce and inspire them with purpose and commitment.

These are the leaders that will create the right conditions to replace the fear currently being felt in the NHS workplace with love and compassion, both for staff and patients.

(1)   How Leaders Can Let Go Without Losing Control; Mark Bonchek; Harvard Business Review; 2 June 2016

(2)  La Loux F; Reinventing organizations; A guide to creating organizations inspired by the next generation of human consciousness; 2014

(3) Community nursing organisation in the Netherlands based on the principles of self managed teams which achieves high levels of patient satisfaction, improved clinical outcomes and reduced cost. Featured in La Loux’s book as referenced above

About the author

Sarah Morgan is the Director of Organisational Development for Guy’s and St Thomas’ NHS Foundation Trust and passionate about creating happy workplaces

 

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culture of compassion, Leadership, Organisational development, Staff development

How to get more love into the workplace – Part Two

What better day to talk about love in the workplace than Valentine’s Day? The day when we profess our undying love for the focus of our affection; we can choose to keep our identity a secret or reveal all; we wear our hearts on our sleeve and chance rejection. We take that risk in the name of love.

The workplace can be a minefield to navigate. There are different ‘tribes’; power dynamics and unsaid rules. It often takes courage to say what you really think; stand up for what you believe in and wear your heart on your sleeve. The question is why? Why do you sometimes feel psychologically unsafe if you speak out? Why are diverse views shied away from rather than encouraged? I can’t profess to fully know the answers to these questions, but I do suspect that it stems from a need to belong and our tribal instincts kicking in. This can lead to bad behaviour; exclusion and a general lack of compassion towards our workmates. There’s an interesting Switch and Shift article on this if you want to read more.

So, if it’s an innate part of us, how do we get more love and compassion into the workplace?

Well to me it’s about appreciating what others have to offer. There’s an old African proverb that says, “If you want to go fast, go alone. If you want to go far, go together.” This sums it up for me. Often we are imbibed with a sense of urgency; short deadlines; stretching targets and the volume of work and weight of expectations is ever increasing. Naturally, this gives us a tendency to lean towards the ‘going fast’. Other people, who may have a valid, but different point of view, could slow us down, and we haven’t got the time to ‘bring them round to our way of thinking’ so instead, divergent views are at best ignored or worse ridiculed and those offering them made to feel inferior or stupid.

Over time, divergent views stop being offered, which gives rise to a different challenge, that of ‘groupthink’. This was described by ACCA in their December 2015 article on the need to diversify Boards as a “psychological behaviour of minimising conflict and reaching consensus without critically evaluating alternative ideas.” Often this is found in highly regulated, performance target-led environments such as banking and healthcare.

The predominant leadership style in the NHS is ‘pace setting’(1) . At first glance this sounds like a style that would get results; sets high performance standards whilst exemplifying delivery themselves; however over time it can have detrimental impact as it depersonalises the work environment, making it all about hitting the targets whilst forgetting about the human aspects.

In healthcare, we talk a lot about the need for compassionate care but often we overlook the need to have compassion in our everyday interactions with our colleagues. We need a more human touch in the workplace. To me this includes treating others as you would want to be treated and showing compassion in meetings as much as on the wards. It also means having honest conversations with people, especially if they are not performing as expected, rather than avoiding the difficult issues and potential conflict and then letting things escalate, potentially leading to festering resentment.

To summarise I think compassion in the workplace involves the following three aspects:

1. Treating people as individuals – acknowledging we are all different and have divergent views and opinions. Building relationships and trust on this basis and being as open and honest as possible.

2. Being open and honest – it’s often much easier to develop a ‘parent/ child’ relationship between manager and staff member than it is to have an adult to adult relationship (2) . Having honest conversations and being open when things are not going as well they might takes quite a lot of courage for some managers. It is far easier to not address issues but this just builds ill will over time. Voicing your opinion and being true to yourself, colleagues and staff, will enable a much more positive and transparent environment.

3. Valuing others’ opinion – as well as voicing your own opinion, allowing others to voice theirs without immediately responding or trying to bring people round to your way of thinking. Often this is more difficult than it sounds, but really listening to other people and opening your mind to other possibilities is the key to working with colleagues from different professional backgrounds, organisations and industries. Working out how to collaborate and work through the net benefit, so there is a shared and collective understanding and an agreed way forward, takes real skill.
I think if we all listen a little more; talk a little less and think of the person in front of us as a fellow human being, we might just start to get a little more love in the workplace.

Happy Valentine’s Day!

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1   Leadership that gets results; Daniel Goleman; Harvard Business Review; March 2000.

2.Eric Berne; Transactional analysis (parent, adult, child model); 1957.

About the author

Sarah Morgan is the Director of Organisational Development for Guy’s and St Thomas’ NHS Foundation Trust and a passionate advocate of creating conditions in the workplace to enable creativity and innovation to flourish

 

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culture of compassion, Leadership, Organisational development, patient centred care, Staff development

My New Year’s Resolution: To Get More Love into The Workplace

December is the month that most people spend more time socially with their work colleagues than any other period in the year.   Increasingly outlandish Christmas jumpers are worn, Secret Santas are drawn and many after work drinks imbibed. Come the New Year, it’s all back to normal and the joy we find in the workplace in December is lost in the cold, dark months of the winter.

I’m fascinated by the need to get more love and joy into the workplace. I’ve been struck this year by the work of Frederic Laloux, whose book Reinventing Organizations – A Guide to Creating Organizations inspired by the next stage of human consciousness has been my most inspirational read of the year. So this coming year, 2016, I’ve decided that my New Year’s Resolution is to get more love into the workplace!

Many of us go to work having created an image of ourselves that is our ‘work persona’. I’m as guilty as everyone else; I have my ‘work wardrobe’ and I don’t mix my work clothes with my ‘fun’ clothes. Anyone else do that?

I think being yourself in the workplace is incredibly important and the way to developing a culture of trust and authenticity. According to the Collins dictionary[1] the definition of authentic isgenuine… accurate in representation of the facts; trustworthy; reliable;” all of which are characteristics of people I want to spend a considerable amount of my time with.     

I’ve been giving a lot of thought over the past year as to how we develop a culture of compassion in our NHS organisation and I’ve concluded that authentic leadership is a vital component. Going hand in hand with this is collective leadership, where everyone takes personal responsibility for the success of the organisation (definitely worth reading Michael West’s work in this area[2]). This is particularly important in an environment where many of the staff enjoy professional autonomy. Ensuring that every one of our 13,650 staff feel part of the organisation and take responsibility for the success of the whole organisation, is crucial to our continued success.

It’s been a challenging year in the NHS and despite the welcome additional £3.8bn from the Treasury in the Spending Review, it feels as though next year will continue to be a huge challenge for its 1.4 million staff. Bringing love and joy into our NHS organisations will be a really important factor in keeping up the morale of our staff.

There was a lot of love for the NHS this Christmas as the NHS Choir beat all the odds and made it to the Christmas No1, with Bridge Over You selling over 127,000 copies and raising money for charities such as MIND and Carers UK. (Watch the video here https://www.youtube.com/watch?v=T8qHXlShfUQ). Keeping that feel good factor and that overwhelming feeling of joy of really being part of something that matters I see as a key priority for our NHS organisation, and the NHS as a whole this year.

So where to start? It was Peter Drucker who said, “The best way to predict the future is to create it.”

I intend to start by building a culture of compassion. Ensuring we have the right culture, driven by our visible values and behaviours; encouraging a culture of authentic and collective leadership; supporting our teams with the development of emotional intelligence and seeing the individuals in front of them rather than just following a policy is this years’ focus.

I’ll keep you up to date on progress; what works (and what doesn’t) throughout 2016 on this blog and my Twitter account @sarahmorgannhs.

This year, I can’t wait to achieve my New Year’s Resolution!

[1] http://www.collinsdictionary.com/dictionary/english/authentic Accessed on 28 December 2015

[2]West M et al; Developing collective leadership for healthcare; The King’s Fund and Centre for Creative Leadership; May 2014

Sarah Morgan is the Director of Organisational Development for Guy’s and St Thomas’ NHS Foundation Trust

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Leadership, Millenial Generation, Organisational development, Staff development

All present and correct?

In today’s increasingly fast paced; always connected, always ‘on’ world, it feels as though there are never enough hours in the day to get done what needs to get done. Time feels like it slips through the fingers like sand but suffers from the polarity of being both fiercely protected and recklessly squandered. A way of making the most of the time we have; our precious 168 hours a week; is to improve our work/life balance, but is that as easy as it sounds?

Work/ life balance is something we all talk about, but achieving the perfect balance appears to be the Holy Grail. The Millennial generation (those born between 1980 and 1995) are particularly protective over their work/life balance and as the Deloitte Millennial Survey (2014) highlighted, by 2020 75% of the global workforce will be millennial, and so understanding what they are looking for in the workplace is increasingly important.

An international study published in the Harvard Business Review report from February 2015 (https://hbr.org/2015/02/what-millennials-want-from-work-charted-across-the-world) demonstrated that the term work/life balance means different things in different parts of the world. Many interpret it as work/me time. Interestingly, except for Central/ Eastern Europe, in every other region, over half the respondents said they would give up a well-paid and prestigious job to get better work/life balance.

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Source: Harvard Business Review, What Millennials Want From Work Charted Across the World; February 2015

Broadly speaking, most Millennials across the world cited spending time with family and to grow and learn new things as the most important to them, if they could prioritise in life.

W150217_BRESMAN_HOWMILLENNIALSWOULD

Source: Harvard Business Review, What Millennials Want From Work Charted Across the World; February 2015

 

This is great in theory, and companies such as Google and Apple are famous for having mastered it, however many organisations still have a prevailing culture of presenteeism i.e. I have to be able to physically see you to know you are working. Frederic Laloux’s fabulous book Reinventing Organizations tries to tackle this very issue, citing the companies around the world that have moved to self-management; putting the power in the hands of the staff rather than the management. He describes these types of organisation as being evolutionally teal, the characteristics of which appear to be looking after the spiritual well-being as well as the emotional and financial well-being of their workforce.  In reality, these organisations are the exception rather than the rule, so the real challenge is how to move away from a culture of presenteeism to one that values effective outputs.

This demands a different kind of leader; one that is comfortable with a more collective or distributed type of leadership; who moves the power to where the skills, energy and motivation lie and creates the right conditions for innovation to flourish (West and Dawson 2014; Kings Fund).

Enabling staff to have more flexible and agile working practices is crucial to ensuring the recruitment and retention of the best talent. Unusually for an NHS organisation, over half of our staff are under the age of 40 (54% against the NHS average of 41%) and so understanding what is important to different generations, particularly millennials, is an important part of our workforce strategy. We are about to undertake some research looking at what is meaningful to the different generations and different professional groups in our organisation, so that we are better able to tailor our training and development; workforce policies and support different working practices. Moving our managers away from a prevailing culture of presenteeism to one where they are comfortable in treating staff as individuals; interpreting policy and managing staff on the basis of the quality and timeliness of their outputs will require investment in supporting our managers to think differently and will require our leaders to change the ‘ask’ in the organisation.

This feels like the right direction of travel and should enable a different type of workforce to emerge to ensure that we remain one of the best employers in the NHS and are growing a workforce that has the work/life balance they both want and deserve.

About the author

Sarah Morgan is the Director of Organisational Development for Guy’s and St Thomas’ NHS Foundation Trust

 

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