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Leadership in the NHS - Is your own 'house' in order?

“To help others develop, start with yourself!” Marshall Goldsmith, Leadership Coach

How many times have you sat on an aeroplane and listened to the safety demonstration? For some it will be once a year as they go on holiday, for others it’s a weekly occurrence. How many of us could recite it? More importantly, if you genuinely needed  to activate the process, would you know what do do?

Thankfully I never have and hope that’s the way it stays. If the oxygen masks did drop from the overhead storage the one thing I would be certain to do is fit my own before helping anyone else. Applying the quote; I would be no help to anyone else unless I first sort my own situation.

Applied to the evolving models in the NHS, how many CCGs or providers can say they genuinely have their own house in order before trying to fix everyone else, or tell them where they are going wrong?

I suspect not many; and therein lies the problem. People talking the talk and being unable to demonstrate or lead by example. Instead we end up being told where we are going wrong and what we should do to fix it. The message comes top down, usually from a sub committee. The command and control method oft used and clearly preferred in the NHS, run by a steering group of a chosen few representatives, which then seeks the involvement of other stakeholders in the name of being able to say that all stakeholders have been involved?  And how often have you seen plans and projects born of that process fully delivered and sustained?

Some readers may know I have used only part of the quote from Marshall Goldsmith at the start of the blog, so here is the remainder:

“To help others develop, start with yourself! When the boss acts like a little god and tells everyone else they need to improve, that behavior can be copied at every level of management. Every level then points out how the level below it needs to change. The end result: No one gets much better”.

If you want to deliver change successfully you must involve those who ultimately have the responsibility for delivering that change right at the start. If they don’t have true and real ownership of the change, they are more likely to resist it, regardless of how good or positive that change might be. 

Those in senior leadership roles often struggle to let go of the process and need to control the outcome, and may only genuinely attempt to involve people, if at all, once the plans or direction of travel is a fait accompli.  Even at that point, the number and range of people involved will often be too limited to ensure proper buy in.

When you are creating an organisation to work at-scale (GP federation, super pracice, PCH, MCP, PACS, ACS etc) it is vital for success and sustainability that you have buy-in and engagement, not just from the chosen few but from everyone within the wider health and care community in which the new model will deliver services – from patients, to commissioners, to other health, social care and voluntary providers.

Consequently, we suggest you take a very different approach to change and development, which whilst challenging in its nature, ensures that all stakeholders in any change are fully involved right from the start through a programme of genuine engagement and collaboration. 

Furthermore, if you have started with a process of planning and development, and are finding that you’re not achieving the results that you want, we would be delighted to support you by helping you to change your approach by use of our model of engagement and collaboration.

Whether engaging with us to support you is at the beginning of the process or mid development, the outcome of participating in our innovative approach will be a fully engaged and motivated community, committed to ensuring that your organisation is business-ready and plans are successfully implemented. 

Not only this, but by adopting our model to change and development, you will have sustained resilience and have the tools to cope with future challenges and change.

Our model of engagement and collaboration is founded on principles of the engagement and inclusivity of all stakeholders involved in the delivery of care e.g. General Practice, GP Federations/Super Practices, Clinical Commissioning Groups, Community Services, Hospital Trusts/Foundation Trusts, Mental Health, Social Care, Patients etc.  

Whilst challenging, this ensures that:

  1. the vision created is one that has been developed by all those who have a role to play locally,
  2. this approach leads to buy-in and ownership of what you create as a “community for care” and bringing about a critical mass for change
  3. the community for care is underpinned by a real appetite and desire for change, leading to your change project being implemented and sustained

Furthermore, the process we will support you through also ensures that your team has the capacity and resilience to meet future demands and challenges in a constantly changing NHS.

If you want to develop a business ready at scale provider organisation, MCP, PACS, ACS, are heading towards ACO or are about to deliver any form of change, and are looking for a model to engage every stakeholder in that change, and would like more information on how BW Medical Accountants can support you, or to arrange to speak to one of our experts please contact or call 0191 653 1022.

Additionally, if you should have questions for us please email and we will do our best to answer these within the blog.

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