Open, transparent andvisible leadership

..and why medical leadership?

Dr Mark NewboldCEO, Heart of England NHS FT

21 June

@drmarknewbold www.marknewbold.com

Outline

What is the leadership challenge?

What style and approach do we need from our leaders?

Why is medical leadership important?

Are we using our medical leaders to best effect?

Intro

Intro

Histopathologist

Range of clinical management roles

Aspiring CEO programme in 2007

CEO since 2007

Transformation of hospitals, and leadership

Role of social media

Outline

The big challenges

• Balancing quality, performance and money

• Improving outcomes

• Creating a culture of safety and compassion

• Transforming care from acute to long term conditions model

• Joined up, dignified and appropriate care for the frail elderly

• 7 day working

• Leading in a ‘goldfish bowl’ and being accountable

• Tackling health inequalities and improving preventative care

The big challenges

• Balancing quality, performance and money

• Improving outcomes

• Creating a culture of safety and compassion

• Transforming care from acute to long term conditions model

• Joined up, dignified and appropriate care for the frail elderly

• 7 day working

• Leading in a ‘goldfish bowl’ and being accountable

• Tackling health inequalities and improving preventative care

questioning involving

clinical engagementempowering, culture of excellence

common purpose, credibleresilient, inspiring, innovative

collaborativeclinical engagement open, transparent

engaging, trusted

broad view, ‘doing the right thing’

Outline

NHS leadership

There is no…hidden / political / managerial agenda, or ‘black book’

There are…inherent challenges that are complex

The job is to… improve care quality, while transforming services, within available resources – and take people with us

Leaders must be able to… manage, understand and work through complex issues, engage and inspire staff, build a relationship with the public, work with partners –and - take criticism, be scrutinised, manage upwards!

There are frustrations!

top down, directive harsh performance culture

narrowly focused targets

organisation trumps system

rules can trump principle

secrecy is ingrained

media

professional conservatism

MP’s

build a regular dialogue

a person not a bureaucrat

open up managerial decision-making

be accessible and transparent

share the dilemmas and complexities

to build trust

we need a new style of leadership…

…and a new way of engaging? Traditionally we use…

comms for ‘telling’

engagement for ‘asking’

but in todays connected world weneed to be part of the debate

Our strategy

‘power lies in connections and networks’

‘issues are debated continually, be part of it’

‘hierarchies are flattening – be accessible, ready to give a view, and willing to be challenged’

separate CEO and organisation- make the CEO ‘human’: personal, open,

transparent- organisation: info, listening, messages,

informing

aim is to build relationships, trust, and understanding

Twitter - social media types, health and social media types, doctors, nurses, midwives, commentators, public, patients, campaigners, patients and relatives, complainants, local ‘watchers’, staff – HEFT and NHS-wide, peers, colleagues, Think Tank people, academics, organisation accounts, journalists, MP’s, policy people, commercial, comms and spoofs!LinkedIn – similar but higher proportion of commercialBlog – as above, but many more unknowns!

..staff and colleagues respond ..

.. as do complainants, satisfied customers, those wanting help, and journalists!

#, live tweeting, twitterchats

SoMe creates opportunities!

Is it a worthwhile use of my time?

many followers, including staff, ‘customers’, public

many readers, including staff, peers, and influencers

queries and complaints come increasingly via social media

I feel informed and ‘in touch’

being open & transparent is building trust and confidence in organisation

Able to influence opinion, land messages, generate debate

How transparent am I?

Has transparency been achieved?

i am contactable by anyone

i am ‘out there’ and part of debate

anyone can debate current issues with me

i can be challenged by anyone

my views are stated and open to comment

details of my decision-making, and how I spend my time are open and available for all to read

Outline

It’s a ‘clinical’ agenda we must deliver• Balancing quality, performance and money

• Improving outcomes

• Creating a culture of safety and compassion

• Transforming care from acute to long term conditions model

• Joined up, dignified and appropriate care for the frail elderly

• 7 day working

• Leading in a ‘goldfish bowl’ and being accountable

• Tackling health inequalities and improving preventative care

Outline

Medical leaders bring…

clinical understanding and expertise

values / vocation

independence of mind (!)

ability to create consensus with colleagues

They also…

understand real challenges better

commit most NHS resource

What do CEO’s want from medical leaders?

guidance and advice

clear clinical planning / strategy

creation of clinical consensus

constructive involvement in ‘real world’ debate on resource / constraints

leadership on outcomes and quality

Some advice to medical leaders…

management - not ‘dark art’ - is about people and their motivations

be straight, honest, principled, and...

...be prepared to take difficult decisions

consult often, be clear and open

policies are broad – it’s the interpretation and implementation that really matters

always understand the wider context

seize the initiative, don’t wait

it’s not about ‘them’, it’s about us!

…and finally

don’t worry about being able to read spreadsheets and budget statements!

concentrate on what you uniquely bring, and work with your general manager colleagues

and…

never forget that your real mandate comes from your patients, your colleagues and your public… not from your manager!

THANK YOU!