From Genghis to Mary Seacole

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As part of the Academy’s two year story, we have asked a range of people from across health and social care to share their own stories and experiences of what leadership means to them.

When I first started working in the private sector, leadership styles seemed to be relatively simple and mainly autocratic – I took it as a compliment (which it was) being told my early leadership style was modelled on Genghis Khan!

If you’re afraid – don’t do it, – if you’re doing it – don’t be afraid!

However in UK manufacturing, the late 80’s and early 90’s were times of rapid change. In my area, automotive component manufacturing, Nissan started production in the UK in 1986 and this quickly bought a new focus based on the principles of Total Quality Management (TQM), zero defects, delivery on time and cost reduction. I quickly learnt, for example, that it was the operators on the production line that knew their part of the process better than anyone else – and if they were given the opportunity to improve they would always surprise you. The culture of continuous improvement was born.

So as leaders, we learnt to give them the tools to achieve improvement, put them into teams with a team leader who was appropriately trained to help facilitate change and took away middle management to make the process quicker. The role of the senior executive has moved away from just being “command and control” to being more of a pace and direction setter, enabling individuals and teams at all levels to make change happen. This was achieved by a mixture of the big step changes and the myriad of small steps focused on delivering continuous improvement and a real culture of zero defects – that is why we now pay less in real terms for a car than we did 25 years ago and it comes with a three, five or even seven year warranty.

Can I see a similarity to our work in the NHS? Quality, Cost and Delivery on time (QCD) was the mantra in the automotive sector– in the NHS we need to demonstrate value for money, I think our patients rather like a culture of “zero defects” – and certainly doing things when we say we will do them is a key part of patient experience. The move towards a focus on “collective” leadership in order to drive change is a significant progression.

As a tutor on the NHS Leadership Academy’s Mary Seacole programme, it is a great privilege to see participants on the course discovering that they really have a key role in local leadership and driving forward change:

I’ve discovered that I can improve quality without being the top manager in my department… I’ve learned masses already and feel energised to take on improvements.” – Sister, Acute Sector, South West

So – move over Genghis – welcome Mary Seacole!

2 thoughts on “From Genghis to Mary Seacole

  1. Great blog Brian. I ‘ve also come to the NHS from a private sector background and fully endorse your experiences. Can we even consider any other way forward? I don’t think so! Contrary to traditional practices, we can achieve quality, cost and delivery on time – but only if we empower the the most relevant people as you correctly suggest. This is a very exciting time for the NHS because the only way is up and those who are ready for the ride will have the ride of their lives. Those who aren’t will be left floundering in the slipstream.

  2. Great blog Brian. I’ve also come to the NHS from a private sector background and fully endorse your experiences. Can we even consider any other way forward? I don’t think so! Contrary to traditional practices, we can achieve quality, cost and delivery on time – but only if we empower the the most relevant people as you correctly suggest. This is a very exciting time for the NHS because the only way is up and those who are ready for the ride will have the ride of their lives. Those who aren’t will be left floundering in the slipstream.