Mike Chitty, a faculty member at the NHS Leadership Academy, shares his view on how we block our own leadership success, often without realising.
The NHS constitution sets out to “value every person – whether patients, their families or carers, or staff.” Culturally, that’s a wonderful place to be, but it’s also pretty utopian to achieve without a concerted effort to build, improve and maintain leadership capacity.
One of the academy’s main objectives is to ensure the presence of inclusive and compassionate leadership knowledge, skills, attitudes and behaviours at all levels of health and care. But the NHS is under unprecedented pressure to improve performance in a context of rising demand and constrained funding. Leaders in post report feeling isolated and less supported. In these circumstances, it’s not surprising that our leadership behaviours can slip.
The way we view ourselves as leaders
We can all be great leaders when our environment allows us to be at our best. But what happens when certain situations bring out the worst in us and we can’t live the values we identify so strongly with? Sometimes the way we behave as leaders and the way we view ourselves as leaders are very different things – it’s a blind spot for some of us. Take our own values – the things we feel we are as people. We’ll probably say something like: “I’m inclusive, passionate and open.” But which values do we model in the grittiness of our day-to-day lives?
Think about what our colleagues or team members might say when we’re having an off day. A bit snappy, a bit arrogant, not a great listener…? The point is that as leaders, we delude ourselves, so while we’re behaving badly our self-image remains resolutely intact. After all, it’s not a conscious decision to let our leadership style stray from our values; often we’re not even aware of it.
Part of the leadership development work the academy does is to pop that self-preservatory bubble and admit that sometimes, a very different set of values shapes our decision-making.
So if we’re talking about the pressure of a stakeholder visit, for example, on the leader versus the pressure of delivering great services, we’ll always say it’s patients at the heart, yet we’ll find ourselves laminating the trust values to put on the wall just before the visit. Deep down we know that has nothing to do with putting patients first and everything to do with the visit, but it’s really hard to let that in. We all know in theory that patients are at the heart of what we do, but let’s be honest: patients and money are at the heart of what we do, because without money, we can’t care for patients.
As soon as you have that honesty, at least people can appreciate that you’re being truthful with them as a leader. Our colleagues will respond to authenticity infinitely better than they will to insincerity or disingenuity.
We view ourselves as subservient to leaders
Lack of aspiration to progress to leadership roles is a real challenge. This is keenly felt at the most senior end of the spectrum – a report by the King’s Fund found that the average tenure is just 18 months – but we need good leadership at all levels of the NHS, and you don’t need the title to display it.
If staff feel empowered to deliver quality services to patients, they’re more likely to lead others to do the same. Morale will increase, and so will retention.
I think where empowerment is concerned, there’s room for improvement. Many staff just don’t identify as leaders. A lot of our programme participants will say things like, “I’m just an AHP – I’m not a leader.”
They view leadership as something people in positional power do to them. They don’t recognise that leadership is something we all contribute to. It’s what we all do to try and get from where we are to where we want to be, whether we do it consciously or unconsciously, well or badly.
Once colleagues identify as leaders, we hope they’ll go out and say “I’m a nurse leader” rather than “I’m just a nurse,” and to really start to believe it. If you see yourself as a victim – “just a nurse,” a victim of the decision-makers – your drive and your ability to make a difference diminishes. The Mary Seacole programme for first-time leaders, for example, helps people see that a leader is not a white man in a suit – it’s about a social process, trying to make our work a more fulfilling and better place.
Power is a dirty word
Do you consider yourself to have power in your organisation? Or do you feel powerless?
Many people see power as a bad thing, but part of identifying as a leader is about becoming comfortable with the notion of power and how it works. It’s knowing how to harness our power, and this includes the power we have over our own lives. We teach participants that self-interest is okay because we can’t care for others if we don’t care for ourselves.
There are 168 hours in a week, your job gets 37.5 from you, but you always give another eight or even 10. Who do you take them from? Many of us identify with selfless values, but we’ll quite happily steal from friends, ourselves, our family or the wider community in order to give more to work.
We need to be comfortable with our right to have a decent life and a voice to assert that without negative connotations. Most of us are socialised to shrink ourselves to keep everything ticking over, but one of the best definitions of leadership is ‘full expression of oneself.’ We should all use our power to express ourselves fully, at least feel that we work in an organisation which allows us to.
We offer a range of tools and programmes to support people working at all levels of the NHS to develop leadership. Please get in touch with us to find out how we can help you flourish on your leadership journey.