Time out for review and reflection

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Proper time for reading the paper mid-week feels like a bit of an indulgence but I am doing it today because really it’s all about work, promise!

We’re currently in the process of designing our core programmes and one really key element of them is developing a suite of interventions that help us better create the kind of leadership behaviours we need in our changing NHS.

We need to know what they are and are consulting widely with the NHS on that very issue … you can respond to me via the form at the end of this blog page. I’m also keen to know about what we can learn from what is going on around us.

Today I am struck by a couple of things that prompt me to think about our behaviours as leaders; Savile and the World Economic Forum.

I won’t wade in to the heated debate surrounding Jimmy Savile, but it does prompt a question about our leadership behaviours. The debate for us might be around the culpability associated with complicity. To what extent does condoning, tolerating or even ignoring behaviour that is unacceptable become culpability for the impact of that behaviour – and as leaders in health, at whatever level, what are the conditions surrounding inappropriate behaviour that make it ok for us to tolerate it?

This isn’t just about those who are nominally responsible, chief executives and those in charge when events come to life, it is about us and our daily behaviours as leaders at every level in an organisation.

I imagine that all of us have at one time or another failed to name or challenge some level of unacceptable behaviour. Savile is an extreme of course and many of the parallels don’t work but they are prompts.

What goes through your mind every time you witness an inappropriate comment, misguided remark, offensive exchange? Or when you witness bullying behaviour, prejudice or intolerance? When policies, processes or practice create an environment where people feel victimised, devalued, undermined, compromised? Do you always speak up, do you always challenge?

If not, what judgements are you making about the perpetrator, the context, the ‘victim’?  Senior leaders are more visible of course so their behaviour is amplified and quickly creates cultures of ‘what is ok around here’. Hindsight allows us to think about when the intervention will have been perfectly placed but that luxury isn’t offered us in our day to day role.

One role for the NHS Leadership Academy has been to offer people the opportunity through the space we create for that kind of reflection and discussion.

The discussion about appropriate leadership behaviours for NHS leaders can’t be characterised by a set of definite statements, our world is more complex than that. But taking time out to critically review our own practice and behaviours, and whether in the rush of work that surrounds us we’re avoiding some crucial decisions that will resonate long after we’re gone, is time well spent.


The World Economic Forum has recently published its latest global gender report and the European Commission met yesterday to decide whether to go for a system of regulation or persuasion in the move to increase the representation of women at board level.

The UK is falling in our rating in the equality table. Apart from a real terms decline in the political empowerment sub index this is largely because other countries are improving faster than us, rather than our performance is declining.

Sir Roger Carr (President of the CBI and chairman of Centrica) argues strongly against regulation and quota systems in the Times: we’re doing ok why get in the way of progress by adding unnecessary bureaucracy?

And if you think about the kind of behaviours that will have been endemic and acceptable when much of the Savile behaviours were being perpetrated you can believe we have come some way.

Pace is important though and this ‘two steps forward, one step back’ approach isn’t delivering the kind of changes we need to see. Look around you at the senior leader community in the NHS: are we becoming more diverse or less? Is the diversity increasing fast enough, is what we’re doing enough?

The Leadership Academy has a number of programmes for under-represented groups in NHS leadership including those for people from BME backgrounds and for women medical leaders. But if we’re learning from what is happening globally those countries which are seeing some of the strongest improvements and changes in diversity are taking very concrete steps, including the introduction of quotas, to make those changes happen more frequently and faster.

Perhaps we should be moving the balance away from investing in individuals affected by discrimination to making system changes that compel us to be different. Part of our emerging discussion on the strategy for the NHS Leadership Academy over the next three years concentrates on that issue.

So the newspaper has provided food for thought as I travel to our induction event for new faculty for the Academy. We have taken on 22 people who can work flexibly with us to provide innovative leadership development. Our discussions about how that leadership development impacts on those we work with and the impact that has on patient care and experience will continue over the coming months. If you would like to be involved please let me know.

[pdf]Karen Lynas’ paper on The Academy Core Programmes (26/10/2012)[/pdf]