Using your proxy

Introduction Text:
Local elections are coming up.  You might well yawn, but this goes under the heading of ‘watch out what you wish for’.  Or more appropriately as Churchill observed, “Democracy is the worst form of government, except for all the other forms that have been tried from time to time”.

I get four votes – in Peoria for local politicians (despite not living there since 69); in Illinois for national elections (don’t blame me for George Bush since I voted for the other guys); in London for local elections; and in Glasgow for general elections.  So as an American abroad born in Leicestershire I get to vote on Scottish independence.  Figure that one out.

As they say in Chicago, ‘vote early, vote often’.  The point is that as citizens we can have some say in what we get.  There are of course limitations on our influence, but at least it’s an opportunity.  How then do your customers exercise their influence?  This is a critical question, since you know yourself how disempowering the NHS can be.  Whether it’s a service you’re using yourself or you’re trying to get for your granny, it’s sure difficult at times to get the customer service you want.  And you guys are in charge.

Accessing NHS services comes up often in conversations that I have with friends and family.  It’s as if I’ve become a translator.  I explain about the pathways of care.  How to access a pathway.  Then for them to enquire about the criteria for care at points along the pathway.  To suggest they ask to see a senior person if they’re getting fobbed off.  And of course to get close to the consultant’s secretary if they want to change an appointment.

You’ve no doubt had similar conversations.  As Top Leaders, you therefore have the proxy vote for your customers to improve their service and outcomes.  How should you exercise this proxy?  Try this:

Walk in their shoes.  This is about getting out and about to see what is going on.  There is of course a management theory for this: MBWA.  Peters and Waterman popularised Management by Wandering About in Search for Excellence over 30 years ago.  Obvious, you might say.  But ask yourself, how much you do this?  What percentage of your time is customer-facing?  Patient stories at the board are nice, but no substitute for walking in their shoes.

Challenge behaviour.  How often do you dismiss behaviour you see that is clearly out of kilter by saying, “that’s just how they are”?  The Diagnostic shows way too much directive style among Top Leaders.  It has its place, of course, but as a default for some people, it’s clearly out of order.  Yet some leaders get away with it way too much.  Face it; you’re colluding at times in this.  If you’re aware, so are your customers.  So call your colleagues on their bad behaviour.

Join the dots.  Your customers see the joins in the services they receive.  They sometimes fall through the service gaps.  If you’re in customer shoes and talking to staff about the services they deliver, then you’re able to join the dots.  I seldom see this at the board.  Exec directors stay in their silo as a default.  Take C.Diff.  The trust is potentially exceeding its targets, so the conversation is about the level of the fine and how to minimise it, rather than considering the means of getting to zero.

Will you vote on 2nd May?  Whether you exercise your own vote or not, make sure you use your customer proxies to best effect.  Turns out I don’t have a vote this time.

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