I’ve celebrated exceptional care at the hands of wonderful NHS staff. I’ve supported emerging leaders to know that we all suffer doubt so encouraging them to transcend their imposter syndrome. I’ve encouraged positive deviants to have courage, and I’ve entreated people to resist the media’s cheap sniping at our National Health Service and instead to engage, reward and motivate the wonderful emotional labourers working in healthcare.
However, this blog will be different. This blog, to be frank, is more critical. I’ve spent the last few weeks, on and off, talking with people at the heart of our NHS organisations. Not the top leaders, but those delivering the clinical care and managerial practice that really makes the system run. I’ve heard some great stories of patient care enabled by good leaders. However, I’ve also heard just too many stories of inept leadership that goes unchallenged.
Several years ago I worked at Roffey Park Management Institute. One of Roffey’s research strands explored the people side of business, especially talent management and staff engagement. I still recall some of the findings: a list of what demotivates bright people and emerging leaders. Number one on the list was ‘working for idiots!’
From my recent chats it appears the problem has not gone away – such people, it seems, are still around. For example…
- A senior nurse passed me her job description. She works stupidly long hours, and is often stressed and exasperated. She is also one of the most dedicated practitioners of leadership that promotes care I’ve ever met. The JD was 7 pages and over 2,500 words long. The list of managerial tasks and responsibilities was jaw dropping. Nestled on page five was a seemingly innocuous statement that the post holder must (not should) maintain at least 50% of time delivering clinical care. The job described on paper is completely undoable. Her bosses, the senior team, and the Trust’s HR manager are all culpable. It’s not surprising that motivation in that particular Trust hovers just above the floor.
- Or how about this one. A senior leader called a large meeting of paramedics to enthuse them to meet the challenges of productivity. Her presentation started by contrasting the road staff to her hairdresser in that if the hairdresser was ill and didn’t come to work she didn’t get paid, and since the ambulance teams got sick pay they were lucky. A colleague put his hand up and said that such comparisons were unhelpful since the hairdresser wasn’t presented at work with a dead baby and then begged by the mother to bring it back to life. Apparently, she had the good grace to blush and backtrack, but the audience was lost.
These (rare) incidents remind me of two of my favourite comedy characters – David Brent of The Office and Basil of Fawlty Towers. These characters are not funny because they are gross exaggerations or implausible caricatures. They are funny because they are only 10% more extreme than some of the ineptitude endured by real staff. Ask John Cleese – he’ll tell you that Basil is based closely on the owner of the Gleneagles Hotel in Torquay where the Pythons stayed whilst filming in 1971. Ricky Gervais’ stroke of genius was to launch The Office with no trailers, no pre-advertising as a comedy, and a cast of unknown (at the time) actors. The first time I saw it I was confused – was it reality fly-on-the-wall or brilliantly off-the-wall? We’ve all met a David Brent, and might know there’s one in the organisation. The uncomfortable question though is – is it you?
How might you know? Ask people. I’m serious. I’ve worked with hundreds of leaders over the years – some as colleagues, many participants or coaching clients. And I’ve researched the age-old question ‘What makes for great leadership?’ I’ve concluded that although there are behaviours and approaches common across the best, you simply can’t bottle it. Leaders are individuals and the finest do it in their own way. One thing, however, that unites all those – from the quite good to the great – is a sense of introspective self-knowledge: they know what they’re like to be around! The best engage in making it very easy to give them feedback – they ask for it. And they ask for it not just through anonymous 360 degree feedback processes, useful though these can be, but they ask for it face-to-face with genuine curiosity. In April we will launch the online tools (self perception and 360 feedback) for the new Healthcare Leadership Model. Maybe you’d like to use it to initiate some conversations with the people who look to you for leadership. Hopefully you’ll find out that, although you’re not perfect, they appreciate you. And they’ll take the time, if you make them feel safe and at ease, to help you become the best leader you can be.
In the meantime, if you’re suffering the incompetence of a real-life David Brent, or worse the collective ineptitude of a Brent-esque senior team, you have my sympathy – you don’t deserve them (and they don’t deserve you!). What can you do? I’d encourage you, without being politically naïve, to be brave. Challenge them when they need to be challenged – as the paramedic did in the example above. Be true to yourself and role model what authentic leadership looks like. Search wider rather than straight up for leadership – reaching to peers and mentors for the support and guidance you need. Most importantly, invest in yourself to stay personally powerful and resilient – eat well, sleep well, stay fit, and share your stories with loved ones.
And, as my classically schooled friend sometimes says, ‘Nil desperandum…’