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opportunitynowhere
No leader is perfect. The best ones don’t try to be
as they concentrate on honing
their strengths and find others who
can make up for their limitations.
‘Truth’ No.1
‘Truth’ No.2
Re-read ‘Truth’ no.1
In Praise of the Incomplete Leader - Ancona et al, 2007
How will I
think or act
differently as a result of
this session?
Individuals can only be effective as leaders if
the organisation recognises many collective
practices and contributions to the organisation
as leadership, and does not solely embrace an
idealised idea of the heroic leader. However
enticing in a pressured environment, the fantasy
that getting the right leader in place will be
enough to change the system is untenable.
Key Message
Setting the
Context
Let’s identify and explore
the current trends and
drivers that are creating
‘uncertain times’
GW
‘Uncertain Times’
• Worst recession since 1930s
• Record public debt which has to be reduced
• Unemployment and economic developments
• Societal and demographic changes
• Demand rising - impact on health/social care
• Carbon taxes and ‘new’ sustainable agenda
• Technology avalanche accelerating
I think the main tensions facing all clinicians involve managing complexity to maintain quality when
we have some serious issues to face such as an ageing population,
economic constraints and rapidly developing technology that we all have to get to grips with at home and work.
It may seem a
strange principle
to enunciate as
the very first
requirement in
a hospital that
it should do the
sick no harm.
The same 5 common themes
emerge from each inquiry.
More than 50 NHS public inquiries
have been conducted to address
catastrophic failures in patient care.
Walshe, K. and Higgins, J. (2002). The use and impact of inquiries in the NHS. British Medical Journal, 325, 895-900.
The same 5 common themes
emerge from each inquiry.
More than 50 NHS public inquiries
have been conducted to address
catastrophic failures in patient care.
Disempowerment of
staff and patients
Isolation
Poor
communication
Inadequate
leadership /
management Failure of
systems and
processes
Walshe, K. and Higgins, J. (2002). The use and impact of inquiries in the NHS. British Medical Journal, 325, 895-900.
One
in 10
One
in 300 Vincent, C. et al. (2001) Adverse events in British hospitals: preliminary retrospective record review. BMJ 2001 322:517–519.
“The recommendations I am making today
represent not the end but the beginning of a journey
towards a healthier culture in the NHS where
patients are the first
and foremost consideration of the system and all those who work in it.”
Failure to deliver
the fundamental
components of care
can bring down an
NHS board faster than
either financial or
performance failures.
(Machell et al, 2009).
Our vision is
one of a Welsh
NHS which
is safe and
compassionate.
What are some
of the challenges
that are creating
‘uncertain
times’ in your
present role? Group
Work
Let’s examine a
leadership metaphor
and model that can
assist you to be more
agile and effective
when leading in
‘uncertain times’
Permanent White Water (Vaill, 1996 & Covey, 2006)
ILL
The Constants
• Change
• Choice
• Principles (Covey, 2006)
The Constants
The one indisputable
fact that characterises
organisational life, is that
CHANGE
is inevitable!
(Beverly Alimo-Metcalfe, 2005)
Challenges to Change
The greatest difficulty in the world is not for
people to accept new ideas, but to make them forget
their old ideas! John Maynard Keynes ‘Are you kidding? I like it here!’
Developing individuals without working with
them to simultaneously change the system
will not lead to organisation change.
Organisation change is not achieved
by the development of unconnected
individuals, no matter how much
investment is made in this.
Key Message
Comfort
Zone
Panic
Zone
Discomfort
Zone
The truth is that our finest
moments are most likely to
occur when we are feeling
deeply uncomfortable,
unhappy, or unfulfilled.
For it is only in such moments, propelled
by our discomfort, that we are likely to
step out of our ruts and start searching
for different ways or truer answers.
“If you
want to see
change…
…be the
change
you want
to see”
The Constants
Between what happens to
us and our response to it…
…..is our freedom to
choose our response
CYW
The Constants
MAIN THING for you as consultants
working in iiiiiiiiiiiiiii
What is
Clinical
Leadership?
When clinicians lead
themselves and others to
provide quality care and
deliver service improvement
Clinical
Leadership
Everything we do
should be benchmarked
against the difference
it makes to patient care
Health care requires colleagues from diverse
professions and with competing perspectives on
what is important to work collaboratively to meet
organisational aims. The NHS requires complicated
leadership arrangements with negotiated authority
between clinicians and professional managers, between
clinicians from different professional backgrounds,
across one NHS entity to another, and for innovations
and change projects that involve different directorates.
Key Message
Management (Order & Consistency)
Leadership (Change & Movement)
John Kotter
Management (Order & Consistency)
Planning / Budgeting
Establish agendas
Set time tables
Allocate resources
Organising / Staffing
Provide structure
Make job placements
Establish rules & procedures
Controlling / Problem Solving
Develop incentives
Generate creative solutions
Take corrective action
Leadership (Change & Movement)
Establishing Direction
Create a vision
Clarify big picture
Set strategies
Aligning People
Communicate goals
Seek commitment
Build teams & coalitions
Motivating & Inspiring
Inspire & energise
Empower subordinates
Satisfy unmet needs
It is a terrible
thing to look
over your shoulder
when you are trying
to lead - and
find no one there Theodore Roosevelt
DS
If management is efficiency
in climbing the ladder…
…then leadership determines
whether the ladder is leaning
against the right wall.
People need to think of themselves as
leaders not because they are personally
exceptional, senior or inspirational to others,
but because they can see what needs
doing and can work with others to do it.
Key Message
What does
leading in
‘uncertain
times’ involve?
• Accepting ambiguity and the fact that things are
never really black and white
• Believing in the primacy of relationships over
structures or skill sets
• Using personal and ‘appreciative’ inquiry as a tool
for transformation
• Trusting collective intelligence rather than individual
knowledge
• Forgetting ego in favour of surrendering to the
reality of the moment
• Being prepared to question and let go of those
things that may be self-limiting and a constraint
upon our potential
“The significant
problems we face
cannot be solved
at the same level
of thinking we
were at when we
created them.” A New Level
of Thinking (Paradigm)
Creating a
Paradigm
Shift
• Be a role model for those who follow
• Be humble and remember your role
is to serve others
• Be visible and accessible
• Deal with team dynamics
• Innovate
• Collaborate and build communities
• Engage people
• Act decisively
A model or strategy
for leading in
‘uncertain times’
Applying the
leadership
metaphor
and model in
your current
role and working
environment
Leadership must be exercised across shifts 24/7
and reach to every individual: good practice
can be destroyed by one person who fails to
see themselves as able to exercise leadership,
as required to promote organisational change, or
who leaves something undone or unsaid because
someone else is supposed to be in charge.
Key Message
• What helpful behaviours do you need to model?
• How can you be of greater service to others?
• How can you become more visible and accessible?
• What team dynamics need to be created or addressed?
• How can you encourage others to be innovative?
• With whom do you need to collaborate and what
alliances can you build?
• What do you need to do to achieve greater
engagement?
• What will you do to act more decisively and when
will you do it?
In order to lead more
effectively in uncertain times:
Co-coaching
exercise
Final
Thoughts
How will I
think or act
differently as a result of
this session?
If we always
do what we’ve
always done…
…and
finally
…I’ll
probably
do nothing
about it!
If I do nothing
about it in 24 hours…
www.ctrtraining.co.uk
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