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Sir Robert Francis

In conversation with Roy Lilley

Whistle-Blowing, Complaints, the CQC and Local Guardians   

Health Chat at the King's Fund 18th May Details here. Tickets selling fast.

...what you gonna do with it?
News and Comment from Roy Lilley

Monday! Hooray! The Duchess calls it 'cold-meat and washing day'. She's right; if you are going to cook once, it should feed you twice. Sunday roast, mince on Monday, delicious. Sheppard's Pie... I miss you!


Monday; the acid test day. Do you wake up thinking 'great, I can't wait to get to work'... or... well, you know... Monday might be a great day if I could spend it in bed!


Mama Cass sang that Monday morning couldn't guarantee what Monday evening would be like.


Like it or not, it is Monday so what can we do in the first ten minutes that will set the tone for the rest of the week? Make everyone a cuppa-builders, empty the inbox, fuse the shredder with last week's stuff. The clock is ticking; who will you ring, who will you go and see, rather than send an email?


How about a whole new approach? How about catching people doing something right? How about saying to someone; 'I watched you do that and you are great. Well done'.


In a wholly misguided attempt to meet targets, hold to budget and improve productivity we focus on things that have gone wrong, analyse data, inspect and crawl over the numbers.


Everything that people have done wrong is emphasised and creates a cycle of self-fulfilling decline. 'It's not worth trying in case I get it wrong'. You can reverse the decline; people who feel good about themselves do good things and are more likely to stretch to do more good things. All you have to do is make people feel good about themselves.


You could raise the issue of the things that went wrong last week but they'd just be a millstone to carry through the week. Alternatively, you might start by referring back to the good things that happened last week and use them as a stepping stone to more good things this week. It's your call.


A lot is said about changing the culture of the NHS. Take my word for it; you can't. NHS culture is ingrained in regulation, inspection, governance, rules, targets, criticism, sanctions and authority.   Just about everything in the big black book of How Not To Manage a Chip Shop; everything the NHS does to destroy moral, initiative, innovation and joy is in there.


If we can't change culture, we might be able to change the climate. In the long run it is climate that dictates culture.


Make a Monday-Start by celebrating the good things, no matter how small. Make a fuss, and whoop your head off when things go right and I promise you, more things will go right.


Put an extra item on the top of your next meeting agenda; 'What can we all be pleased about' and watch the mood change. Ask; 'Who deserves a pat on the back?' I promise you; somewhere in the organisation there is a back that needs patting and it is your job to find it and do it.


A lot used to be made of the Friends and Family Test. It's useless. Based on the 'net-promoter-score' it is a measure of customer loyalty and has to be underpinned by offerings that are made in a competitive environment. Wholly, the wrong test for the NHS. Anyway, it is so easy to fiddle just by picking the time and place where you ask the question and who does it!


For me the acid test is what staff think of the organisation: 

  • Treat your staff like you want the patients to be treated, the patients will be better treated, a lot of your problems will disappear and you can stand back and take the credit.
  • Treat your staff like they are slaves, need to be micromanaged, have no capacity to think for themselves and the knock-on effect will be to drive out all empathy, concern and kindness and you can step forward to take the blame.

Leaders create the time a space for good people to do great things and you'll never have good people unless you tell them they are good people, remind them they are good people and then tell them again they are good people. If you want a highly engaged workforce... engage with them. Simples... leaders are visible, have a vision and share it often.


Today is the first Monday of the rest of your life... what you gonna do with it?  


Sir Robert Francis,

in conversation with Roy Lilley 

Details here 

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Sir Robert Francis
In conversation with Roy Lilley
18th May 2015
King's Fund
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