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21st September 2015 3

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1st December King's Fund 5.30pm

Janet Davies CEO and General Secretary of the Royal College of Nursing.

Discusses the future of nursing, safe staffing, Vanguards and the 5YFV

This will be another sell-out Tickets... here.

What kind of a banana are you?

News and Comment from Roy Lilley

Do you watch much TV? Apart from the news, almost everything I watch is via the iPlayer. I'm a scheduler's nightmare.

I came across a BBC Three programme; a group of three, hard-up youngsters who leave the UK in pursuit of dreams, dosh and better days, trying their hand at some of the toughest jobs.

They've tried sheep shearing, Canadian forestry, cattle ranching, skyscraper window cleaning (don't look down), trawler fishing and deck-hands on a rock-lobster fishing boat in Oz.

A bit of me is full of envy at their joie-de-vie and another bit where I'm embarrassed to have lived such a soft life! See what you think.

We don't have to look too far to find tough jobs on our door step. Pick anything at the patient facing front-line of care; emotionally shredding and exhausting. Looking after the ungrateful, the unknowing and the unbelievably appreciative and deserving.

In an entirely different context there is another job that is becoming so tough, no one wants to do it. Running a Trust...

The average tenure of a Trust Chief Executive is about 30 months.

In 33 trusts the chief executive post is held by an interim or acting or the post-holder is due to leave shortly. It's becoming a dog's job.

The perfect storm; no money, improbable regulatory requirements and professional isolation drives good people to the point where they say 'thanks but no thanks'. The NHS is destroying its leaders.

Why would anyone want to rise above middle ranking senior posts that are interesting, demanding-but-do-able, reasonably secure and rewarding?

What does it take to step up to the top job?

Would you want it? Being the boss is a lonely place. That's why the Shelford Group started; a secure place where the leaders of the most complex organisations could share problems and solutions.

Even that hasn't provided air cover; one of their members, I thought to be a good man, has just left the oh-so-posh Cambridge in very strange circumstances. Thrown in the towel or thrown out? Prized out of a prize job my Monitor and the CQC? The Board seems to have gone AWOL. It looks like a shambles. Cambridge University FT; too special to be in special measures? Apparently not.

You volunteer for a job like ChEx, knowing the extent of the exposure to your professional life and in some cases prurient press interest in you and even your family.

In this excellent article, from the HSJ, Rob Webster explores, in thoughtful detail, the collapse in NHS senior leadership. The comments are very revealing.

What does it take to be the boss? Perhaps you have to be self-confident to the point of being selfish or egocentric? In the right context, both of those qualities contribute to the poise, self-assurance and coolness you need.

All of the top leaders I have met, in the NHS and outside, speak of self-doubt and moments of uncertainty. Being the boss is emotionally confusing and perplexing. When it becomes befuddling it is dangerous.

Becoming the boss means the good old days of being able to pass the really gritty problems up-the-line are over. You are the end of the line.

Running something else helps. Yes, I'm serious, get on another Board, a voluntary organisation, a company, anything different. Wrapped-up in running a large organisation is insulating and suffocating. Working a few days here and there in a different environment will test your skills, open your mind.

There's an old adage; 'think outside the box'. I can tell you; it's a lot easier if you've been outside the box.

In a top job there are precious few opportunities to redefine you. Leaders are visible, have a vision and share it often. In other parts of the organisation you can 'do the job' and keep you head down. The higher up you go the more you will have to take people with you.

The confidence of the board, the belief of the senior staff, the trust of the people whose livelihoods depend on you and the expectations of people you serve. They all become partners in your success.

Leadership is about having a conversation.

Charles Durning, the actor, he of Dog Day Afternoon and The Best Little Whorehouse in Texas and a war hero, is attributed with a quote I just love...

"... I'm not often the top dog, but sometimes it's better... If a movie or play flops, you always blame the lead. They say, 'He couldn't carry the part.' They always blame him... they rarely blame the second or third banana."

What kind of a banana are you?

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Contact Roy - please use this e-address

roy.lilley@nhsmanagers.net

Know something I don't - email me in confidence.

Leaving the NHS, changing jobs - you don't have to say goodbye to us! You can update your Email Address from the link you'll find right at the bottom of the page, and we'll keep mailing.

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