Recent events have called to mind a book buried on the shelves in my study. It's by Eileen Shapiro. '
Fad Surfing in the Boardroom'. In it she says:
Fad Surfing: "The practice of riding the crest of the latest management panacea and then paddling out again just in time to ride the next one; always absorbing for managers and lucrative for consultants; frequently disastrous for organisations"
Fad management in the NHS? Surely not!
Light touch, grip, organisations with a memory, quality circles, inspection, regulation, earned autonomy, safe staffing, every contact counts, right-treatment right-place, no decision about me without me, drop-in, walk-in, crawl-in... blah, blah.
I could fill the page with management fads the NHS has employed to disguise the fact that the service is not adequately staffed by happy, motivated people, secure in the knowledge that they work in a stable environment, with a clear focus on what they are supposed to be doing.
Management crazes, deployed to camouflage the fact the NHS is obliged to deliver more care than it is funded for. The latest infatuation is intended to disguise the fact that there are not enough talented people, willing to take on the Sisyphusian task of running a hospital.
The average tenure of a Trust boss is just over 20 months. Does the NHS have a special aptitude to find the klutz of this world and give them a job? I don't think so.
I think the NHS has a special talent to regulate, govern and oppress managers to the point where they hit the targets and miss the point or miss the targets and get hit on the head with a pointy-thing.
Most Trusts are unable to balance their books and two thirds of them can't reach the CQC's Mickey Mouse, arbitrary, quality requirements. Does this mean two thirds of Trust bosses are fit only to run a whelk-stall? No?
Does this mean the task of running a Trust, whilst complying with the plethora of made-up standards, goals, guidance and political vanity projects, is no longer possible? Probably...
It is true that some Trust Chief Executives, mainly a handful who have been in post for many years and sit on a cushion of stability and reserves, are likely to be able to ride out a storm but in time even their buttresses will give way.
And, therein the seeds of the next NHS fad.
The cockamamie idea that because a Trust boss can run one hospital, they can run two, or three, or more. They can't. Only hubris would whisper to them that they can. Flattery persuades them. Force-majeure obliges them.
The grand deception that the shortage of stable, senior management talent can, somehow, be overcome by getting people, good at doing one job, to do two.
Running a Trust is like running a village... a community. A family of people. People driven by a common purpose. Shared objectives. Good Trust CEOs create a presence, an aura and they do that by being ubiquitous and omni-present.
They are open about their problems and turn staff into fellow travellers, to
help them with the journey.
The idea that a successful trust boss can run more than one trust brings us to the inevitable question; could they run three, or four, or more?
That drives us to the conclusion that a super-talented-boss could run all the Trusts from a desk in Whitehall... that is the worst kind of stinking thinking.
There is only one way a canny and successful trust boss might expect to run an extra hospital.
I'll tell you how...
They would scour the management ranks for a talented, trusted lieutenant; develop them, create a rapport of confidence and an environment of certainty. Install them, back them, celebrate and f�te them. Protect them; stand-point, watch their back... and give them the freedom to express their skills and gather experience.
They would step forward and help them in the bad times; step back and let them take the credit in the good times.
And if you think about it; if we'd have done that in the first place we wouldn't be in this mess now.
