nhsManagers.net

31st August 2016

Live Health News | Weather | Archive

HealthChat

Ed Smith

Chair of Not-Monitor, or whatever it's called. In conversation with Roy L

Good conversation, networking and a glass of wine. Lots to talk about now the STP s are ding their thing.

This will be a full house.

If you are intending to come, get your tickets organised!. A few left.

Details here

Go for that

News and Comment from Roy Lilley

As health services management comes under more and more pressure and greater skills are required, we could do no better than turn back to the father of modern management thinking; Peter Drucker.

Drucker provides us with a blue-print for every thinking leader. I'm not sure he ever intended his principles to be fossilised, he would have been the first to admit times change.

Drucker's corporations have given way to more nimble organisations that are data driven, with conduits to customers, through social media, that were never invented, never mind envisaged in Drucker's hey-day.

That said, Drucker talked about decentralisation, treating employees as assets and the idea of the company as a community.

Drucker talked of 'liberating' people a theme later picked up by Tom Peters, in his opus, 'Liberation Management'.

Drucker taught us to recognise that it is more important to learn something than it is to say something.

In Drucker's later work he described himself as a "social ecologist," a close observer of the way humans are organised across all sectors - in business and in government.

In the context of the NHS, we are organised in such a way that politicians are the reluctant custodians of health services. They understand its popularity with a public who are reassured by a system that whatever befalls them, their survival will not depend on their ability to pay.

The difficulty? The drive towards a low tax economy. The belief that re-election means lower taxes. No one seems to have asked the public what they believe, or how they would like things organised.

You don't have to be a social ecologist to recognise the disorganisation of the NHS, the Lansley legacy and the unwillingness of his successors to scrap it, leaves managers stranded in an eco-system that is all but unmanageable.

It falls to managers to reshape the NHS; politicians will not admit their errors. They were blind-sided by Lansley's reforms, left disoriented by their consequences, bewildered by austerity politics and have no viable alternative in sight.

It's up to managers now. Liberating? Maybe. There is no golden age reference point. We can only carry out repairs with what is in the management tool-kit.

We need a strategy? Noooo... I hate strategy.

STPs are strategic health authorities in drag. But, I like them. I like them because they are spontaneous. They are examples of positive deviance; individuals or groups whose uncommon behaviours and approaches means they can find better solutions than a top-down, regulatory, hierarchical approach.

They are asset based. They ask; what have we got and how can we use it better? They can prioritise opportunity over problems.

However, unlike SHAs they must not be permanent. They will fail if they become part of the furniture. Their mission is; improvise, revise, devise, analyse, surprise, and clear off.

STPs should be 'people sorting themselves out'. They must be inclusive (local councils involved, along with the third sector) their goal should be to put themselves out of business, leaving a nimble and agile legacy.

STPs are the replacement for strategy. They are tactics and techniques.

Drucker would approve because in the complexity of political indecision, unpredictable funding and overwhelming demand, whatever we 'strategize' will be obsolete the moment we devise it.

There is more; Drucker tells us there is no checklist for the overriding quality that management needs in tough times... courage.

He is right. Change-plans will have to go through the ritual of 'consultation'. It will take courage to tell the truth; there is no time for judicial review, nit-picking, self-interest, palavering and gain-saying.

The over-riding question, sweeping aside the niceties of business-as-usual, is; 'How fast can we get out of what we are doing and into something different?'

The opportunities are huge but remember Drucker's advice; cost driven services always fail. They are the wrong way around. We are looking for service driven costing.

Success will be found in discovering what good looks like and doing it; making important decisions quickly. Accept that little will go as planned and be prepared to abandon a cherished idea for a better one.

Above all, STPs need a crystal clear mission. A raison d'�tre. Nothing elaborate. Something that fits on a T-shirt.

How about; 'Our purpose is to create happy patients'.

I think Peter Drucker would go for that.

------------------------

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.

----------
Disclaimer

Medicine for Managers