Gone

Do we need it anymore?

Has it become an anachronism?

Modern data capture, gives us centralisation. Centralisation creates single points of control and control crowds out leadership.

Is leadership something ‘we used to do’. Something we will look back on and say ‘do you remember when…’

In politics and business the demand for leaders who can navigate complexity, foster trust and empower others is greater than ever. 

I fear, no longer in the NHS.

The NHS is heading towards a period of centralisation. The DH+ power grab tells us that. 

Command-and-control structures will stifle local leadership, discourage initiative and prevent responsive, context-specific decision-making and take care of the enemy of the control freak… variation.

Trusts and FTs, born into the legacy of management freedoms have seen their inheritance largely, clawed back. What room for manoeuvre do they have?  

GPs, the ultimate lone-guns of the system, are being corralled and brought into line. Their partnership model, the ultimate expression of freedom within a system, crumbling.

In the name of quality, consistency and predictability…

… data, detail and forecasting will redefine the ‘national’ in the health service. Leaving no room for nuance, subtlety, colour, texture, variation. 

Uniformity managed across the system.  Performance and its outcomes, administrated.   

NHS leaders are becoming little more than middle-managers, implementing top-down policies. Translators of management speak into the language of the day-to-day. No longer can they drive change based on frontline realities.  

Almost without us noticing, a system has evolved designed around compliance.  

The likes of the Confed’ and Providers, flat-foot. Spectators, rather than leaders of the leaders of change. 

The upshot will be a reactive, risk-averse culture, scrambling to comply.  Innovation squeezed out. Local needs, nuance and variation overlooked, ignored and unwelcome.  

The NHS is no place for leaders.

Right now health services are unstable: vulnerable to political whims; unsure about the impact of technologies; nervous about the forces of bio-pharma; the direction of the public’s health; struggling with a collapsing estate; and ends that don’t meet…  

… it should be a golden age for leaders but there’s a clear message…

… no matter how senior you are, your position can vanish overnight. No consultation. No warning.

NHS leadership has become the Starbucks’ cup… it might have your name written on it but in the end, it’s disposable.

When strategic direction can change overnight without warning or consultation, what incentive is there for capable leaders to step forward and take on the burden of responsibility?  

Why should leaders with the experience, insight and the drive to steer the NHS through its current crises step forward if the very structures they are meant to lead can be dismantled, beneath their feet.

Why invest years developing strategic acumen, operational insight and the ability to drive transformational change if a single ministerial whim can render roles obsolete? 

NHS leadership has always been about impossible targets, political minefields and short-term policies. In a sense that’s been the attraction. The huge challenge. A challenge, pretty well unparalleled in any other workplace.  

Making the best of the impossible and the trick of making one pound do the work of two.

In a system that lurches from one short-term solution to another, leadership is now the first casualty.

Successful leaders know they must do three things;

• Leaders are visible, have a vision and share it often.
• Leaders create the time and space for good people to do great things.
• Leaders always recruit people who are better than them.

How can we expect leaders to see beyond the daily chaos and have a vision beyond their own survival.  

How can leaders find the time to create space. Developing people is pointless when half of them will be fired and no one is sure which half.  

How can leaders recruit and give talent the security it understandably demands? Recruitment is impossible when people know they are likely to become the victim of the bluntest tool in the HR department’s tool-kit; headcount.

Leaders are reduced to implementing instead of innovating. Executing directives instead of shaping strategy.

There will come a time when we will wake up and ask…

… where have all the leaders gone? 

News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at thetrainingnet.com by kind permission of Roy Lilley.