Derek Mowbray's Comments
Comment on: Staff should be protected from 'never events'
This is interesting - is the never event the suicide or the investigation? It is interesting because this is an issue of psychological wellbeing. One of the overriiding never events should, of course, be the prevention of psychological distress at work, as this will have some impact on the events that do take place that are already on the never event list. A culture that provokes psychological wellbeing will, also, provoke peak performance. which is about the capacity to concentrate. Concentration is impaired by feeling psychological unwell (amongst other causes that divert the mind), and this is often found in organisations with a culture that is not actively provoking psychological wellbeing. As culture is determined by leaders and managers, anything less than a positive work culture is unethical. and should be an overriding never event.
Comment on: Stress levels on the rise in Britain
Whilst it is useful to have the results of surveys published in this way, the real problem is finding the right people to do something to prevent the misery behind the figures. The cost of waiting for people to become stressed is enormous; using the same time to prevent people from being stressed would save the economy and organisations a phenomenal amount of money but, at the same time, improve performance. These figures indicate that psychological presenteeism is rising; the cost of psychological presenteeism is about twice the combined costs of sickness absence and attrition (staff turnover), and is the biggest challenge, by far, that organisations face. Yet we don't have the type of leaders in place to understand and resolve the problem. We are about to hear more about Mid Staffordshire and a need for cultural change. Yet we don't seem to have anyone in place who knows what to do to change culture. This is my expertise. The Wellbeing and Performance Agenda is based on the knowledge that if you feel psychologically well you perform at your peak (if you also have the right skills, knowledge and experience). Feeling well is governed in large part by the context in which you live and work. The workplace can provoke workers to feel well by adopting some well researched, well understood and well founded ideas. The workplace should be the oasis from which people retreat from the challenges of everyday life as we experience it. The workplace is a controlled environment, controlled by leaders and managers. Yet we don't seem to have the right people in place to make this happen. Why not? It must now be one of the crowning ethical issues facing organisations - they are set up to perform at their peak, yet we have leaders and managers that allow organisations to flounder and for workers to suffer misery. Why? Why haven't we got the right people in place to lead and manage organisations in a manner that provokes peak performance, performance that only happens when people feel terrific.
Comment on: Mike Farrar and Sir Andrew Cash set up consultancy supergroup
This is obviously an outstandingly brilliant idea.
Comment on: Demystifying the I in QIPP
Having just facilitated a workshop in the NHS on corporate resilience in times of challenge, this model that Helen outlines seems perfect in the context of sustaining resilience - the need to be a healthy organisation by constantly re-thinking purpose and process. But there needs to be a coathook. Improving quality doesn't really do it for me, simply because I think the workforce element of improving quality is often forgotten. So, I'd like to see the coathook as improving wellbeing and performance through a constant process of rethinking, but orientated towards commitment, trust and engagement, as when these are achieved, quality exists and is made even better, and encouraging innovation (however defined) is a key element of commitment, trust and engagement as it provokes challenges, and challenge is a strong feature of commitment and engagement.
Comment on: NHS chief executives should be 'held to account' for improving staff health
As psychological presenteeism is one of the largest avoidable costs of any organisation it is pleasing to see some movement to address this massive but resolvable problem. However, the link between wellbeing and performance is not yet directly made, although the words are edging towards this basic connection. One strategy and four approaches are suggested - the strategy is to promote wellbeing and performance. The four approaches are: to create and sustain healthy organisation; to adopt adaptive leadership and effective management behaviours that provoke commitment, trust and engagement; strengthen personal resilience, and improve lifestyle@work - the environment, life balance, support services, nutrition and exercise. Programmes to implement a wellbeing and performance strategy are offered by MAS (www.mas.org.uk) and OrganisationHealth (www.orghealth.co.uk). Gratifyingly some parts of the NHS are taking up these programmes now, but there's a very long way to go.
Comment on: The dilemma of appointing senior managers
I agree with Neil completely on this. Too often top people are bottom people in top positions rather than being top people in top positions - strategists and mosaic interpreters as opposed to operationally switched on and methodical. I'm not wholly convinced the differences are preference based. I know, from my own experience, I'm a strategist who loathes the operational aspects of running businesses, but have learnt how to do that., avoid doing it like the plague, and, when I have to, my concentration on the tasks is hopeless. But I can spot operational problems a mile away. I'm not convinced it works the other way round, that operational and methodical people, excellent at operational management, are able to acquire strategic thinking skills, and the pattern analysis skills that this involves. I remember being appointed by a Board after I presented what I was going to do; did it and seven months later the same Board people announced they didn't like it, and waved me goodbye. If Boards don't have strategists and operational mix then there will be problems ahead. Of course there is the imperative to earn more, and by moving into a different kind of role the earning capacity increases. It's very tempting to go where the money is and where people suggest a career should go - upwards. There's also the issue of preferred leadership style. Here, I think, there is massive confusion over what style produces the most effective performance, which to me, is pretty obviously Adaptive Leadership style. To do this successfully, you do need to be a strategist, and have the inner capacity to appreciate that everyone else knows much more about what to do than you do, and the driven desire to find out from them, quiz them and challenge their knowledge and what they do.
Comment on: NHS managers to face tighter checks on behaviour
The IHM Code of Conduct, recently revised, is based on the behaviours that produce commitment,trust and engagement. It is focused on the organisational culture, managing people, managing the service and managing self. Every NHS manager should adopt this Code. It is an enabling Code and not a policing code for good reason. Changing the culture of the NHS comes from the top, and requires those in managerial positions to think differently for their behaviour to change. A policing code doesn't assist with this, and has the danger of promoting behaviours that are the opposite of that which generates high personal performance, but effectively neutralising initiative and limiting risk taking, both of which are what successful organisations do as they are signs of a healthy organisation. Generating commitment, trust and engagement between members of the organisation results in high levels of wellbeing and performance. It is best achieved by adopting adaptive leadership principles that shares responsibility for the organisation amongst all it members so that members act in the interests of the organisation and not the managers. This makes a policing Code for managers constraining rather than liberating. There is another way. It is the IHM way. Download the IHM Code at www.ihm.org.uk
Comment on: Resilient NHS managers lack required leadership skills, DH research says
Hopefully the new academy will really take note of some of the features of really superb organisations. First, the training of leaders needs to be at three levels - level 1 - managing people; level 2 - skills to do the job and 3 - eclectic skills, knowledge and experience to be wise. Next, that all leaders and managers should follow the new IHM Code of Conduct for managers based on the wellbeing and performance agenda that links wellbeing directly with performance and has the starting point that people's psychological wellbeing is determined by the culture, and the behaviours combined with personal resilience. Next, that the workfroce should be central and first consideration for all leaders and managers - without a high performing workforce you have massive risks which cause the spiral of manager diversion to deal with the risks - deal with the workforce first and the risks will be dealt with by the workforce. Next - adopt an Adaptive Leadership style where the responsibility for the organisation is shared between everyone - in other words everyone responds to the organisation NOT the leaders and managers, so independent judgement is expected, and the complex and difficult issues are dealt with, and the fear expressed by some commentators here will be eliminated. The platform for all this commitment and trust, as this produces engagement, and this produces high performance. One day the penny will drop - it dropped a long time ago in the world's brilliant organisations or all sizes and purposes. I, for one, always wanted the NHS, or that bit I've been responsible for, to be world class. The way to do it is as I've described.
Comment on: Making time for successful management development
Cultural change doesn't have to rely on a management development programme that takes years for everyone to experience. 'Getting Started - a Guide to Cultural Change' is currently in preparation. Amongst the steps is the critical one of embedding the cultural values of commitment, trust and engagement into the corporate strategy, establishing what this means when manifested in individual behaviours, and reinforce the desired behaviours, particularly of managers, by routine reinforcing events, such as brief, but regular, team meetings with the purpose of reinforcing the cultural foundations of the organisation. Incentives might be relevant - reverse appraisals, for example, where staff appraise their manager. Producing a Manager's Code with the behaviours that encourage commitment, trust and engagement, which lead to high levels of wellbeing with the impact on performance, is a useful framework for cultural change. However, it has to be visibly driven by the top person and her team, as she has to exhibit the attributes and behaviours that promote wellbeing and performance for the change to be credible amongst everyone else.
Comment on: Regulating managers will not resolve the issues they face
A big risk is that any regulatory approach will regulate the wrong thing. There is an expectation in our society that everything has some kind of quick fix that can be easily applied to every situation. This gives rise to a focus on the idea of efficiency as the key attribute of managers, ignoring the far smarter idea of effectiveness. So we have bankers that are so focused on achieving their goals that the costs associated with their achievement are only measured when they become too great and register somewhere in someone's mind. Even then the Groupthink associated withi this obsession prevents much in the way of improvement. So too, with a large array of organisations, alas, including the beloved NHS. We have to understand that all formal organisations are controlled communities, controlled by managers. The Quick Fix expectation places on managers the pressure to accomplish their tasks in the linear direction that is aimed at the goal. The costs involved in this are massive. The costs of psychological presenteeism are estimated to be two or three times the combined cost of sickness absence and staff turnover - in the NHS someone has suggested £4b per annum. That is the cost of a 'so called' efficient management approach, that has little interest in being effective in the achievement of tasks - being mindful of the wider implications of all controlling actions - the essential job of managers. Unless and until there is a shift in the thinking about managers and their behaviours the massive costs will continue, and in current difficulties where staff are uncertain about their futures, the costs will rise. Worse still, are the by-products of linear efficiency - the stifling of engagement, of innovation, of shared responsibilities, of corporate responsibility, of all the attributes that make successful organisations hugely resilient. Regulation of managers will have the risk of regulating the wrong thing. Licensing managers to practice, and to practice in accordance with the new Manager's Code, based on commitment and trust, that's a different matter altogether. Most professionals have a licence to practice. The term professional means an expert. What we need are expert managers - or professional managers who know that the way to persuade people to do things is to feed their self interest first, and then find they reciprocate by feeding the self interest of managers second. No Quick Fix, but hugely effective.
