Neil Goodwin's Comments
The FT authorisation process does bring capacity and capability development, which did not really exist in a systematic way across the NHS beforehand. The process also brings a welcome focus on the role and contribution of boards, which also was also something of an afterthought before the FT movement. I would agree that unless prospective FTs can reach the required levels of leadership and OD, questions should be asked how many times they should be allowed to try and cross the bar before an alternative, local system solution is agreed. The phrase flogging a dead horse springs to mind; and unfortunately the NHS will sometimes overdo the flogging before stepping back.
Comment on: Invest in commissioners' leadership training now
These views are spot on. My own way of looking at this is that the development of policy and plans needs to be complemented by spending at least as much time - if not more time - on implementation planning. Failure to do so results in policy implementation and the best intended transformations failing. This is important not only for commissioners but for all organisations including government. So, to be successful don't we need to combine the importance of leadership with the nitty-gritty detail of management?
I agree with comments above about being positive. Is it necessary for anonymous commentators to be so gratuitously insulting. It does neither them - whoever they are hiding under, sneering cloak of anonymity - nor the HSJ any credit. Mark Britnell worked for me some years ago as an operational manager. Quite frankly, he was excellent, a joy to work with, and was one of the handful of really good managers I had the pleasure to work with during my 20+ years as a CEO. I can understand the decision he's made and I hope he continues to make thoughtful contributions to NHS policy from his KPMG role. L
Comment on: Berwick chief: review critics 'miss the point'
David Dalton is quite correct in his reaction to publication of this important report, as are the comments above about culture change. But an important part of that change is allowing local organisations, in the operating context of their local health systems, to work out how best to implement Berwick for themselves. There still remains a dependency culture of looking to the centre for how to do it; and seeking action or check lists is symptomatic of that. Each restructuring of the NHS endeavors to address this, and largely fails. There does however remain two points of optimism for the future: the development of CCGs led by people outwith the historical management culture; and the appointment of the new CEO to NHSE who, along with regulators and government, must make every attempt to turn the NHS from a national organisation to a national industry.
Comment on: Alastair McLellan named 'editor of the year'
Well done Alastair, great news.
Two points. First, many of the people on the clinical leaders' list gave up their clinical career a long ago. So to what extent their medical degree impacts on how they undertake their current role will be debatable. Second, we shouldn't assume that someone who qualified as a clinician may make a better CEO of NHSE (or any other healthcare organisation). Reflecting the management research, as people progress through their careers, it's their personal skills which determine their future success and not their professional knowledge or background. So, what this says to me is that choosing the new CEO of NHSE should be driven as much by an assessment of their style as well the substance of their career to date. Whilst applicants need to understand international healthcare trends (and ideally also the UK NHS) - coupled with an ability to understand and relate to clinicians and patients - their professional background will be largely irrelevant.
Comment on: Burnham backs central planning
Central planning undoubtedly has its place and it's the default approach of most governments. But... it fails to acknowledge the importance of local context. It would be naive to assume that national organisations implement national policy and change in the same way and within the same timescale. They don't - as we see clearly across the NHS. Each component (region, district, organisation, etc) will have differing contexts of politics, relationships, resources, approaches to decision-making, etc; all of which influence the way they pursue change and transformation. This is frequently insufficiently understood by governments and explains their frustration in implementing national policy, leading to comments along the lines of why can't the whole country perform to the level of the best Re the reference to China above. It's interesting that they have largely abandoned central planning and are now a successful market-based economy within a single party system. It seems that like communism, China's historical approach to leadership has also been judged to fail.
Comment on: Exclusive: Chief inspector of hospitals revealed
A superlative choice. Mike Richards has the track record of operating at the interface of government and the NHS, excellent knowledge and intellect, and equally importantly, the right style to make this role work for the benefit of patients and the NHS.
I know that Chris would not want this to be considered as an 'either, or' issue but we must be careful not to throw the baby out with the bath water. Pace setting and achieving targets have their place, and are just as essential as quality and safety for maintaining public confidence. Historical context is crucial here. It wasn't too long ago that long waiting times were the norm with the public calling for improvements. They probably contributed as much to increased morbidity and mortality as those issues highlighted at Mid Staffs. And those of us who are old enough can equally remember the mess that public services were in at the start of Mrs Thatcher's premiership, although Chris is right when he says that she - like the majority of leaders in power positions - eventually began to believe her own rhetoric that led to her downfall. The trick is to balance the achievement of performance with developing a good quality culture using appropriate leadership styles. But as I have said in one of my recent blogs, I do see a disconnect between the hierarchical practice of management and the multi-disciplinary, team-based practice of clinical care. I believe this disconnect will make it harder for management to change. Hence, I argue for the need to pause and consider the purpose, role and practice of NHS management; and for it to establish a closer relationship with the clinical professions.
Comment on: Break away from 'heroic' leadership
Good piece for stimulating discussion. I too have called for more evaluation of leadership along with a stronger emphasis on management, which with administration has been somewhat sidelined by an over-emphasis on leadership. But perhaps the most important variable to take into account is the relationship between developing a stronger NHS ethos of caring and compassion, and how these qualities are viewed in society as a whole. I would argue that whilst I share Clare's aims, unless we are seen to be a more caring and compassionate society - as is the case in many other countries - we may have limited success in changing NHS (and social care) culture. Finally, and this is another way of looking at Clare's points, there is an increasing gulf between the multi-disciplinary, team-based approach of clinical care and treatment with the hierarchical nature of leadership and management in the NHS. NHS management needs to be reinvented so that it mirrors clinical care - perhaps then we would stand a better chance of developing the improved behaviours that we talk about.