By continuing to use the site you agree to our Privacy & Cookies policy

Your browser seems to have cookies disabled. For the best experience of this website, please enable cookies in your browser.


Your browser is no longer supported

For the best possible experience using our website we recommend you upgrade to a newer version or another browser.


The People Manager

Five Myths about the Austerity Diet

2 September, 2015 Posted by: -

It works you lose £s fast.- rapid cost cutting is rarely  sustained.

A radical efficiency program is the only way to lose £s- not true ,real efficiency savings require small changes that can be sustained over a long period.

Outsourcing is an effective way to loss of £s in the long term - no its not , and it carries a high risk of permanent damage. 

Reducing staff terms and conditions will result in the £s dropping off - it will also lead to high staff turn over recruitment problems and the use of expensive agency staff. 

Cutting out management posts  is a good way to lose £s- not a good idea you are more likely to to use expensive management consultants, lose expertise and valuable experience. 
Blair Mcpherson 

Comments (1)

Change Fatigue

27 August, 2015 Posted by: -

Causes, Symptoms, Treatment 


Frequent service reorganisation
Too many management restructurings 
Unresolved tension between efficiency goals and performance targets
Confusion over priorities
Unresolved conflict with partners
Rapid turnover of chief executives (on average 2 to 3 years in severe cases  can be 18 months)
Low staff morale
High levels of cynicism throughout organisation
Image problem
Negative inspection reports 
Strident senior management language 
Debt/money problems
Blame culture
Replace chief executive 
Replace chair and some board members
Merger with another Trust(s)
Restructure and reorganise 
Invest in bigger communication team 
Set new targets
Issue new (additional ) priorities 
Invest in fast track leadership development
( There are no proven cures but many retain faith in the above giving case examples of short term relief. There are management consultants who believe the only effective treatment is a prolonged period of stability, financial security and a focus on safety and quality ).
Blair McPherson

Comments (1)

The Amazon Jungle

23 August, 2015 Posted by: -


Amazon may be a terrible place to work but is it a good place to be a manager? Close supervision, performance improvement plans, long hours, ultra competitive culture and a killer mentality, the Amazon office is a jungle. But a jungle is not necessarily a bad place to be if you are top of the food chain. 

If you're a senior manager you have probably read the evidence that happy more cohesive teams get better results. But keeping morale high and getting people to be nice to each other is hard when you need to deliver budget cuts , make people work harder and longer and impose inferior terms and conditions of employment whilst holding the threat of redundancy over them. It's much easier to say,"this is the job if your not up to it you can leave"and justify the management style as necessary in such a competitive market. After all it works for Amazon.

The public sector is keen to take what works in the real business world and see if it to can be more efficient and competitive. The biggest expense in the NHS is staffing so if we could reduce costs by paying staff less, getting them to work harder for longer and having less time off sick we would have a more efficient and a more competitive NHS. Given the right tools and the total backing of the board any NHS Trust could be more business like. Amazon has some useful tools in close supervision, performance improvement plans and and the real killer an anonymous feedback system on colleagues performance. Let's face it who knows who is skiving, who is incompetent and who is swinging the led better other members of the team? It could also help identify those subversives who undermine change initiatives with their negativity and cynicism. Our modern HR computer systems could collate this information identify those who would benefit from tighter supervision and a detailed performance improvement plan. Obviously if there is a lack of improvement then any reasonable employer would be justified in dismissing the individual on the grounds of competence.

How easy would this make the job of management. As a senior manager you could have real confidence that if after due consideration you and your board made a decision it would be implemented. Policy would always be practise, there would be no gap between rhetoric and reality and what needed to be done would be done.

If it works at Amazon.

Blair McPherson former Director of Community services 

Comments (1)

Same circus different clowns

10 August, 2015 Posted by: -

Organisation change fatigue is where a significant proportion of staff within an organisation are feeling exhausted by continual change. Organisation change fatigue or OC Fatigue is not the same as staff resistance to change, individuals or groups of staff are not against specific proposals but rather apathetic to yet another restructuring/ reorganisation the attitude is one of "oh no not again"or a resigned and cynical "seen it all before". Organisations suffering OC Fatigue are characterised by lots of projects and working groups members of which feel they are generally unproductive and time consuming. Before one set of changes is fully implemented another set are introduced and then another often over turning rather than building on previous changes. There is confusion over priorities.  Staff feel overwhelmed by the volume of work and unconvinced by management's claims of urgent need for change.

It is as if a well paced marathon has become 26 one mile sprints. 

There is considerable cynicism particularly towards senior management who are regarded as increasingly out of touch, arrogant and intolerant of those who raise concerns. Yet senior managers are not immune they to can become disillusioned and find it increasingly difficult to get enthusiastic or sell the latest efficiency initiative, reorganisation or cultural change programme. Frequent restructuring,mergers, outsourcing and bring services back in house are a serious distraction for senior management and they are frustrated by this. 

In organisations suffering from OC Fatigue front line staff claim that following a restructuring they are hard pushed to say what the disruption has achieved, what has really changed. Changes frequently mean new job titles, new logo, new chief executive but as one cynic put it ," same circus different clowns". 

He only rings when he needs a fix

3 August, 2015 Posted by: -

"I meet him in a car park and give  him £20. No doubt some people would say that I am crazy giving money to a drug addict but I am his mother and he only ever rings me if he is desperate. He is living rough, he hasn't contacted me in months, the only way I know he is still alive is when I get a phone call from the support worker at the drop in centre. He has agreed to enter rehab but he can't take up the place till the end of next month. I can't have him back home last time he stole all my jewellery. So when he asked for money I gave him just enough for a fix. "

Blair Mcpherson author and blogger 

Just like True Detective

28 July, 2015 Posted by: -


There has been a lot of comment on social media about the second TV. series of highly praised True Detective. Five episodes in and it couldn't be more confusing. With several back stories to untangle, a complicated plot and difficulty in working out which characters are important let alone who are the baddies. It reminded me of far too many inter departmental and multiagency meetings.

What on earth is going on? I missed the first ten minutes of the meeting now I’m playing catch up. Quickly scanning the minutes of last meeting leaves I am none the wiser. It doesn't help that I’m not sure who's who, clearly I'm not the only substitute. The agenda seems to be jumping around, people’s names are dropped but I have no idea why they are important. The chair seems keen for everyone to have a say and some people have clearly come with something to say although the relevance of their contribution is not yet clear. A couple of people seem preoccupied with what’s happened in the past, going into great detail about who agreed what with whom. I listen intently hoping for clues. By the time we get to the last agenda item I think I am on safer ground and able to ask a question without appearing foolish. I don't want people to say he came and didn’t say a word. 
The chair feels this has been a very useful meeting and everyone else seems to be in agreement however people seem to be having difficulty finding space in their diary for the next meeting. A date is fixed but several people explain that unfortunately they may have to send a sub. The chair again apologise for the mix up over the  rooms and says next time coffee and tea will defiantly be made available. 

On my way out I over hear one of my colleagues say to the person she was sitting next to " so just to recap .....did we decide we were or we weren't doing ...." It appears I was not the only one confused. 

Blair McPherson former director, author and blogger 



Why doctors don't make good managers

21 July, 2015 Posted by: -

The transition from professional to manager can be uncomfortable and difficult. It requirers a different set of skills, it's not just the responsibility for budgets although this can result in a conflict between professional values and rationing services or imposing eligibility criteria it's the emphasis on people management skills. Being a gifted teacher doesn't mean someone would make a competent head teacher. Clinicians go through a long period of medical apprenticeship where they live in a command and control environment and then they become a consultant and now they are independent . Make them a medical manager and the easiest thing for them to do is to revert to the trainee mode and start telling others consultants what to do and in an integrated health and social care world try and tell partners from social care what to do.
Perhaps the answer would be joint health and social care senior management leadership training but the cultural problems should not  be underestimated.
Blair McPherson former director of community services 

How the game is played

17 July, 2015 Posted by: -


How the game is played

The brilliant fictional detective has no time for the higher ups and their preoccupation with budgets, performance targets and the media. They get the job done despite the system, they have no career ambitions, they hate the politics and they think the service isn't what it use to be. They don't play the game, they don't get the promotions their experience  and ability warrant, they end up sidelined or forced out. What makes you think this is fiction or just restricted to the police force? 

To succeed you need to know how the game is played. 

Questions of justice and fairness are only relevant between those with an equal power to enforce them.
The only question of relevance is self preservation and that involves not openly resisting those who are far stronger than you.

Do not rock the boat
Loyalty to your boss is expected to your organisation required 
The reputation of the organisation must be protected

It is not the done thing to criticise a fellow officer to members.
This rule does not apply to private conversations.
Gossip is useful, gossiping isn't gossiping if it is putting your boss in the picture.
Tell the boss what they want to here let some one else tell the boss what they don't want to hear. 
Always present the service/department/organisation in the best possible light.
Be confident and certain even when you're not.
Of course their is a blame culture so cover your back .
People like and promote people who are like them, be like them.

Be agreeable 
Do favours 
Dress appropriately 

This is not intend to be cynical but experience and ability on their own are not enough. You can get away with the occasional transgression but if you can 't be " trusted" you won't go far.
You can of course be a maverick and not play by their rules as long as you are very good at what you do and have no career ambitions.

Blair McPherson former director, author and blogger 

To Kill a Mockingbird

13 July, 2015 Posted by: -


So it turns out that Atticus the great liberal lawyer had racist views in latter life. That the character that inspired a generation to make a difference was not so different a Southern man. That the story as told by Scout was seen through the eyes of a naive young child who hero worshiped her father. Do all children grow up to realise their parents are imperfect? Is it inevitable that those we give hero status to will fall short and disappoint us? Do we all turn into reactionaries in old age?

We repeatedly hear that what the NHS needs is leaders that inspire their staff, that there are only a few made of the right stuff, that the task is immense and requires someone special. 

We are encouraged to identify these “special ones” who have made a real difference and regard them as heroes. 

Would it not be better to demonstrate a little more maturity,  to draw from experience and without becoming disillusioned or cynical recognise that leaders make mistakes that they have weaknesses as well as strengths, that we can have leaders at every level in the organisation as long as they have skill, integrity and a willingness to listen.

The young may need their heroes but the rest of us should be wise enough to set our expectations at a more realistic level, competent leadership. 

Blair McPherson form director of community services, author and

The NHS doesn't do sorry

9 July, 2015 Posted by: -


The NHS doesn't do sorry 

The General Medical Council has issued tough new rules to doctors, nurses and midwives about admitting mistakes and apologising. The NHS doesn't do sorry. NHS managers will tell you that Legal have told them that apologising could be seen as admitting liability and weaken the Trust's position in any subsequent negligence claim. Professionals in all areas of business don't like admitting they get it wrong but the medical profession has traditionally had more difficult than most. Hence the need for the GMC to issue new rules. 

Perhaps its the aura of infallibility consultants like to project, after all you do need to have absolute confidence in your surgeon, perhaps it's because if you take off the wrong leg it's a very big deal but a culture of not saying sorry runs through the NHS. Whether its managers fearing legal proceedings or clinicians protecting an image it can result in a reluctance to apologise for any mistake. 

The  ambulance drops an elderly confused patient at the wrong house, a patient spends all day on the ward waiting to go home because some one forgot to collect their medication from the pharmacy, a patient is discharged to a care home and wheeled through the car park wearing only a hospital gown leaving them exposed and embarrassed. In each case a swift, preferably face to face, apology would have been accepted and that would have been an end to the matter instead a complaint became a formal complaint, resulting in a protracted investigation, the intervention of senior management and still the relatives were left feeling that the chief executive's "My trust regrets...." letter was just weasel words.

So I am glad that the General Medical Council has made clear it expects doctors,nurses and midwives to say sorry I just hope their employing Trust supports them.

Blair McPherson  former Director of community services author and blogger 

View results 10 per page | 20 per page | 50 per page |

Sign up to get the latest health policy news direct to your inbox

Job of the week

Somerset Partnership NHS Foundation Trust

Chief Executive

Very competitive


Head of Clinical Quality and Clinical Governance

£45,000 Per Annum plus £5,000 Per Annum Car Allowance

NHS Complaints Case Handler

£200 per day + competitive

Diabetes Specialist Nurse

£32 - £36 per hour