I was talking to a peer from another trust who was moaning about the constant stream of central ‘good ideas’. In particular, she was confused about the proposed leadership council and top 250 programme.

“Why can’t they just make up their minds and decide what they want to do,” she said. “One day they launch it and the next day they seem to have changed their minds about what it’s supposed to be for.”

One of my colleagues has a wonderfully graphic way of describing things. We were talking about a particular work matter and he put one hand high in the air and the other low down and said the issue was a great example of people saying something was as important as the raised hand and doing as little about it as the lowered one.

Aside from this superb melodramatic gesture, the underlying point was well made. If people are serious about something, then they should show this in actions as well as words. It is hard to disagree with that, but it is equally difficult to put it into practice.

In 2006, I was fortunate to be able to complete the excellent Leadership Through Effective Human Resource Management programme commissioned through Manchester business school. I made the most of the opportunity and like many of my peers went on to gain my MSc. The programme was almost universally acclaimed - a rare feat in today’s swamp of training and development mediocrity.

“There is no point changing your appraisal scheme or workforce metrics every year”

A year later, funding for the programme was stopped - just at the point when a number of senior clinical leaders were beginning to take part. Every NHS chief executive I have ever known has stressed the importance of clinical leadership. Development for those leaders is pretty essential. So it is particularly concerning and confusing to say the least to see the good stuff changed as well as the patently poor - especially when it is just starting to have an impact. This type of development is a long term investment, not a short term fix.

Back to my peer from another trust. I told her that one of my working principles for HR policy and process was to try to put only simple building blocks in place and not undo these later.

There is no point changing your appraisal scheme or workforce metrics every year. Line managers should know what you are expecting them to work to. Equally, if you have systems in place that no one can use effectively, you should at the very least discontinue them until you have a viable alternative. In this example, the point is to get an appraisal done, not spend hours recording it on a cumbersome system.

I watched a slow dawn of realisation appear over my peer’s face when we started thinking together through some of our own approaches. The conclusion to the conversation came when we agreed this was not just an issue of “them up there” but that every level of management needed to review its practice to see whether it was guilty of this stop-start way of working.