NHS managers, if your time is being wasted on pointless chores, bin the boring bits and limit the endless meetings, says Jenny Rogers
An NHS client describes the feeling brought on by being constantly too busy and harassed, chased by emails and pressured by meetings, with no time for the great passions of his life - golf and his children. How can he, and so many others like him, retrieve life from the binge working that has become the default?
This man has also fallen out of love with his job big time and tells me about a gruesome 12-hour day where the boredom quotient is off the scale. It involves: editing - and then returning for further rewriting - papers that people lower down the chain have written; writing papers for someone higher up the chain which this person will scrutinise, edit and return for rewriting; attending an evening meeting where papers other people have written are exposed to much bad tempered wrangling over detail. Here, the recommendations will invariably involve the commissioning of yet more papers.
What about patients?
My client told me despairingly: "The P-word wasn't mentioned once!"
"Which P-word is that?"
There is a dispiriting sense of time wasting in so many large organisations and the health service is, of course, not unique here. Along with the time wasting goes a long-hours culture where people are afraid to leave the office early enough to have a private life and will often become highly professional at creating the appearance of a whirlwind diligence which disguises the reality of not having anything truly important to do.
National Service saw a whole generation of young men become equally accomplished at avoiding the pointless chore of "square-bashing" through faux-busyness. The columnist Katharine Whitehorn describes in her recent autobiography how her husband had used this to advantage in the RAF by going around with dustbin lids, ostensibly checking whether they matched their bins. Invariably they didn't.
"What are you doing, airman?"
"Just checking lids, sir - the officer told me to."
"Don't know sir, an officer, sir."
The essential absurdity of matching bins to lids was evidently never questioned.
Creating pointless work
So many of the tasks of corporate life are as intrinsically absurd and they are also soul destroying. I asked my client to keep a detailed diary of his activities for a week.
On the basis of this, I challenged him with the likelihood that he was himself a generator of meaningless work for his team - for instance calling unnecessary meetings or commissioning papers knowing that no meaningful action would result. Also that he was attending other people's meetings when an email might have served the purpose. Here is one simple tip: when someone asks you to come to a one-to-one meeting, send them the following polite request:
"Can you email me the agenda in advance so I can prepare, and also let me have a list of the decisions that you think we need to make?"
Mostly, the reply will reveal that the information can be swapped electronically in a few minutes and that the meeting need not happen at all.
I also suggested that instead of my client scanning his emails every few minutes, which an amazing number of very senior people do, he should restrict this activity to once a day and then, later, to once every three days, with an automatic message telling people he was doing so and giving his mobile number for contact if it really was a genuine crisis. I promised him that nothing terrible would happen. It didn't.
The real secret of liberation from this treadmill, however, is to delegate. So often in the fear-ridden culture of the health service, staff delegate upwards through skilful schmoozing. "I'm afraid I might get this wrong and if I get it wrong I will be punished so I'm giving the problem to you because you're more senior/more experienced/wiser."
When just one person in your team does this once, it leaves you with one problem to sort. When the entire team does it all the time, you then become a bottleneck for your staff because you are doing several other people's jobs instead of, or as well as, your own. Result: action paralysis and one very stressed senior manager. For examples of how badly this affects the culture of an entire organisation, read the staff survey results of the Department of Health for any recent year.
Trust your staff
The rule should be: trust people to get on with the job. Give them both responsibility and authority and do this at the lowest level consistent with the task. Say no to flattering requests to take over a subordinate's work. Any task that needs several fine brains to revisit and paw over it is the wrong task. The "improvements" made, for instance, by constant editing and re-editing of board papers are largely a waste of time: invest it instead in a one-off tutorial for everyone on how to write a crisp, short paper and then let them get on with it.
There are some essential truths here. Just because a job takes a long time, this does not mean it is worthwhile. And if a task is intrinsically unimportant, doing it well does not make it important.
By implementing some of this advice, my client found his job could be done in under five hours a day, leaving two questions: why he was paid so much to do it and why he was still doing it.
His story has a happy ending. His chief executive left, unsurprisingly citing "stress". My client took over as interim chief and implemented a 30-minute meetings protocol, and a "two pages only" rule for any document. He told his team to bring him solutions and suggestions rather than wasting hours agonising about what the problem was.
He then relaunched his career as a professional interim manager and now routinely does a seven-hour day, works from home one day a week, takes at least 10 weeks of holiday and has improved his golf handicap no end.