The NHS struggles to measure one of the most important factors driving trust performance – leadership.
Until recently, part of the challenge has been a lack of clarity about what leadership behaviour should be measured. Undoubtedly there are many views on what might constitute good leadership for the NHS, but for the present, senior figures within the NHS are backing the Medical Leadership Competency Framework (MLCF), devised by the NHS Institute for Innovation and Improvement.
So, will leadership measurement begin?
Now in its second edition, the MLCF is to be introduced to medical college undergraduates in the autumn. Its initiatives on personal development, self awareness and self management for doctors are well thought out and long overdue Yet, as with much leadership development, it seems surprising that a course and framework are necessary to establish these values as part of a new management leadership culture.
However, there is a high risk that the well meaning aspirations of the MLCF will not be met, so comprehensive and wide reaching are the implications of the Framework.
From our research across 300 trusts, we have learnt that few trusts understand either the challenges or the opportunities presented by the MLCF.
NHS trusts are expected, but not obliged, to follow medical colleges and introduce the MLCF into their own training and leadership development programmes. Some trusts may simply add a few modules to existing programmes, while others are singling out specific groups for some specific attention. This is hardly perfect and a far cry from the broad and far reaching leadership programme envisaged by the MLCF.
The framework is more than series of competencies to be delivered piecemeal. It is a tool that wisely used will enable trusts to invest in the key leadership competencies known to drive trust performance that are relevant to the individual trust’s circumstances. It cannot however be used widely if it isn’t supported by effective measurement.
In his speech to the King’s Fund in September, the Secretary of State for Health Andy Burnham told his audience that the NHS should “step back, measuring less but with a relentless focus on what matters: clinical quality, patient safety and, particularly, patient satisfaction with services.”
The call to measure less applies equally to the current management of leadership training, where there are endless NHS statistics on course attendance but next to nothing on training effectiveness. Without measurement, the MLCF’s great ambition to generate a “better management” culture across undergraduates, post graduate and doctors in more senior roles will follow the well-meaning management frameworks in other industries that have faded away because they are next to impossible to implement in practice.
There is widespread belief that effective talent measurement is impossible, and doubly so in an organisation with a management structure as complicated and diverse as the NHS.
Our experience of management frameworks shows that unless their clear and precise measurement of specific, desired outcomes from leadership development, tailored round the needs of individual organisations, it will become just one more tick box on the current management programme.
Hedda Bird is chief executive of the ROI Academy, a performance measurement and evaluation company. www.roiacademy.co.uk