Kay Young

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Developing Leadership in NHSS

• Kay Young
• Leadership Consultant
• Scottish Government
• Health Directorates
• Kay.Young_at_scotland.gsi.gov.uk

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Outline of the session

• Leadership in general
• NHS service change agenda
• New, emerging models of leadership
• NHSS Leadership Framework, Qualities Behaviours

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Global focus on leadership
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Leadership defined

• Becoming a leader is synonymous
• with becoming yourself. Everything
• a leader does reflects who he or she is
• Bennis, 2003
• Leadership is a performing art
• a collection of practices and
• behaviours rather than a position
• Kouzes and Posner, 1997

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Leading with passion, purpose, people
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Leadingbut to what end?

• To change organisations and the systems within
  them
• To empower others and create cultures that
  support this alteration in stance
• To work with, in and through teams in de-layered
  and increasingly technological environments
• To change peoples mindsets and to give them
  clarity of purpose by managing the meaning of
  situations
• To drive forward adventurous and visionary
  strategies Van Maurik, 2001

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Change, complexity and ambiguity

• It is not the strongest of the species that
  survive, nor the most intelligent but the one
  most responsive to change
• Charles Darwin

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Leadership synonymous with change

• Resisting change is as futile as resisting
  weather, and change -relentless change - is our
  weather now. It is that constant and that
  unpredictable. Leaders live it and so do
  organisations.
• Bennis, 2003

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NHS Change Agenda

• The NHS in Scotland needs to change. Not
  because it is in a crisis as some would have us
  believe it is not but because Scotlands
  health care needs are changing and we need to act
  now to ensure we are ready to meet the future
  challenges
• Prof. David Kerr, 2005, p 3

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The shifting carpet
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New ways of delivering care

• Current view
• Geared towards acute conditions
• Hospital centred
• Doctor dependent
• Episodic care
• Disjointed care
• Reactive care
• Patient as passive recipient
• Self care infrequent
• Carers undervalued
• Low tech

• Evolving model
• Geared towards long term conditions
• Embedded in communities
• Team based
• Continuous care
• Integrated care
• Preventative care
• Patient as partner
• Self care encouraged
• Carers supported as partners
• High tech

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A way to go
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And not only thatleadership is changing

• Findings from UK research
• Heroic leadership has had its day
• New model of engaging leadership
• Leader as servant and partner leadership as a
  social process
• The soft stuff is the hard stuff

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The real impact of poor leadership in the NHS
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So what is leadership really about, now?

• Engaging the human spirit
• Building shared visions
• Recognising everyones strengths, contributions,
  aspirations
• Bringing humanity and humility in through the
  front door
• Being open minded and curious
• Being transparent and open
• Believing that people are not the problem.but
  part of the solution!
• Delivering service and health improvements
  through leadership passion, purpose, people,
  performance.

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Part of the NHSS leadership journey so far..
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NHSScotland Leadership Development Framework

• Scope
• Strategic coherence local space
• Strategic and distributed leadership
• Clinical and non-clinical leadership
• Team and individual
• Health and wider public sector
• Leadership and management development
• National 360 feedback tool

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LEADERSHIP QUALITIES SUMMARY
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LEADERSHIP DEVELOPMENT FRAMEWORK OVERVIEW
Strategic Team Development
Leadership Capacity
Front-line Leadership
Succession Planning
Future Focus
CHP Development
Personal Qualities
Service Excellence
Top Leaders Careers
Single-system development
Leadership Capability
Career Development
Culture and Behaviours
Leadership in Managed Clinical / Care Networks
Clinical Executives Development
Local Career Management
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What about clinical leadership?
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Defining clinical leadership

• Driving service improvement and the effective
  management of teams to provide excellence in
  patient / client care
• Scottish Executive, 2005, p4

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Clinical Leaders-key role

• We are committed to finding better ways of
  recognising the key leadership role of clinicians
  from all professional backgrounds
• Partnership for Care, 2003

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Key Clinical Leadership Challenges

• provide strong clinical leadership across
  professional and organisational boundaries
• think creatively and work collaboratively to
  overcome obstacles to the service change and
  health improvement
• exhibit leadership behaviours that are consistent
  with the leadership qualities and create an
  enabling culture for managing complex change

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The dilemma leading change, whilst hold the
balance - yes..and

• Be innovative and manage risk
• Think long term and deliver results now
• Cut costs and improve staff morale
• Reduce staff numbers and develop team work
• Be flexible and respect the rules
• Collaborate and compete
• Decentralise and retain control
• Specialise and be opportunistic
• Provide low cost and deliver high quality

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Why bother?So that.

• Instead of seeing the rug being pulled from
  under us, we can learn to dance on a shifting
  carpet
• Thomas Crum, 1987