Healthcare Leadership needs to change.
At all levels. And now.
The NHS cannot continue to teach and encourage leadership along traditional models. The current leadership model embeds nine leadership dimensions based upon current NHS principles. Currently Managers and Leaders can encourage, engage, develop and hold the organisations to account so that the central targets are delivered; within the fiscal targets agreed by the senior leadership teams.
This is failing.
The emergency department targets have not been met for several years. Cancer targets are barely being met. Referral to treatment standards are not reporting in several organisations as the internal systems are in turmoil. Widespread rota gaps and a diminishing multidisciplinary workforce challenge the organisational ability to provide seamless care. The workforce is exhausted, and the public are demanding more than the current finance envelope can provide. External consultancies and agencies are pillaging the scarce NHS financial resources that do exist.
Doing the same, in the same way, will deliver the same and result in downward spiral as the vision becomes blurred and staff are disheartened.
Martin Hancock, NHS Head of Talent Management states: “It’s not just a question of not having sufficient people: we need to be clearer about what capabilities we need from senior leaders and then make better use of the talent we already have.” This is not enough.
Change is needed and needed fast.
It is time for disruption.
The junior leaders hold the key to the success of the NHS, not the senior leaders. Jeff Bezos has demonstrated that successful business is not based on traditional models. New leadership within the NHS will have to look outside the conventional NHS hierarchy and consider new ways of working and communication as well as healthcare technology. It is time to invest in the new generation who will adapt to these ways with ease rather than envisage a culture change, which will be slower paced, within the senior generation. The rules of engagement will have to be different from the ways senior hierarchy have perpetuated over the years.
The new generation of NHS staff will not be wedded with unquestioning loyalty to the NHS for a lifetime. They will demand a work-life balance, respect and an ability to succeed with portfolio careers. The NHS environment will have to cater to the workforce who will, irrespective of gender, take responsibility for childcare and adult care as their parents grow older without access to social care.
Change is needed in the system. The workforce has the answers if the current leaders are willing to ask the right questions and listen. Experience of medical management for emerging Consultants should not be attendance at a Management and Leadership course. All staff should experience management decision making at a corporate level, and a multitude of opportunities exist. FY1s and nursing students are not aware of the pressures of flow across bed challenged organisations nor the fiscal challenges for each organisation. This disconnect reduces innovation as these front-facing members of staff are unaware of their power. For example, the power to discharge and the ability to set and drive patient expectations can accelerate bed flows and contribute to exemplar elective care.
Perhaps organisations and HEE should mandate that all trainees experience a taster week across the senior management teams so that they can envision their best fit for their own careers.
The talent pool that exists within the NHS is phenomenal. The challenge is how to invest in the younger talent pool, early on in their careers, promoting the concept of challenge and innovate rather than accepting the status quo. A sign of a successful organisation may be measured in the future by the ability of the system to embed the passion and purpose of the individual and mould it to the visionary strategy.
The senior leaders may save the NHS. The junior leaders can.
Stella Vig is a Consultant Vascular and General Surgeon and Clinical Director at Croydon University Hospital