By Jason Bloomfield, Chief Operating Officer for Finance Solutions, and Davo Ruthven-Stuart, Head of Organisational Development, at NHS Arden & GEM CSU
Change may be constant in the NHS, but the scale of structural change we’re currently experiencing feels different – and tough.
Many of us have or will be leaving organisations and roles as NHS structures are rapidly streamlined or dismantled and rebuilt. But amid this short-term turmoil, the values and purpose of the NHS remain unchanged, and patients still need to be cared for. Leaders face the challenging task of navigating themselves and their teams through this period of change and uncertainty while still delivering the day job. So, how do we do that in a way that genuinely acknowledges the upset that many employees may be feeling, while embracing opportunity and maintaining enthusiasm for the future NHS?
There are no easy answers here – and this article isn’t intended to offer trite suggestions which ignore the reality of job losses. But we owe it to patients to implement these changes in the best way possible, and to our colleagues to enable those leaving to ‘leave well’ and secure new, fulfilling opportunities. We have identified four practical areas leaders can focus on to help navigate the next 12 months successfully. They are:
- Communicating openly
- Securing purposeful handovers and skills transfer
- Embracing opportunities to work differently
- Enabling collaborative discovery.
To achieve any of these, however, the first step is to accept where we are. Decisions have been made, recognising that the NHS needs reform. Whether you agree with them or not, accepting the results gives the headspace to begin focusing on positive steps to deliver the best available outcomes. This does not mean brushing aside the challenges. We all need to spot when people need help, regardless of hierarchy, and draw on the wellbeing and support networks available to provide emotional and practical assistance. But behaviours are contagious. If we want to do right by our colleagues and achieve the best outcomes for patients, retaining a positive mindset and practical, problem-solving approach is key.
1. Communicating openly
Leadership skills will be tested when you’re managing a team that may include some who are about to leave, some faced with an increased workload and some with an unknown fate. Your team may all be in the 'same storm', but their experiences will differ. Be open and honest about these challenges, their potential and real impact, share what you can so that your team continue to feel engaged, and give them opportunities to contribute ideas and share concerns.
2. Securing purposeful handovers and skills transfer
Endings are both an individual and collective experience. For those that are leaving, we want them to leave well, maintaining and developing their skills to the last day, for their own benefit and to continue to deliver purposeful work. For those remaining, knowledge and skills need to be absorbed and developed. Task teams with developing seamless handover plans which will ultimately support better patient outcomes. Provide clear deliverables which demonstrate their continued value to the organisation. In some cases, more detailed management oversight may be needed, but this needs to go hand in hand with compassionate leadership to maintain a positive approach which people can carry into their next opportunity.
3. Embracing opportunities to work differently
As ICBs reduce their headcount by 50%, activities will have to be streamlined and bureaucracy reduced. There will be little scope to add in optional processes. We need to find simpler ways of doing things in what is a complex environment, with more efficient structures and support functions to enable quicker, well-informed decision-making. Good governance and quality must be retained, but with leaner and more efficient processes and better use of data and AI to focus our attention and minimise unnecessary admin.
Ask yourselves and your teams how you would work if you were starting now from scratch. With a clear goal in sight, how might you work differently as a team and with others? What systems and processes would you prioritise? What assumptions are you holding that no longer apply or add value? What would you remove? How can we turn this into a genuine opportunity to simplify and redesign processes around more integrated, streamlined and digitally proficient pathways? This is as much about energising those that are staying as it is about giving those moving on an opportunity to share their insights and knowledge to help shape what comes next.
4. Enabling collaborative discovery
Letting go of bureaucracy means trusting people to do difficult work. As organisations shrink and responsibilities are handed over, leaders tasked with delivering the future NHS will have tough decisions to make and new challenges to resolve. This creates an ideal environment for individuals to tackle the hard tasks together, particularly as existing networks are strengthened through more focused neighbourhood working. Explore where there is opportunity to generate low bureaucracy and high trust, typically achieved through regular collaborative tasks that allow space for vulnerability, reflection, awareness and learning.
Key to this is accepting that you don’t have all the answers. The explorer, Ernest Shackleton, is perhaps best remembered not for his successful expeditions but for his leadership which saw his whole crew return safely despite their ship being crushed on route to Antarctica. Shakleton trusted in the ability of his team to collectively find answers, pivot when things went wrong and continually problem-solve. While our circumstances are less hazardous, the current changes in the health service do involve many moving parts and several unknowns. We need to let go of the expectation that as leaders we have all the answers, and instead enable teams and individuals to analyse, innovate, pivot and go again.
There is no question that the NHS is a better, stronger service thanks to the personal investment of the people who work in it – the discretionary effort which comes from our belief in the purpose of the service and a desire to deliver the best possible outcomes for patients. None of us can afford for that to be wasted or vital knowledge to be lost. Maintaining that collective will and commitment will undoubtedly be harder as some of these changes unfold. But if we can use our awareness and leadership tools to help make every member of every team continue to feel valued, with purposeful opportunities to shape what comes next regardless of personal or organisational roles, we will be giving our colleagues and the NHS the best chance of future success.
This article was originally published by Healthcare Leader.
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