Bankers out of control, NHS on the brink of failure?

This systemic failuremorning, I listened with increasing dismay to various politicians, officials and apparatchiks talking about unusually high numbers of deaths in some NHS trusts. This comes on the back of yesterday’s disclosure about the demise of the Liverpool Pathway and reminded me of all the troubles laid at the hands of bankers in recent years.

It seems to me that what we have here are a series of systemic failures each of which leads to discussions first of all about who to blame and secondly about which processes and procedures needs to be written, rewritten or improved. But to me all of these discussions miss the core point – that the failures are not of systems, processes, procedures, policies or off whatever artefact you want might want to name, but of people. It is about NHS managers who decided that meeting financial and operational targets was more important than caring for patients; it is about bankers who decided that personal and corporate profit was more important than the health of the global economy. These are ethical issues, not process or policy or regulatory ones.

And that is where thinking starts to fall apart. We are going to have a new banking code, the Liverpool Pathway is to be abandoned and the new one written, there is to be an enquiry into the failures of the NHS trusts with excess deaths. But all we will end up with is another set of regulations, policies, procedures etc designed to constrain future behaviour on the evidence of past events. Regulation, for what it is worth, is always behind the event. What none of this does is address the core ethical issue. I have worked in regulated industries and also do some work in the NHS and I am pretty certain that most of the employees I have come across want to do the best they can for their customers or patients. The woman who comes out to mend a burst in the water main outside in the road, or the man who massages a patient’s legs to prevent bedsores, has probably never read the reams of regulatory and policy guidance and nor should we expect them to. Surely what we expect of them is that they have the customer or patient at heart and I know that what most of them want to do is what is best.

Let me tell you a story. Throughout the autumn of 1995 and the early spring of 1996 I was part of a team that was leading a response to one of the most extreme droughts the country has ever seen. So severe was this drought that there was a very real possibility that customers would first of all have their water usage massively restricted and then even run out. At one early point in the proceedings, a view was expressed that this was “OK because our regulatory deal allows us to cut water off every 125 years”. The realisation that this was OK in principle, but far from acceptable in practice, occurred quite quickly. Once every 1 25 years sounds okay until those odds mature during my lifetime when I certainly do not expect to pay full price for a non-existent service. This recognition, and it was very clearly expressed by the CEO when he said “We will not run out of water whatever it costs”, galvanised employees in a way that was a delight to be part of. We maintained supplies at all times.

How many other managers and leaders in the banking and NHS continue to drive regulatory targets even when they contradict the principles of good patient care? It is too easy to get captured by regulation and to start to think that meeting regulatory requirement is the be all and end all of managerial leadership. I would suggest that true leadership is about making the regulators redundant by consistently delivering what the customer needs. After all regulators have often been described as pseudo-customers, put in place because the individual customer has too weak a voice. Well, let me suggest that success is about dealing with individual customers, each with their individual needs, rather than a surrogate represented by a regulator.

Success is about doing what is right, not what is allowed for in, or at the very edges of, regulation. We do not need more rules, we need states of mind that put the customer first whilst recognising the (often financial) constraints of the system. Isn’t it strange that so many people seem to think that the way to fix a systemic failure is to tinker with the very causes of that systemic failure. As someone[i] once said, “If you always do what you always did, you always get what you always got”.

It is time to do something different, not more of the same.



[i] In the modern world, many people attribute this quote to Anthony Robbins, renowned motivational speaker and self-improvement guru.  Go back a few years, and people will tell you that Albert Einstein said it. Go back another generation or two, and Henry Ford gets the credit; before him it was Mark Twain.  It doesn’t really matter which of these thought leaders said it.  What matters is the truth of it…and the point of it.

Driving Organisational Change – 7 Tips to Help you Succeed

“The one constant is change” – and perhaps especially so in these difficult times.  These tips will help you make the most of your investment in consultancy.

 7 Tips to help your change succeed

  1. Lead as well as manage

Hundreds of books have been written about the need for change management and I am not going to disagree because any project needs appropriate management. Yet project management is not enough – it is about processes and the biggest challenge in change is that it affects people. This is where leadership comes in – be active in showing the future and the way to get there, support individuals and groups, listen as well as speak, be there when you are needed.

  1. Value and use resistance

You will meet resistors – they have their own reasons for not wanting to change and those reasons make absolute sense to them (if not you!). Listen to them – have they perhaps spotted something that has been missed? Have they got personal challenges (lack of training, concerns about future security, etc) that you can help them with? Resistors can cause more damage than the supporters can help. Treat them carefully, respectfully and individually – a ‘convert’ will be worth their weight in gold.

  1. Do what you can, where you can, when you can

I have yet to see the path of any change effort go smoothly; some things prove more difficult than expected and others simpler. For a big change you night think of it as lighting little fires all over the organisation – some will die out and you will need to come back to them but others will flare up and those you fan and help spread more widely.

  1. Ignore losses, consolidate wins

If you focus on losses or failures, they get bigger and more overwhelming, you then pull in even more losses. So find ways to ignore these losses. Shift your attention to something positive, stop talking or thinking about them. What can you do to consolidate your successes? Write them down or put them on a wall. Keep a record of your wins. Talk about them to everyone you can. Celebrate them. Make a habit of finding and focusing on the wins of others. The more attention you put on success, the more success you get.

  1. Communicate, communicate, communicate…

THE most important issue. Everyone involved in the change needs to know why it is happening, what the future is going to be like, how it will affect them and their colleagues (don’t underestimate ‘solidarity’). It’s not just about newsletters, much more effective is routine face-to-face discussions in formal and informal (canteen, coffee machine…) settings – use your apostles (see Tip #6) to spread the word and explain what’s happening. And remember that you have two ears but only one mouth – this is where you sense the resistance that is so useful for Tip #2.

 

  1. Recruit sources of power

The power you can exercise is in direct proportion to your ability to meet the needs of your people. Power comes in many different flavours and they are all needed to create effective change as different individuals will respond to different power bases (the fact that you are the boss may matter more to you than them!). Your, and your apostles’, Personal Power will be much more valuable than all the Formal Power you can muster – the latter might create compliance, the former commitment.

  1. Find and nurture your apostles

You can’t do it all yourself, you need a small and growing number of individuals who are totally with you and actively supporting you. These advocates need constant support – ‘feed and water’ them because your change really does depend on them. Keep them close to you, allow them time and actively encourage them to get out on the shopfloor convincing others through the sheer commitment they show. Finally, reward them for their efforts.

What do you think? Can you offer any tips of your own?

 

Giving things up

calvin-hobbes-new-years-resolutionsA couple of days ago my wife called me into the kitchen. She had been rummaging around in one of the cupboards and found some paperwork and one or two other items that she thought were mine, and indeed they were. Not only were their mine but they had been in “Geoff’s Drawer”, situated immediately above the cupboard in which she found them. So full had this drawer becomes that a few items had overflowed and fallen into the cupboard below, only to be discovered some months later when my wife just happened to be rummaging around at the back of the cupboard.

Is your life, your office, your brain a bit like this? So full of stuff and ideas and projects and ‘must dos’ that some of them get overlooked for a very long time. Mine certainly is.

Well this is a time of year when we typically start to think about what we are going to do new or differently next year – those New Year’s resolutions. Whether or not the New Year is a good time to make such resolutions is perhaps the subject of another blog, but assuming that we make them at some time or another there is another aspect to which we might pay attention. What am I going to give up?

It is a bit like that a full drawer, only when I have a good clear out and throw away some stuff  do I really appreciate what is important to retain. Similarly, creating change typically involves stopping doing things as well as starting new things.

So here is a suggestion, when you make your new years resolutions how about making one of them that you will stop doing something, that way you will create space in your brain for whatever it is you want to start doing.

The immovable object and the resistible force

In the second of my pieces on guiding principles for delivering effective change I want to talk, in a tangential way, about one aspect of how to handle resistance.

The one thing that is certain when you embark on a process of change is that you will meet resistance. Perhaps that ought to be two things of which are certain, because the other is that you cannot predict where, from whom or in what form that resistance will appear. But appear it will and you must address it. The point of this particular piece is one way of addressing it – not that  this is only one way, indeed there are several other tools that you will need to use. This tool is particularly useful in the early stages of the change efforts.

So, many moons ago I completed my masters degree in organisational change and my then boss asked me “What was the most significant thing that you have learned in two years of very expensive study?” My answer might seem somewhat glib, let me assure you it wasn’t and isn’t. The answer was “Do what you can, where you can, when you can”. And this is the second of my guiding principles for leading change effectively.

 Do what you can, where you can, when you can

When you get involved in change you will find some people who are really keen (the marketeers would call them early adopters), some who just sit and wait but will follow the crowd once they know which way the crowd is going ( I will call them ‘the herd’)and some who will actively or passively resist. My question to you is “Why would you want to spend time, especially at the beginning of a process, working with resistance when you could be creating change and generating enthusiasm by working with the early adopters?” As you work with early adopters they start to show the direction for the herd and slowly but surely the herd will follow. The contrary scenario is one in which your efforts are frustrated by and your energy sapped by resistors from whom the emerging messages to the herd are negative. All you do by working with resistors in the early stages is tire yourself out, build up more resistance and risk and entrenching yet further resistance in the herd.

So, perhaps my principle to do what you can, where you can, when you can is not so glib after all. I have likened the job of a change agents to lighting a series of small fires in an organisation. Sometimes the fire will take hold and it is those ones, especially in the initial stages, that you pay attention to, giving them whatever support they need to burn effectively whilst not becoming a wildfire. Some of your fires will just burble along, not dying out nor turning into wildfires – these you also support, looking for easy opportunities to help them along and maybe connect to different yet related places that are all part of the overall thrust of what you are trying to achieve. The ones you ignore are the fires that just flicker before dying out. Fire dies because it does not have enough fuel or enough oxygen, or enough people to supply it with fuel or oxygen. So let it die out until such time as you can find enough fuel enough oxygen (enough support and energy) to be able pay it some consistent attention.

To me this Principle –  “Do what you can, where you can, when you can” – is probably the most important principle in leading change. We only ever have a limited resource available so let’s make sure we commit our resource to areas in which we can make a short term difference, after all John P Kotter did talk about realising quick wins.

 

What stories could you share about how this division of effort, or perhaps lack of it, helped or hindered your change efforts?

Am I deluding myself by studying world class leaders?

So many article, blogs, books, presentations etc are based on the proposition that we can learn from ‘world class operators’ – if they can do it, so can you; if you just model how they do it, you can do it too, that sort of territory. Some NLP’ers even propound the view that “if anyone can do it, you can do it”.

I want to open an enquiry into the legitimacy of that view.

World class operators are, by definition part of a very small tail in a statistical distribution of performance, and many (most?) of these outstanding performers have physical or mental attributes that I cannot attain:

  • Usain Bolt is blessed with a super-abundance of ultra-fast-twitch muscle,
  • Richard Branson is dyslexic and didn’t really get on well at school,
  • many others around the world had ‘challenging’ childhoods.

So some have physical advantages that no matter how hard I try or visualise or set challenging goals I will never be able to replicate and others have a past that I managed to avoid. Moreover, their performance is so far removed from mine that it lies well outside my comfort zone, maybe even in the “Here be Dragons” territory that is more disabling than empowering.

What if we were to challenge ourselves with performance that lies in the stretch zone instead? What of we were to model our performance on those who perform 10/20/30%  better than ourselves, rather than the zillion% outperformers whose achievements are practically unobtainable?

Now, let’s be clear here – I am not saying that these people cannot be and are not inspirational, what I am suggesting is that their performance is so far from the norm that us mere mortals might be better off concentrating our learning on how our local business, charity, church, theatre etc leaders do it. When I look for a book on “What you can learn from you above-averagely successful but not world-class leader” they don’t seem to be there.

Is this a field for research? Do you find such global inspirations too far out of sight as to be really helpful? What do you think of this topic generally? Go on, comment away…

The facilitation hamburger

A recent article I was reading referred to the ‘additional roles of a facilitator’ – definitely Advanced Level stuff, so here we go with the O-Level version.

I like to think of working in a team as a bit like a hamburger, there are three aspects of teamwork that need attention:

  1. The Task – the ‘what’ of the work. What is the deliverable/outcome? The hard end-point of the work.
  2. The Process – the ‘how’. How are you going to get the job done?
  3. The People – the ‘who’. Who needs to be involved? How do I keep them involved?

The task leader – the person who is responsible for delivery of the task – needs to keep as much of their attention as possible on getting the job done, so having to devise and keep track of the Process and the People issues is a distraction from ‘doing the job’. Nonetheless they are both essential and this is where the role of Facilitator comes in.

A good facilitator can help the Task leader by working with them to devise a suitable process and then keep the team on track; they can help by watching the people and helping everyone to contribute. The facilitator can concentrate exclusively on these ‘non-task’ aspects of team performance and help deliver outstanding performance. Now one interesting ‘side-effect’ of this division of labour is that the facilitator does not need to know anything about the content of the task, indeed there is a risk that a facilitator who does havecontent knowledge can get sucked into the task and neglect thier primary duties on the Process and People aspects of performance.

So next time you have a challenging task that needs a process to be invented and a new team – that’s the ideal situation to employ a process facilitator, they will add huge value and you will soon learn just how effective facilitation can add to your team performance.

One day at a time

One day at a timeDo some of your goals sometimes seem a bit too challenging, a bit  too long-term or a bit too much to take on? Do you find it hard to make and maintain the committment necessary?

Well, I came a cross a suggestion that I found helpful – take it one day at a time. Now just a minute, isn’t that what is always advised? well, what I heard was a slightly different take.

The suggestion was to commit to your goal, or more accurately the action needed to achieve it, one day at a time. When you wake up, promise to yourself that you will eat only healthy food, run for 30 minutes, contact one new potential customer, whatever…today. If you miss it, you miss it, get on with life and re-make that commitment again tomorrow when maybe you will be more successful.Yoou will probably hit your action more often than not, each step still moving you forward, but without the weight of months or years of effort in your head weighing you down.

I find it easier to do something one day at a time than ‘for ever’. Maybe you will too.

Do pay attention!

Pay attention to detailI came across this quotation (apparently from a movie – do you know which one, becasue I don’t?) recently…

“Wars are won one battle at a time. Battles are won one bullet at a time.”

We all need to keep our eye on the big picture, but when this gets in the way of the detail then there is a risk that the war will be lost one battle at a time.

A friend of mine, Julie Kay, recently wrote in her blog about ‘caring’ and it struck me that there is a resonance here – if I really care about what I am doing then I will do it to the best of my ability, getting it right first time and avoiding re-work and wasted effort.

Often getting the detail right can make or break getting the job right. If this is the case and someone says “I don’t do detail”, are they in the right job?

How about you commit to excellence to day? Do every job as if it really really mattered.

Are you really listening?

I hear you but am I listening?Yesterday, I was driving my granddaughter to meet Peppa Pig. The radio happened to be on and it was one of those “my favourite tracks” sessions. The subject, I can’t remember who it was and it doesn’t really matter anyway, played Michael Jackson’s ‘The Man in the Mirror’, introducing it with comments to the effect that it was a song about how effecting change in the world necessitated starting with the man in the mirror (that is, yourself). I have heard this track many times and never, ever made that connection.

Then, this morning, I am driving that same grand daughter to nursery listening to a programme about The Jam Generation – that generation brought up in the 1980s with The Jam as part of their youthful soundtrack. The commentator seemed surprised that some senior Tories claimed to enjoy The Jam, and other groups of that ilk, despite the relatively left wing nature of their lyrics. He could not understand how they could subscribe to the lyrics in the song and yet be right-leaning Tories.

What both of these incidents suggested to me was the difference between hearing something and listening to it.

I have heard the Michael Jackson track many times and many times I have explained to other people that when I am listening to music. I very rarely pay attention to the specific words in the lyrics. More, I am concerned with the patterns of sound.

In the second case there the similarity, the commentator did not seem to acknowledge the possibility that these right-wingers could be hearing the lyrics while not listening to the words.

Now this observation is no great shakes but it does remind me of the need to be clear about whether a conversation I am part of is simply part of my life’s soundtrack or something whose contents might have much more meaning if I paid attention to what the other person was saying. Listening is an active process, its demands mental effort.

So today my challenge is to pay active attention when you are listening – whether to the radio, your colleagues at work, your partner, or whoever. Maybe it’s okay to have the radio on as a background soundtrack; but surely when we are face-to-face with someone they deserve as much attention from those as we might expect from then in reverse

Life is for living

Richard Bach - OneI have just been reading another wonderful little book by Richard Bach called “One”. I first came across Richard’s books when I was introduced to Jonathan Livingston Seagull over 30 years ago. JLS can take you half an hour to read or a lifetime; it can be a simple story about a Seagull are a complex parable about learning. For many years I never left the house without a seagull on a chain around my neck, until the day that I realised the seagull had flown away when the chain broke,  never to be seen by me again.

Anyway, back to this latest book “One”. He posits a situation and an exercise that I challenge you to take on yourself. Somehow or other  he meets himself in the future and that future self  knows, for certain, that he only has six months to live. Let me give you the exercise by quoting from the book:

“I think we ought to take this napkin here”, she reached into her purse, “and this pencil, and we ought to list what we want to do most and make this the best six months, the best time in our lives. What would we do if there were no doctors with their dos and don’ts? They can’t cure you, so who are they to tell others what to do with whatever time we have left? I think we ought to make this list and then go ahead and do what we want.”

I don’t know whether the subject of this piece was lucky or not that he knew for sure that he had another six months to live. I don’t know whether or not I will be alive when you read this entry-there is no reason why I shouldn’t be but who knows what happens on the roads or in that complex biochemistry that keeps is running every day?

So my challenge to you is to do the exercise, to figure out what it is that you want to do (not need to do – that’s usually someone else’s agenda), to make a list and to get out there and do it. Oh, there will be challenges, but isn’t a life full of those anyway? Yes, you might upset a few people but you are living your life and you probably only have one of them so you might as well get the most out of it.

And some people will tell you that it’s impossible, selfish, not affordable, etc  – those are their hangups. So let them deal with them rather than dump them on you. I urge you do this exercise , after all you might only have six months to live.