Kings Fund on Nasty and Nice Cultures

The great Terry Pratchett’s Granny Weatherwax is not usually a big figure in management theory.  Which is a shame, because Pratchett’s books are full of useful life lessons.  One of Granny Weatherwax’s key thoughts is that Nice is not as important as Good.  Nice is passive, it’s attractive but it doesn’t act.  It doesn’t tackle the hard problems.  And sometimes Nice can hide malice behind its friendly face.  Good, on the other hand, does act, even if it’s hard.  It says the uncomfortable but necessary truth, from a place of kindness if it can (although in Granny’s face it could be a hard kind of kindness…), but it tackles the issue.

So it was Granny that I thought of when I saw this article by the King’s Fund on the perils of both Nice and Nasty cultures in blocking necessary discussions and proper conversations, and the need for “cognitive diversity” – which is academic for the freedom to disagree and to come up with new ways of doing things.  It’s worth a look.,63BO6,FQCH6Q,NX8WT,1


Obama’s Four Rules (cross posted from my other blog)

You’re always advised to keep politics out of your business, but I don’t think anyone can follow me, either as Ceiling Dragon or as Sarah, for more than five minutes and not guess I am more in team Obama than team Trump.  In fact, I get the Obama Foundation newsletter.  I’m extremely unlikely to turn up at a community building forum in Chicago, but I think it’s still worth following.

The last email we got was Obama’s four rules for living, which he sent out as a thought around the time of the big launch forum.  I wanted to share them here.

  1. Listen to the people around you.  Make connections and share your stories.
  2. When you disagree, don’t be disagreeable
  3. No Selfies! (you can’t have a conversation with people when you’re looking at your phone or taking a picture – I don’t think he’s trying to blanket ban the selfie!).
  4. Have fun


Not that the former president of the USA needs my approval, but all of those make perfect sense to me.  Many of the big problems I’ve seen have stemmed from breaking one rule or another.  The obvious one you see a lot at work is the failure to listen – there’s an established idea about how to do things that you’re following, despite the fact that the knowledgable front line think it’s ridiculous.  But he’s also talking more broadly – start the conversation with your neighbour, share stories with the people you meet – build a more connected world, out in the real world.

But as more and more business moves online, more and more people fall foul of number two – emails are bad enough for losing tone of voice, let alone social media – and it’s far too easy to snipe and slam down when dialogue is needed.  No Selfies?  Well, I recall a far off day, in roughly 2009, when I went to the NHS Confed conference, and sat at the back whilst a shadow minister called Andrew Lansley reeled off a messy, internally contradictory speech about what he would do when he came to government.  And you would be surprised how many glowing phone screens there were in that audience, lighting up faces that were subsequently astonished to find that Lansley went on to do exactly what he said he was going to do that day.  You can’t focus with your ears if your eyes are already too busy.

And have fun? I’m going to steal this one wholesale from Mr Obama.  “This work is hard [he’s talking about his foundation, and doing good in general, but this applies to everything I think]. It’s full of frustrations and set backs.  It can be lonely – but it doesn’t have to be.  Know that there are other people who share your frustrations and your joy in the small successes – and how those small successes can turn into big ones.”

I think that last one is key, and it relies on the first three.  We need to make genuine connections to survive, and to build the villages we need to thrive.  But whatever you’re doing, the joy can fall out of the slog.  Have fun with it.

citation: email sent on behalf of the Obama Foundation, 1st Nov 2017.


King’s Fund on Public Involvement in the Sustainability and Transformation Plans

I think this is quite an interesting take on the necessary power shifts to involve the public properly in the STPs.  Change is coming, and necessary; keeping things in the dark will only damage our chances of making things work.,4MHAK,FQCH6Q,H7P5B,1

Evaluation of the Achieving Self Care Project, Lancashire Mind

I very much enjoyed working with Lancashire Mind on the evaluation of the Achieving Self Care Project, which they ran in Blackburn, Lancashire.  The project aimed to improve people’s self care and coping skills, allowing people with long term conditions, anxiety or depression to set their own goals for improving their life, for example returning to work or volunteering, or making it to the shops independently.

The project also took an asset based community development approach, aiming to support people to run their own groups, and help others.

The project was very successful, seeing 2200 people and improving employment rates, reducing health care utilisation and seeing people report improvements to their quality of life on a range of measures.  Several people have emerged as real leaders in their communities.

I wish Lancashire Mind every success with their next steps, and was very glad of the opportunity to work with them!


Click to access ASC-evaluation_Full-report.pdf

Article in the Guardian on the challenges of NHS Management

Although I don’t always agree with Polly Toynbee, I thought this was an interesting article on the challenges of NHS Financial (and other back of house) management.  Worth a quick scan at least:

Interesting – Deloitte Australia on the cost of too many rules

This is a really interesting paper from Deloitte Australia, about the origins and costs of having too much red tape. Whilst acknowledging that rules are necessary to prevent anarchy, the paper talks about how overlapping rules, multiple conflicting compliance regimes and over caution stifle businesses and cost the Autralian Economy an estimated $249AUS billion a year.

Another interesting finding in the paper was that the private sector is, at least in Australia, no role model for the public sector. The private sector was as likely to be drowning in foolish, contradictory rules as the government. The paper talks about one company that introduced compulsory ergonomic checklist forms for each employee to fill in every time they changed desk or chair, and then imposed universal hot desking, costing 20 minutes per employee every single day. Another company introduced an “approval to seek approval” process with so many hand offs that it took 270 days.

As well as the interesting case studies, the paper produces some steps for reducing rules – 5Cs, in the best tradition of alliterative management techniques. I hope that Deloitte will forgive me quoting verbatim, as their language is a little punchier than I’m used to in policy documents!:

Slash the stupidity – ask staff to list thedumbest things they are required to do as a result of the business’s own rules, then stop doing them.

Businesses should stop asking “What could go wrong?” and focus on “What must go right?”, then challenge their rules in that light. What are their rules really trying to achieve, could they be improved and are they cost-effective? If not, there may be more to dump.

Foster a culture focused on performance rather than compliance, and ensure the organisation’s rule-makers are aligned to its business goals.

Businesses and others should change the way they set new rules and audit old ones to better link rules with strategy and risk appetite.

Make the most of these changes to realise the business’s full potential.

I think these are great headlines when reviewing processes. Of course, in the British Public Sector, some of the rules we follow are legislative and we don’t have a choice. But there are many places I’ve worked where internal rules have grown up around the legislation, often intended to be helpful. I worked in one place, some time ago, where three separate teams had to review each job description to ensure consistency, but didn’t know roles in each others’ teams well enough to spot actual errors. There is a lot of potential for improving productivity even in small ways, by taking small delays and irritants out of processes. Worth bearing in mind!

Department of Health blog – Coming Home from Sierra Leone

This is a really interesting blog from Debbie Hawker, a nurse who has been working as a volunteer in Sierra Leone, treating Ebola.  I just thought I would share it with you all!

HSJ’s Respect for Managers Campaign

It’s lovely to see the HSJ and so many clinical leaders calling on more respect for managers.  It’s a little worrying that we need to point out that “NHS managers are as dedicated to the service as any other group of professionals”, but it does need restated.  I’m always keen to point out that, although the emphasis on clinical leadership is essential, there will always be roles that can’t be filled by clinicians – dedicated procurement specialists, HR experts, finance professionals – and, I suspect, strategy and improvement managers to synthesise the great ideas other professionals come up with into workable plans.  I wish the campaign every success.

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