1. Leadership for ImprovementPersonal Development through Challenging Times Dr Catherine HannawayDurham University13th May 2011

2. Leadership and Management -definitions • Leadership is showing the way-showing what to do next. Leadership is not dependent on role or seniority. • Management is the responsibility for the use of resources. Management is dependent on role and includes seniority.

3. Leadership and Management • Leaders lead people • Managers manage tasks

4. The Context • Since 1974, the NHS has undergone 11 major reorganisations (1 every 3 years) • The average career expectancy of a Chief Executive is currently 22 months • Leadership instability is not conducive to change because it creates a ‘trust’ deficit.

5. From the ‘Leadership for Health Improvement Programme’ in ‘Managing for Health’ Chapter 7. Hannaway, Hunter & Plsek 2007

6. What Matters? • What matters is the approach to leadership and management • What matters is how you do it • What matters is what you say, what you do and how you behave.

7. Leadership Framework for Improvement 1. Set Direction: Mission, Vision and Strategy Make the future attractive Make the status quo uncomfortable • 4. Generate Ideas • Understand organisation as a system • Read and scan widely, learning from other industries and disciplines • Benchmark to find ideas • Listen to patients • Invest in research & development • Manage knowledge • 3. Build Will • Plan for improvement • Set aims/allocate resources • Measure system performance • Provide encouragement • Make financial linkages • Learn subject matter • 5. Execute Change • Use Model for Improvement for design and redesign • Review and guide key initiatives • Spread ideas • Communicate results • Sustain improved levels of • performance 2. Establish the Foundation • Reframe operating values • Build improvement capability • Prepare personally • Choose and align the senior team • Build relationships • Develop future leaders Source: Robert Lloyd Executive Director Performance Improvement Institute for Healthcare Improvement January 16, 2007

8. D x V x FS > RRichard Beckhard's Change Formula • D = Dissatisfaction: The higher your dissatisfaction with the status quo gets, the more likely you are to initiate change. • V = Vision: The clearer and specific your vision is the more traction you can acquire in making change. • FS = First Steps: The clearer you are on your ‘First Steps’ the more capable you are at following through on change.

9. D x V x FS > R R = Resistance to Change: Resistance can be about fear, time or monetary costs, emotional concerns or any number of issues or reasons that hold you back. Basically, resistance is anything that stops you from making change. Richard Beckhard's Change Formula

10. The definition of insanity is continuing to do the same thing over and over again and expecting a different result. Albert Einstein

11. “ People do not resist change per se. People resist loss.” (Heifetz and Linsky 2002)

12. Change is different from transition Change is situational: new site, new boss, new team roles, new policy. Transition is the psychological process people go through to come to terms with new situations Change is external, transition is internal. Bridges, W. (2003) Managing transitions: Making the most of change, 2nd ed London, Nicholas Brearley.

13. Unless transition occurs, change will not work • transition starts with an ending • the neutral zone is the no-man’s-land between old reality and new • transitions end with a new beginning ENDING NEUTRAL ZONE BEGINNING

14. A Leaders Role in Preparing for Change • Create a compelling narrative about the status quo and the consequences of failing to change that is tangible, logical, has intellectual rigour and touches individuals • Articulate a coherent vision about a future state that is both inspirational and desirable, and the role of the individual within it that makes them want to go there • Develop a strategy which has clear and ambitious goals aligned wholly with the vision (not National targets!) • Empower the staff, give them the permission and the skills, and help them develop their plans to deliver the strategy and achieve the vision • But there must be: • Consequences for not changing • Disincentives for resisting • Benefits from moving to the new state • Incentives for getting there quickly

15. Some thoughts on leadership and management • Genuine concern for others • Ability to communicate and inspire • Decency • Humanity • Humility • Sensitivity • Respect for others Prof Beverley Alimo-Metcalfe summarises the 7 qualities as the leader being a servant not a hero

16. Act Plan Study Do Understanding the problem. Knowing what you’re trying to do - clear and desirable aims and objectives Model for Improvement What are we trying to accomplish? Measuring processes and outcomes How will we know that a change is an improvement? What change can we make that will result in improvement? What have others done? What hunches do we have? What can we learn as we go along? Langley G, Moen R, Nolan K, Nolan T, Norman C, Provost L, (2009), The improvement guide: a practical approach to enhancing organisational performance 2nd ed, Jossey Bass Publishers, San Francisco

17. One to one coaching • Coach will contact you to arrange date, time and location • Works well when participants can provide a suitable location • Allow around 2 hours for the session • Please provide at least seven days notice to re-arrange a session

18. LEADERSHIP QUALITIES FRAMEWORK (LQF)

19. The 360 Degree Questionnaire The LQF 360-degree feedback questionnaire has been specifically designed in conjunction with the Leadership Qualities Framework tool. The feedback you receive will enable you to relate where your strengths and development areas lie in line with the Leadership Qualities.

20. Some Questions For You …… • Why are you doing it? • What do you want to get out of it? • How will it help inform you Personal Development? • Is it the right time for you to do it? • Can you identify enough of the right people who are prepared to complete the questionnaire (within the time frame)? • What use might you make of it following your feedback?

21. Buddying or Learning Trios Develop a habit for valuing diversity and different perspectives. We want you to become accustomed or strengthening your working across boundaries of geography, organisation, experience, and styles and also giving others the opportunity for doing so.