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CLINICAL LEADERSHIP DEVELOPMENT PROGRAMME Leadership in “Wicked” Times Friday 13 January 2012

CLINICAL LEADERSHIP DEVELOPMENT PROGRAMME Leadership in “Wicked” Times Friday 13 January 2012. Carole Langrick Director of Strategic Development / Deputy Chief Executive. Aims of the session. Offer you a model for thinking about how you might behave and lead in a change situation

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CLINICAL LEADERSHIP DEVELOPMENT PROGRAMME Leadership in “Wicked” Times Friday 13 January 2012

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  1. CLINICAL LEADERSHIP DEVELOPMENT PROGRAMME Leadership in “Wicked” Times Friday 13 January 2012 Carole Langrick Director of Strategic Development / Deputy Chief Executive

  2. Aims of the session • Offer you a model for thinking about how you might behave and lead in a change situation • Introduce you to the idea of tame and wicked problems • Encourage you to think about how you apply your leadership qualities to wicked problems • Use Momentum as a backdrop to thinking about how you might behave differently in your leadership role.

  3. Us & Our Behaviours Resources What How Successful leadership of a change programme

  4. Us & Our Behaviours Momentum Leadership Qualities Tame & Wicked Problems & Clumsy Solutions Successful leadership of a change programme

  5. Three elements to the Programme: • Service Transformation and the redesign of care pathways, • New community based facilities to deliver care closer to home, • New hospital to replace the existing two in Hartlepool and Stockton. Our Vision “A patient centred and clinically driven local NHS responsive to the needs of local people, delivering the best quality care available in an integrated and efficient way, in first rate facilities as close to home as possible by well trained professionals using state of the art knowledge and equipment.”

  6. Momentum is a massive change management programme: • 20% reduction in general & acute beds (124) beds • 18% reduction in average length of stay (0.8 days for emergencies) • 10% reduction in acute based staff (400 wte) • Fewer operating theatres and consultation rooms • 40% of A&E attendances in town centre minor injury units (40,000 patients) • 40% of all outpatient appointments in community locations (160,000 appointments) • 15% of elective procedures in community locations (6,000 procedures)

  7. Pre-requisites for successful change management • Accepted need to change • A vision / alternative state • Change agents • Sponsorship from above • Scale and pace of change • An integrated transition programme • A symbolic end to the status quo • A plan for likely resistance • Constant advocacy • A locally owned benefits plan • (Grint, 2008)

  8. Management vs. Leadership Management – deja vu – seen this before – do it – solve it – tried and tested methods. Leadership – vu jade – never seen this before – novel – unique – no experience of this before.

  9. Tame vs. Wicked Problems Tame problems • Complicated • Difficult • Usually resolvable through unilinear acts • Likely to have occurred before • Limited degree of uncertainty • There is always an answer Wicked problems • Complex • Affects the environment in which the problem lies • No relationship between cause and effect • Often not really solvable • Requires leadership

  10. Wicked problems in the context of Momentum • Funding approval • Capacity Planning • Managing the transition • Local politics and public opinion • Policy environment • New players on the block • Collaboration v competition • £40m Challenge

  11. Or perhaps? • Which services does it just not make sense for us to continue to provide? • What is our core business? • Do we really believe in integrated care pathways or only when we are the boss of that pathway? • Others?

  12. Increasing uncertainty about solution to problem WICKED LEADERSHIP: Ask Questions MANAGEMENT: Organize Process TAME COMMAND: Provide Answer Increasing requirement for collaborative compliance/ resolution CRITICAL COERCION/ PHYSICAL (Hard Power) CALCULATIVE/ RATIONAL NORMATIVE/ EMOTIONAL (Soft Power) Approaches to Problems

  13. Setting Direction Broad scanning Political astuteness Intellectual flexibility Personal Qualities Self belief Self awareness Self management Drive for improvement Personal integrity Drive for results Seizing the future Leading change through people Collaborative working Holding to account Effective and strategic influencing Empowering others Delivering the Service Leadership Qualities

  14. Clumsy Solutions

  15. Some Scenarios • The availability of neonatal services………………… • The integrated provision of musculo-skeletal services……………. • An integrated approach to reablement…………………. • The increasing usage of (expensive) diagnostic facilities and tests………………… • Uneasy relationships with other OOHs providers……………. • Building relationships and understanding with the new clinical commissioners……………………. • Your directorate CIP……………… • A network approach to providing your service across multiple providers………………………. How as a leader might you behave differently to how you may have behaved to date to facilitate a clumsy solution (rather than yours) to the wicked problem of:

  16. Tactics for resilient leadership • Think options, not solutions • Learn to value not knowing • Embrace ambiguity • Re-connect with your personal anchors • Avoid feeling overwhelmed • Make conscious and deliberate choices

  17. Thank You

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