Tuesday, 6 September 2011

Understand, Decide, Communicate, Motivate. The NHS takes on the Army

I was invited yesterday to observe an Introductory Briefing of the NHS Staff College, following a presentation I gave on the subject of Perseverance on August 9th to a previous course. The aim of the briefing is to introduce groups of senior leaders in the NHS to a leadership course provided at The UCH Education Centre in partnership with Philip Mostyn Associates (PMA).

For me this was a great opportunity to see a thorough assessment and analysis process at work. While the delegates were being introduced to the course and invited to explore various aspects of leadership, their syndicates and group activities were filmed in readiness for detailed debriefing which is being delivered today. The assessment and debriefing methodology are based on techniques developed over many years by the British Army, who prize leadership development beyond all other forms of personal development. Those delegates that opt / are selected for the rest of the course will attend separate modules addressing
  1. Self Awareness
  2. Self Management
  3. Leadership and Teamwork
As an organisation employing 1.3 million people, the NHS dedicates a relatively low proportion of its resources to leadership development when compared both to public and private sector employers, and this course is one of a number of initiatives designed to raise the quality of leadership in the healthcare sector.

To start the day, the directing staff led the delegates into a room with an instruction to say nothing. In silence they read further instructions on a flipchart and circulated around the room examining each other, restricted to non-verbal communication. They were then invited to separate themselves into various "Tribes". Separating factors included age, level of involvement with patients, gender, childcare responsibilities and style of dress. Having recently co-founded www.thistribe.com, I was pleased to see tribes used to describe the way people see themselves and their groups.

After this the delegates explored how leadership could benefit the NHS and patients in particular. One factor that was a common subject of discussion was "Silos". Delegates explored the challenges and opportunities posed by the co-existence of different tribes such as doctors, nurses, managers and physiotherapists. Communication and the need to coordinate the activities of teams made up of professionals from the different silos were key issues, and delegates considered the dangers of "Dysfunctional Tolerance" - the process of accepting poor performance out of a misplaced sense that challenging it is futile.

John Mackmersh provided a valuable distinction (following Grint's Leadership: A Very Short Introduction (Very Short Introductions)) between leadership and management. He described "Tame" and "Wicked" problems. Tame problems require the application of known processes, whereas wicked problems require the asking of questions and the development of new methods. Tame problems are the domain of management and wicked problems can only be addressed by leaders.

Philip Mostyn Associates specialise in the leadership assessment techniques that were first introduced by the British Army in the dark days following the crushing defeats of 1940. As Philip Mostyn explained to the delegates, these techniques were gleaned by studying the leadership of the German Army, and in particular its use of psychological profiling to identify leadership potential in recruits. The British Army Officer Selection Board (of which Philip was President for several years) has developed and refined these techniques over the subsequent 7 decades, and they have also been widely adopted by private sector organisations in the UK and the US. An early adopter in the US was the Office of Strategic Studies, the forerunner of the CIA.

PMA applies these techniques previously used for selection to leadership development by sharing the perspectives of the directing staff with the delegates. By replaying video clips of their group behaviour, the directing staff help delegates establish an objective view of their role and behaviour within the team. Each individual is assessed - and invited to self-assess - according to their ability to
  • Understand
  • Decide
  • Communicate
  • Motivate
As Philip pointed out to the delegates during his presentation entitled "How leadership can help the NHS", it is usually easy to spot the absence of leadership by asking the question

"who is responsible to whom and for what?"

If you are unable to answer this question in your team then it's time to find, or give, some leadership. I'm very glad that the NHS is taking the opportunity to apply such well-tested leadership development techniques to its formidable clinical skills portfolio.


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