Tag Archives: Hospice leadership

Latest news – November 2017

Learning from improvement: special measures for quality
A retrospective review

November 2017
Excerpt from NHS Improvement “Four years after the introduction of special measures, we reviewed the experience of trusts that exited the process so we can better understand why they entered special measures, what actions they took and how they implemented change to improve.”
Leadership is mentioned frequently throughout this report

Robin Baddeley: Leadership thinking is swinging back from the “big picture” to local issues
BMJ, November 14, 2017
Robin Baddeley, editorial registrar, The BMJ.

Experiences of nursing students and educators during the co-construction of clinical nursing leadership learning activities: A qualitative research and development study
Nurse Educ Today. 2017,Vol 55, p90-95
Ha L and  Pepin J

The medical director induction guide
A joint NHS Improvement and Faculty of Medical Leadership and Management publication October 2017

Support local leaders or risk having no leaders in future ,15 November 2017
The NHS’s current management approach favours the stick rather than the carrot, leading to huge pressures on local leaders and could undermine the success of STPs, warns Helen Buckingham.

STPs: Destined to fail or the road to better care? Sustainability and Transformation Plans survey of clinicians: The hospital doctors’ view
A report by the Hospital Consultants and Specialists Association
October 2017
HCSA press release

A two-way street What can CCGs teach us about accountability in STPs?
Nuffield Trust , Holly Holder and Helen Buckingham
November 2017
Excerpt from page  19 of report (Chapter : Leadership challenges)  “The leadership environment for CCG chief officers is clearly not as supportive as might be hoped, and is some way from the aspirations that the NHS has for itself in terms of creating a positive context for leadership to flourish. The key issues that emerge from our interviews and research include: • the consequences of coping with austerity and a system under stress • excessive reporting demands • a culture of blame • lack of development and support • high turnover – loss of experience and skills. In addition to this, there is also some significant uncertainty about the future shape and role of commissioning as ACOs and ACSs start to emerge.”

Getting the most from developmental well-led reviews: Commissioning external suppliers and working with peer reviewers
NHS Improvement
October 2017
Following the recent publication of  the well-led framework, publications of two new guides with practical advice on how to get the most from reviews.
NHS Improvement also explain how you can incorporate peer input in these reviews, to make use of and enhance the skills and experience of leaders within the NHS.

Developing People – Improving Care A national framework for action on improvement and leadership development in NHS-funded services
An update on the implementation of DPIC will be published shortly. See http://nhsproviders.org/media/3932/developing-future-leaders-across-the-healthcare-sector.pdf (November 2017)

Quality improvement is not for the faint hearted13 November 2017
Embedding quality improvement into the fabric of the NHS organisations requires a fundamental shift in leadership, say Joni Jabbal and Siva Anandaciva

Using video-reflexive ethnography to capture the complexity of leadership enactment in the healthcare workplace
Adv Health Sci Educ Theory Pract. 2017 Dec;22(5):1101-1121
Gordon L, Rees C, Ker J, Cleland J
Excerpt from PubMed abstract “A whole (interprofessional) team workplace-based study utilising video-reflexive ethnography occurred in two UK clinical sites. Thematic framework analyses of the video data (video-observation and video-reflexivity sessions) were undertaken, followed by in-depth analyses of human-human and human-material interactions. Data analysis revealed a complex interprofessional environment where leadership is a dynamic process, negotiated and renegotiated in various ways throughout interactions (both formal and informal). Being able to “see” themselves at work gave participants the opportunity to discuss and analyse their everyday leadership practices and challenge some of their sometimes deeply entrenched values, beliefs, practices and assumptions about healthcare leadership. These study findings therefore indicate a need to redefine the way that medical and healthcare educators facilitate leadership development and argue for new approaches to research which shifts the focus from leaders to leadership.”

Heard about the Inclusion nudges guidebook: Practical techniques for changing behaviour, culture and systems to mitigate unconscious bias and create inclusive organisations ?
…….quick nuggets available on a free website
Deloitte Case studies : Inclusion nudges guidebook
Free short version (40 pages ) PDF available  (Jan 2016) 
Excerpt from Deloitte case study website : “A key finding  of the guidebook, is that while ‘Feel the Need’ nudges are most commonly used to raise awareness of unconscious biases, the addition of ‘Process’ and ‘Framing’ nudges can act as enablers to help individuals make objective and inclusive choices more easily. They therefore will have a greater impact in sustained behavioural change. Results have also found that “Feel-the-Need”and ‘’Process’’ Inclusion Nudges are also useful in bringing about compliance and accountability in employees without linking D&I to rewards; this is because they create a follow-the-herd reaction, showing the inclusive behaviour of the majority.

Other examples of where the nudges have been used are in:

  • Helping individuals verbalise uncomfortable biased interactions
  • Encouraging women to take promotional opportunities
  • Highlighting biased customer- claim handling
  • Understanding  the importance of diverse customers
  • Retention of senior employees  (age 55+).

This Guidebook is a worthy edition to the literature on unconscious bias, helping  managers and employees identify the critical moments across the employee lifecycle where there is an opportunity create a Nudge and then to h behave more inclusively. The Nudges can be used to focus D&I efforts on making sustainable changes in behaviour and culture.”

Measuring up: your community and your workforce
NHS Employers
1st November 2017
This online tool aims to help employers in the NHS compare their current workforce data with data from their local communities. The aim of the tool is to highlight groups in the local community that may be missing from the workforce, and it offers signposts to advice on how to better attract, recruit and retain from these groups in order to strengthen the workforce supply.
This is a newly developed and launched tool, if you experience any technical difficulties please get in touch by emailing Cat.Clark@nhsemployers.org.
See also Engaging with and recruiting from your local community

Characteristics of highly rated leadership in nursing homes using item response theory
J Adv Nurs. 2017 Dec;73(12):2903-2913
Backman A, Sjögren K, Lindkvist M, Lövheim H, Edvardsson D
Excerpt from PubMed abstract: “Five specific behaviours of highly rated nursing home leadership were identified; that the manager: experiments with new ideas; controls work closely; relies on subordinates; coaches and gives direct feedback; and handles conflicts constructively. The regression analyses revealed that managers with social work backgrounds and privately run homes were significantly associated with higher leadership ratings.”

Factors supporting dentist leaders’ retention in leadership
Community Dent Health. 2017 Nov 10 [Epub ahead of print]
Tuononen T, Lammintakanen J, Suominen AL
.
Excerpt from PubMed abstract: “Out of the five main components, two were significantly associated with staying as a leader: ‘career intentions’, which represented intent to continue or to leave the leadership position; and ‘work time control opportunities’, which represented how leaders could control their own work time. Other factors that supported staying were leadership education, more work time available for leadership work, and lower age. The main component ‘work pressure’ decreased, although not significantly, the odds of continuing; it included lack of leadership work time, and pressure from superiors or subordinates.”

High-performing trauma teams: frequency of behavioral markers of a shared mental model displayed by team leaders and quality of medical performance
Scand J Trauma Resusc Emerg Med. 2017 Nov 10;25(1):109
Johnsen BH, Westli HK, Espevik R, Wisborg T, Brattebø G
Link to PDF 
Excerpt from PubMed abstract: “The results showed a positive correlation of quality of medical management with leaders sharing information without an explicit demand for the information (“push” of information) and with leaders communicating their situational awareness (SA) and demonstrating implicit supporting behavior. When separating the sample into higher versus lower performing teams, the higher performing teams had leaders who displayed a greater frequency of “push” of information and communication of SA and supportive behavior. No difference was found for the behavioral marker of team initiative, measured as bringing up suggestions to other team members.”

Collective leadership and safety cultures (Co-Lead): protocol for a mixed-methods pilot evaluation of the impact of a co-designed collective leadership intervention on team performance and safety culture in a hospital group in Ireland
BMJ Open. 2017 Nov 3;7(11):e017569
McAuliffe E, De Brún A, Ward M et al
Link to PDF 
Excerpt from PubMed abstract:There is accumulating evidence implicating the role of leadership in system failures that have resulted in a range of errors in healthcare, from misdiagnoses to failures to recognise and respond to patient deterioration. This has led to concerns about traditional hierarchical leadership structures and created an interest in the development of collective ways of working that distribute leadership roles and responsibilities across team members. Such collective leadership approaches have been associated with improved team performance and staff engagement. This research seeks to improve our understanding of collective leadership by addressing two specific issues: (1) Does collective leadership emerge organically (and in what forms) in a newly networked structure? and (2) Is it possible to design and implement collective leadership interventions that enable teams to collectively improve team performance and patient safety?  METHODS AND ANALYSIS: The first phase will include a social network analysis, using an online survey and semistructured interviews at three time points over 12 months, to document the frequency of contact and collaboration between senior hospital management staff in a recently configured hospital group. This study will explore how the network of 11 hospitals is operating and will assess whether collective leadership emerges organically. Second, collective leadership interventions will be co-designed during a series of workshops with healthcare staff, researchers and patient representatives, and then implemented and evaluated with four healthcare teams within the hospital network. A mixed-methods evaluation will explore the impact of the intervention on team effectiveness and team performance indicators to assess whether the intervention is suitable for wider roll-out and evaluation across the hospital group.”

Red Bull’s Wingfinder tool
(Assessment of strengths tool – focusing on four areas: Connections, Thinking, Creativity and Drive, all together comprising 25 Strengths in total . Wingfinder assesses the four areas over 35 minutes (approximately 280 questions) through five different assessment formats. Self-against-self and self-against-others measurement. The assessment provides a report about the strengths, with coaching guidance .
According to https://www.wingfinder.com/science Published Scientific research on the Wingfinder assessment by can be seen here (Leutner, Yearsley, Codreanu ,Borenstein, Ahmetoglu 2017 )
From Likert scales to images: Validating a novel creativity measure with image based response scales. Journal of Personality and Individual Differences , (2017) Vol 106, 36–40.
Leutner Franziska, Adam Yearsley, Sonia-Cristina Codreanu, Yossi Borenstein, and Gorkan Ahmetoglu

Book : Clinical leadership in nursing and healthcare: values into action
Stanley, David
2017  Chichester, West Sussex : John Wiley & Sons
The new edition has been updated in light of recent key changes in health service approaches to care and values.

Book: The Oxford handbook of compassion science
Seppala, Emma
2017, Oxford University Press, New York
Publishers website for book states “Includes diverse psychological perspectives, including clinical, social, developmental, organizational, sociological, and neurobiological. Written by established and rising experts in the emerging field of compassion science for basic and applied researchers. Addresses the various definitions of the term “compassion””

Peering over the precipice : a toolkit for hospices to survive and thrive 
Peering over the Precipice is published as part of Hospice UK’s Good Governance programme supporting hospice trustees, boards and senior teams.
The toolkit will give hospice boards and executives the means to diagnose future risks, to make robust plans and to support any changes that need to be made to ensure the sustainability of their service.
To download the report, please register on the website : currently the report is restricted and only available to Hospice UK members. If you work for an organisation that is a member of Hospice UK please select your organisation from the drop-down list, selecting “Other” if your organisation is not listed.

Improving staff retention – a guide for employers
NHS Employers, Sept 2017 
Excerpts “During 2016/17, trustees of the NHS Confederation granted funding for NHS Employers to work closely with 92 NHS organisations, to help equip them with tools and resources to develop and implement their workforce retention plans. This guide draws on the learning and experience from the organisations we worked with, and is aimed at individuals who are leading or working closely on retention issues.”
“During the work programme, several key retention themes emerged which are explored in more detail in this guide. These are: • looking at data in depth • developing organisational values and culture • supporting new starters • supporting flexible working • development and career planning • flexible retirement options • building line manager capability.”

Executive Level Leadership and Talent Management in NHS Scotland
Scottish Government , May 2017
This paper provides a set of actions to address the Health and Social Care Delivery Plan’s (the Delivery Plan) priority of developing a new approach to leadership development and talent management in NHSScotland.
See also Della Thomas’s Public health leadership in the face of complexity, NHS Health Scotland

Latest news – April 2017

New national head of NHS talent management appointed
Posted 22nd March 2017, NHS Leadership Academy announcing
Martin Hancock to take on the role.

Mindful nation UK
Report by the Mindfulness All-Party Parliamentary Group (MAPPG)
The Mindfulness All-Party Parliamentary Group was set up to: • review the scientific evidence and current best practice in mindfulness training • develop policy recommendations for government, based on these findings • provide a forum for discussion in Parliament for the role of mindfulness and its implementation in public policy

Next steps on the NHS Five Year Forward View (online view)
March 2017
Direct link to PDF
Executive Summary
The Five Year Forward View was published in 2014, this report looks at what’s been achieved in England over the past three years, and looks forward to 2019 and what can be implemented, with reflection on fact that “next year the NHS turns 70”.
Chapter 8 looks specifically at “Strengthening our workforce”
Excerpts: “The national leadership bodies will take action to implement the next steps of the ‘Developing People, Improving Care’ framework for improving leadership and improvement capabilities across the health and care system, with a particular focus on systems working, building improvement skills for staff at all levels, and compassionate inclusive leadership. The framework set out a number of immediate actions in 2017/18, including making available support for systems leadership development to each STP footprint, developing the role of local leadership academies, launching a system-wide programme to address discrimination against staff with protected characteristics, supporting organisations to improve talent management, and establishing a national support function for senior leaders. We are also developing specific improvement capability programmes for boards and executive teams and for primary care practitioners, and CQC and NHS Improvement are jointly creating a single ‘Well-Led’ Framework.”
“The NHS will become a better and more inclusive employer by making full use of the talents of its diverse staff and the communities it serves. On workforce race equality, over the next two years trusts are expected to show year-on-year improvements in closing the gap between white and BME staff being appointed from shortlisting, and reduce the level of BME staff being bullied by colleagues. The programme to improve the employment opportunities for people with learning disabilities will be expanded. And in 2018/19 over four-fifths of trusts, CCGs and national NHS leadership bodies will have set their baseline measurement for the new Workforce Disability Equality Standard and set out their first year action plan. The NHS will work actively with Government to safeguard and secure the contribution made by international nurses, doctors and other staff as the Brexit negotiations proceed.”
“By 2018/19, the CQUIN incentive payment will be paid to NHS providers that improve the health and wellbeing of their staff by 5% (on a 2015/16 baseline), as measured by the staff survey.” See ref  NHS staff health & wellbeing: CQUIN Supplementary guidance and  The King’s Fund blog post by Marcus Powell on March 23rd ,  A mixed bag of results from the NHS Staff Survey: “the NHS should regard the Staff Survey as an annual report on the quality of leadership within the service”.

Sending shockwaves through the NHS?
Ben Collin’s blog post, The King’s Fund , 24th March 2017
Ben sees a role for system leadership as 6-10 Sustainability and Transformation Plans are set to become Accountable Care Organisations (ACOs) or accountable care systems ending the purchaser-provider split, but the methods by which they will be held to account are still unclear as well as questions on patient choice. See also HSJ’s  First nine ‘accountable care systems’ revealed (March 31st 2017)

Sustainability and Transformation Plan Questionnaire Report
Faculty of Public Health
The UK Faculty of Public Health (FPH) undertook a survey of directors of public health (DPHs) to look at the public health aspects of STPs in England, early in 2017. An outline report was presented to the FPH Board in February 2017. This report presents more detailed findings.

NHS Women on Boards: 50:50 by 2020
Sealy, R (Prof)
Published by University of Exeter Business School in conjunction with NHS Employers and NHS Improvement.
Executive Summary and full breakdown of demographic data from 452 organisations, including arm’s-length bodies (ALBs), NHS trusts and clinical commissioning groups, analyzed regionally, by type of board role, and service type. Includes narratives from
– Kathy McLean, Executive Medical Director, NHS Improvement
-Alison Hill, Non-Executive Director, Royal Berkshire Foundation Trust
-Clare Panniker, Chief Executive Basildon and Thurrock University Hospitals NHS Trust, Mid Essex Hospital Services NHS Trust and Southend University Hospital NHS Foundation Trust
Excerpt from report’s conclusion and recommendations;
This report has endeavoured to start the collection of a complete and longitudinal dataset on the board composition of NHS trust, ALB and CCG boards in England, with a view to contributing to the overall aim to achieve gender-balanced boards – 50:50 by 2020. We need an additional 500 female-held board seats by 2020. If we use the EU Commission’s definition of gender parity of at least 40 per cent of each sex on each board, then there are still 209 boards that do not meet that target. Given the gender split of the NHS’s workforce, if we use our own definition of between 45-55 per cent of each sex, then there are almost 300 organisations who need to pay attention to their gender composition. The scale of the task is stretching but doable: 1-2 more women per board. However, there is a real imbalance in certain roles. While we have a very high percentage of chief nurses, we need more specific research and data on why there is a dearth of women in other roles, (particularly chief financial officers and medical directors). Are women applying and not getting jobs, or are they not applying? If not, do we have a supply problem, or is it a demand problem? Where we know we don’t have a supply problem in terms of availability of competent women eg for non-executive director positions, what is not attractive and/or what is not being recognised? A very helpful meeting was convened in January 2017 with all the major search firms operating in the NHS, and a number of actions were agreed: In addition, it is incumbent on board chairs to insist that they get top-quality female candidates from their search firm or other sources, providing a broad search covering private, public and tertiary sectors.
Footnotes  include several key references .
The standard voluntary code of conduct for executive search firms

The NHS sets leaders up to fail – and then recruits more in the same mould
Guardian Healthcare Network – news from the NHS Frontline
Monday 27th March 2017
Blog opinion post (anon) regarding a shift in leadership characteristics needed, away from business skills to softer skills encompassing staff engagement and partnership working.
Excerpt: ” The NHS cannot afford to lose a swath of senior managers. Many of these people could develop the skills we need, we just need to help them to do so. After all, we require doctors and nurses to refresh their skills regularly, revalidating their qualifications; and these days, the disciplines of management and leadership are changing just as fast as medical practice”.

A Masters degree to grow hospice leadership
For information about the Hospice Leadership and Management module at Cass Business School (part of City University London ), and how to apply for a £4k Hospice UK bursary, see the Leadership and Management Development pages of the Hospice UK website.

Visibility Generates Trust: Walking the talk as an inclusive leader
Bobbie Petford of Walsall Healthcare NHS Trust on the value of  staff networks  as for example  lesbian, gay, bisexual and trans (LGBT+) staff networks. Excerpt: “Successful staff networks need sponsorship from the organisation’s executive team and adequate resourcing. They also work best where reciprocal participation, accountability and co-production involves members, the organisation and the public. The benefits for all concerned are shared expertise, critical friendship, and improved staff wellbeing and patient care.”

Second podcast on inclusive leadership in the NHS
3rd April 2017
Jackie Daniel, Chiief executive, University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT) talks about the  practical side of inclusive leadership.

19 in-depth interviews with ward leaders and modern matrons – how do they perceive their leadership role and lead improvements in the quality of care ?
Tensions within management roles in healthcare organisations
Nursing Management Vol 24, Issue 1 (Mar 2017): page 31.
Scott A and Timmons S

Does leadership style of modern matrons contribute to safer and more effective clinical services?
Nursing Management 2017 Vol 24: Issue 1 , p21 -25
Hill, B
(Reflections from a Matron for airway, ear, nose and throat, and reconstructive plastic surgery, Imperial College Healthcare NHS Trust)

New book: The essentials of nursing leadership
Authors : Ruth Taylor and  Brian Webster-Henderson
Sage Publishing
Key features include (taken from Publishers website for the book):

  • Real life focus, grounded in everyday practice, with lots of case studies and examples to help students see how theory relates to practice
  • Activities to help students reflect about their own practice, and about themselves as leaders
  • Video interviews with nurse leaders and students on the companion website
  • Further reading and links to journal articles in both the book and the companion website help students delve deeper and prepare for assessments.
  • The Essentials of Nursing Leadership

 

Staying for the long haul? Thinking about retaining talent earlier on as part of talent management
Meaningful interviewing for retention
Nursing Management;  Vol 48. Issue 3      Mar 2017): p7.
Widman, K et al

Technical Guidance for the NHS Workforce Race Equality Standard (WRES)
March 2017
Prepared by Dr Habib Naqvi, Roger Kline, and Saba Razaq
This document updates both the March 2016 version of the Technical Guidance for the NHS Workforce Race Equality Standard, and the July 2015 Supplementary Technical Guidance: Clinical Commissioning Groups and the Workforce Race Equality Standard.
Want the literature ? To assist the development of good practice the WRES Implementation Team has undertaken a significant amount of work (field work and literature search) to identify the shared characteristics of effective interventions against each of the WRES indicator and across organisations as a whole – looking at good practice in the private sector, other parts of the public sector, and within the NHS itself. The results of this  work will be shared from spring 2017 and should further assist organisations’ WRES action plans, which in turn will be evidence-based.

BMJ Leader – Volume 1, Issue 1
Welcome editorial from Stephen Powis and James Mountford

How expert mentoring can pave the way to successful leadership
Teaching associate. School of health sciences, University of Nottingham
Assistant professor. School of health sciences, University of Nottingham
Associate professor. School of health sciences, University of Nottingham
Nursing Children and Young People, April 2017, Vol 29, issue 3 pp20-22
Excerpt from abstract: “A pioneering module developed at the University of Nottingham brings together nurses at the top of the profession with those on the threshold of careers in nursing children”

Equipping future doctors: incorporating management and leadership into medical curriculums in the United Kingdom
Sonsale, A and Bharamgoudar, R  Affiliated to
 Franklin-Wilkins Building, King’s College London, London, UK.
 Imperial College London Business School, London, UK.
Perspectives on medical education6.2 (April 2017): 71-75.

Shared leadership and group identification in healthcare: The leadership beliefs of clinicians working in interprofessional teams
Forsyth, C and Mason, B
Journal of interprofessional care31.3 (May 2017): 291-299.
Excerpt from abstract: “An online survey was responded to by 229 healthcare workers from community interprofessional teams in mental health settings across the East of England”. Professionals responding to survey were psychiatric nurses, clinical psychologists, consultant psychiatrists, occupational therapists, and social workers. The authors “predicted that psychologists, social workers and occupational therapists would report greater agreement with shared and distributed leadership  when compared with consultant psychiatrists”, the latter have been found in their literature review “to work in a directive manner and view leadership as a prominent part of their role in teams”. “The current study reaffirms previous research that has demonstrated it is possible for clinicians to hold strong dual identifications with their teams and professions in situations when the level of professional threat is low.”

Future leaders course prepares nurses for the top
Jones-Berry, S
Nursing Standard. April 2017, Vol 31, issue 33, 12-13
11 nurses were selected for the master’s level course for deputy chief nurses ( launched at London South Bank University) .The course is a collaboration between NHS Improvement (NHSI) and Health Education England and aims to prepare participants to move up to chief nurse roles within 12-18 months. Although there will be fewer director of nursing posts as organisations merge the course participants think their futures may lie in becoming directors for sites within organisations as health and social care organisations merge. A fresh intake is confirmed for the course running from April to October 2017.NHS Improvement (NHSI) says there are 15 places available in the new cohort for the aspiring nurse directors’ course, and 15 places on the aspiring deputy nurse directors’ course.

Leadership and the everyday practice of Consultant Radiographers in the UK: Transformational ideals and the generation of self-efficacy
Booth L, Henwood S, and  Miller PK.
Radiography (Lond). 2017 May;23(2):125-129
Excerpt from abstract : “Using a qualitative-thematic approach, the leadership-related experiences of a purposive sample of six participating Consultant Radiographers are explored, alongside the systems through which they evaluated how successful they had been as leaders.”

Ambition London Toolkit 
Skills for Health  released this toolkit on 4th April 2017
This toolkit aims to ensure that a standardised high quality information advice and guidance is available for people who are looking to join the health and care sector.