I don’t know where the year has
gone. The days have flown by and it’s hard to believe there are just 23 days
left until Christmas Day 2018. And in the words of the famous song ‘Christmas
is all around us’. Which is a problem when out and about with grandchildren.
They of an age now and have cottoned on to the need to write a list to Father
Christmas setting out what they want for Christmas. Television advertisements
don’t help – ‘I want one of those, and those, and that’.
They haven’t yet got to
understand the joy of giving, and it’s all about what they might receive now.
So, Christmas is a season of managing expectations. And it’s not just the
grandchildren’s expectations that need managing. Due to the gales last week, I
was able to catch up with some of my reading. One of the things I read was a
blog on the fabulous ‘The Conservative Woman (the philosophy not the party!)’ website.
There was much I recognised in the author’s view of the world, and it’s a good
read. You can read it too here.
I won’t spoil your read, but I
was really struck by the expectations articulated by the blogger’s fellow
patients, their friends and family and my own parents’ experiences and
expectations of health care. They are of a generation which is still very
deferential to the medical profession, although these days, they do complain
(loudly) of the difficulties in getting to see their GP, or specialist consultants.
And I am sure I can’t be the only person frustrated by what appears to be a lack
of assertiveness when it comes to asking their doctors questions. Time and time
again when they have been to see a health care professional and I ask them what
was said, they have nothing to report – or more often than not when I ask what
it was they asked, they say they didn’t ask anything – if the doctor wanted
them to know something, they are sure they would be told. My parents have high expectations
of the NHS and how those who work in it should operate.
They are not alone in this. Last
week, the Secretary of State for Health and Social Care, Matt Handcock, spoke
to an audience of health care professionals at the Kings Fund, setting out his
expectations for NHS leaders and managers. You can read the text of his speech
here. He compared the NHS to the US Department of Defence, McDonalds, Walmart
and the Chinese’s People’s Liberation Army – all great British institutions – in
fairness, he was trying to make the point about organisations comparable in size
to the NHS and highlighting their approach to management and leadership development.
One of the organisations, which Matt
Hancock wants to take a larger role in achieving similar leadership development
programmes for the NHS, is the well-respected charity - Staff College. You can
read more about their work here. Refreshingly, they describe themselves as
being agnostic about styles of leadership and leadership theory, focusing more
on the leadership context. Likewise, they also believe in the importance of
people, and the quality of relationships leaders have with those around them.
An absolute expectation of the students who attend the Staff College
development programmes, is that they explore more deeply and reflectively their
sense of self and their sense of self in relation to others.
This is an approach I have championed for many years.
Partly, I think, because it reflects my clinical background and my love of
psycho-dynamic approaches to therapy. Indeed, over the last 25 years my CV has
stated: My professional background is in mental
health care. The focus for my research interest is on
inter-personal, intra-personal and extra-personal relationships and how
individuals are prepared to use such relationships. My research has centred
around exploring the impact of such relationships on nursing practice, policy,
organisation and education using psychodynamic and managerialist analytical
discourses.
35 years ago there was another chap,
whose expectations of managers and leaders in the NHS had a profound impact on
how the NHS has developed since that time. He was Roy Griffiths, who when he
was alive was the Chairman of Sainsbury’s. Spookily, the first job I had on
leaving school was as a management trainee for Sainsbury’s. The Griffiths report,
published in 1983, introduced the concept of general management to the NHS. This
was something I was to benefit from, gaining my first senior management position
some seven years later. It was also the first role in the NHS where I wasn’t employed
primarily as a nurse.
I set out on that journey with great
expectations of the contribution I would be able to make to the NHS. Many of
those things I dreamt about doing I’ve realised. And there were many other
career achievements that have happened that were completely unexpected, such as
becoming Dean of School at a university and a Professor in mental health care
and travelling all over the world to present my research. Not bad for a former management
trainee at your local supermarket – maybe Matt Hancock has a germ of a good
idea after all!
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