Thursday, October 12, 2006

Excellence? - What Excellence?

Tom Peters famous best selling management book published in 1982 was called 'In Search of Excellence.'

That book began a quest for excellence in the business and corporate world and ‘excellence’ became a fashionable, some would say, 'jargon' word.

Today’s report about the performance of the 570 NHS organisations tells us that only 2 (0.003%) of them have achieved the standard of ‘excellence’ in both finance and quality. Click here for more details

Many factors are taken into account before arriving at the assessment of performance of NHS Trusts and as always, there is not a ‘one bullet solution’ to the many problems of the NHS.

I worked for 35 years as a manager in the NHS until two years and I suggest that the biggest single problem is leadership that has its priorities wrong.

The dedication and hard work of staff in the NHS is legendary and in order to motivate those people top class leadership is required. Sad to say in my experience the leadership is usually more concerned about meeting targets and balancing budgets than the welfare of their staff and therein is the problem.


Anonymous said...

But doesn’t the ultimate leadership come from the government? Maybe it’s because they keep setting targets, changing priorities, launching initiatives, that those trying to run the NHS (the same applies to education) struggle to deliver.

Talented professionals though they may be, the England football team don’t seem able to get the ball in the net at the moment. And in their case, the goal posts stay in the same place!

Widening the debate (is that allowed?), I was reading an article about the shortage of head teachers. I seem to recall it saying that around 1000 schools were without permanent heads. This is despite the government having put in significant additional funding to allow heads to be paid very high salaries. The problem appears to be that government interference has made the job of a head untenable. The majority of deputies now do not want to step up into the top job, which means that more schools will be leaderless in future.

Going back to our debate of a few days ago, perhaps we might just be better off letting Mr Cameron have a go? Or indeed anyone who appreciates the need not to interfere unduly.

Trevor Gay said...

Hi David

I agree government has a role but in the end local leaders have to be prepared to stand up and argue with government. Yes of course that is a tricky one but CEO’s of Trusts are paid well in excess of £120k per year so they should be able to support local staff and resist government interference. I don’t have a problem with government setting targets if those targets are reasonable. Most NHS targets are achievable but only through hard work and changing services - that is the real challenge. Excellent ‘organisations’ not only meet government targets but also tell the government to keep away from local detail. The ‘easy’ option for managers is to blame the government for everything.

I am certainly not an expert in the world of Education although in the 1990’s (interestingly under a Tory Government) I served for 5 years as a School Governor in a Primary School. The head teacher took early retirement because of the stress and frustration of paperwork that took him away from children and teaching. That scenario is tragic but it is hugely different to the picture in the NHS. Most of the top managers in the NHS have never worked with patients – more’s the pity in my view. I’m sure Hilary will confirm that! The majority of CEO’s in the NHS and the Finance Directors have never worked directly with patients or their carers and I believe many of them are out of touch with the real needs of patients. And unlike Education there are always hundreds –if not thousands of people in the NHS queuing up for a chance to become CEO’s. The accountants just cannot wait to take over the NHS my friend to make it even more ‘removed’ from patient care.

I think Mr Cameron’s views are almost identical to Mr Blair’s views in reality – they both say they want local decision making made by staff at the front line. The job of local CEO’s is to turn that rhetoric into reality rather than worry about ticking all the boxes on the money as if it were the Holy Grail.