This series of articles will appear weekly and present Seven Survival Steps for black and ethnic minority staff working in the NHS, but may have provide a wider focus for discussion. The articles are excerpts from a forthcoming handbook, and provide highlights.
Step 6: Influence your leaders
Leaders of NHS organisations have a duty of care towards staff employed to provide services and a key Survival Step is to understand how leadership operates, how to hold leaders to account, and ultimately how to become a good leader.
There are exemplary NHS leaders running the some of the best organisations in the country, with effective leadership at all levels. This is not the case throughout the NHS and this impacts the experience of everyone working and using organisations. Promotion in the NHS too often brings with it a sense of entitlement. A perverted sense of entitlement with senior positions being perceived as a 'reward' for previous years of service. There is, among some NHS leaders, a sense of escape, and removal from hard work and conditions of workers at more junior levels. Too many of those who have 'arrived' have the perspective that life for them should now be as easy, they will stand on the shoulders of others, breathing in clean air, and have an army of people to do the work, and report to them. They fail to understand what 'assurance' means, believing erroneously that this is about receiving committee reports from those further down the ladder, and bringing pressure to bear on the juniors to report positive stories. Some trust boards foster a culture where it is impossible to bring hard truths to board meetings, especially to the public part of the board.
Leading healthcare is tough, and things will go wrong. But too many boards see things going wrong as a personal threat to their power, status, and jobs and have great intolerance to hearing bad news. So their stance on bad news is to pretend they are not aware of it, or to not to want to be told about it, or they only want to hear about it once it has been sorted. The mantra is often 'don't bring me problems, bring me solutions'. But this approach absolves them from providing support, and taking responsibility. If leaders genuinely prioritise people over their jobs, their main concern should be to identify and root out risks, and problems, admit when things have gone wrong, and take action to correct them.
So what can you do to impact leadership as a survival step? Three actions are outlined at this Survival Step:
1. Know and understand how leadership in your organisation works. Attend meetings that are part of your role. If they are not, ask to start attending and observing them as part of your development..
Attending the organisation's governing body meeting such as Trust Board meetings at least twice each year is a very useful part of your education, and provides an overview of roles. Other meetings that are useful to attend are quality, governance, audit, safety, performance and workforce development. These meetings are often provide opportunities to ask questions, and you should take the opportunity to do so.
2. Learn how to manage your leaders. Start by understanding the difference between managers and leaders. The NHS appears to be more committed to a management style of leadership, and for most of your career, you will report directly to a line manager. This is the person you will report to directly on a day to day basis, and the person you will rely on for your first line of support, information and guidance. Unfortunately you will probably find that some line managers do not have appropriate managerial or leadership qualities, and may not even be interested in staff management. Managing staff may simply be an inconvenience that came with the promotion or grade they were interested in. Many see it as a cross they have to bear, and pay little attention to the needs of their staff team. In such cases you will need to decide if you can contribute and progress sufficiently with that manager, long enough to move on to another role, or whether it would be in your best interests to move on sooner. Explore whether you are able to take steps to bring out the desired managerial and leadership qualities in your line manager. It may be that they do not currently have the competencies, but do listen, and will develop and improve over time. In such situations, there will be benefit in staying in role, contributing and growing. However, with a poor manager, who has no insight, competencies, or the will to change and grow with their team, you will need to make a decision about your future with that manager. This is where mentors and particularly sponsors can be useful sounding boards.
3. Aspire to Leadership - If you are interested in leadership, take active steps to put yourself on this path. There is no rush, as arriving in senior posts that you are not appropriately skilled, experienced and prepared for, as that will prove to be a step too far, too soon.
There are BME leadership programmes available, and it is a matter of personal choice if you want to pursue that avenue. The main benefits are opportunities to network and build alliances with other BME NHS staff that will provide useful sources of support during your career.
4. Learn from the best leaders: One of the most inspirational NHS leaders today is Dr Umesh Prabhu, Medical Director at Wrightington, Wigan and Leigh NHS Foundation Trust, a beacon nhs trust in equality standards in the NHS. Dr Prabhu,and his perspective on leadership brings many insights.
Appoint right leaders with right values.Not someone because he is a member of your club If not patients suffer staff suffer and NHS suffers. Dr Umesh Prabhu