The 4 NHS Ways to Work Framework

The fields of management and leadership are full of simple schemes and classifications for understanding how people and processes tick. These can be a useful tool to turn to when planning change or when there is problem that is difficult to put a finger on. They provide concepts and vocabulary to help us explain problems to one another and find solutions together.

I encountered a new leadership concept this week…

 

4-nhs-ways-to-work-sketch

Kurt Gebhard Adolf Philipp Freiherr von Hammerstein-Equord, the Commander-in-Chief of the WW2 German Army, had a fascinating system for classifying his officers.

“I divide my officers into four groups. There are clever, diligent, stupid, and lazy officers. Usually two characteristics are combined. Some are clever and diligent — their place is the General Staff. The next lot are stupid and lazy — they make up 90 percent of every army and are suited to routine duties. Anyone who is both clever and lazy is qualified for the highest leadership duties, because he possesses the intellectual clarity and the composure necessary for difficult decisions. One must beware of anyone who is stupid and diligent — he must not be entrusted with any responsibility because he will always cause only mischief.”

This system is amusing for its frank, perhaps outdated, description of most workers as stupid and the image it conjures of that much mocked workplace character – the “little Hitler”. We all recognise that person who enthusiastically applies rules and regulation without proper judgement or understanding of the systemic harm they are doing.

However, I think it is too reductionist, rigid (and rude) for the modern workplace.

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4 Things the NHS could learn from Disney

Working as a GP in the esteemed but overstretched british national institution which is the modern NHS can be tough at times. I felt this a little more than usual last week having just returned from my summer holiday in the artificial bubble and pinnacle of one of America’s own national institutions – Disney World –  the “happiest place on earth”.

Since beginning this blog, I’m always on the lookout for innovative ideas. Free association of unrelated concepts is a great source of inspiration. So I kept my iPhone in hand to jot down any thoughts that might help improve life and care within General Practice or the wider NHS.

lesson-for-nhs-from-disney-sketch

 

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GP Federations – Live long and prosper?

GP Federation Pic

Are GP Federations the answer for General Practice?

This week’s sketch is inspired by the return of TNG to Netflix.


While you are here, you might enjoy some of my recent posts…
Why I'm excited about Pokemon Go
Why I’m excited about Pokemon Go
How storytelling helped at out CQV inspection
How storytelling helped at out CQV inspection
How we used speed dating to help GP recruitment and retention
How we used speed dating to help GP recruitment and retention

 

 

 

 

 


 

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How storytelling helped our CQC inspection

Sometimes you need to communicate a crucial point. To instruct individuals or a team to do something important. To encourage a trainee or team member to change a negative behaviour. It may be vitally important to a patient’s health or the success of your organisation. Fortunately medical training has prepared us well.

We know what to do. Present them with the facts. Support the message with data, graphs, risk ratios, tables and diagrams. This will help. Describe the options and the outcomes. Allow questions. Agree a course of action. Check understanding. Arrange to review progress.

People will then do what is best for themselves, society, or in the case of staff, the practice. Lose weight, complete the QOF prompts. They’ll be responsive to a logical case well made and do the right thing. Won’t they?

All too often, I find that, they don’t.

You will all recognise this story.

Tom is a smoker and we want to convince him to stop. We tell Tom that smoking kills 96,000 people a year in the UK, will shorten your life by an average of 10 years and that 80% of lung cancers are caused by smoking. The list of impacts and risks goes on. The logical case for stopping smoking is overwhelming. But, Tom had a friend… Bill. He smoked for 50 years and was fine. Until he stopped smoking. Since he stopped he had never coughed so much. He developed “heart trouble”, deteriorated and died. Bill always said that it was when he stopped smoking that his health started to go down hill.

“No doctor, I don’t want to stop smoking. It’s not worth the risk.”

Patients like Tom often show us the power of anecdotes and stories, and that they can be more compelling than the clearest of figures and facts.

It seems that many medics are missing a trick when communicating, motivating and leading. The use of stories and narrative are a great tool, and many professionals with technical and scientific backgrounds can under appreciate their impact.

Storytelling Pic

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The worlds of speed dating and GP recruitment, together at last!

Ask Practice Managers and GP Partners to list the challenges currently facing their practices and GP recruitment will poll high on the list.

Practices are facing a perfect storm of factors making it difficult to find and keep salaried and partner colleagues. Senior GPs are making an early dash for the exit and juniors are looking to other specialities or to more work-life balance friendly overseas or locum roles.

The issues almost roll off the tongue. Pension caps, insurmountable workloads, business uncertainty and risk, premises issues, increasing patient demands, more regulation, higher indemnity costs, the recent GP bashing mood of the media, and active recruitment by sunnier parts of the world. It’s enough to make even the most dedicated partner consider their position.

In many areas, even finding locum GP cover means using expensive agencies to find someone to drive across counties to the practice. It is not unusual for vacant sessions to go unfilled adding to the pressure on remaining staff.

Fresh thinking and innovation can throw up novel ideas and solutions to complex problems and turbulent times.

“Innovation comes about through combining disparate ideas and disciplines in ways that seem weird at first.”Ben Weinlick

In 1439 Johannes Gutenberg combined the wine press and the coin punch to create movable type and the printing press. He revolutionised the world.

In March this year the the RCGP Vale of Trent Faculty applied an innovative idea to the problem of GP recruitment and retention in the East Midlands. Perhaps not quite in the same league as the printing press, but exciting none the less.

GP Job Speed Dating Pic

The worlds of speed dating and GP recruitment, together at last!

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Levelling up! Six lessons about professional development from the world of role playing games…

It’s 9pm. I’m alone. This was a busy supermarket. Was. The air is filled with the smell of long rotten food and the sound of silence. A can falls loudly to the floor. A feral zombie like creature darts towards me. My heart quickens as I raise my AER9 laser rifle…

No, this is not Dr Puddle’s usual trip to the local Tesco Metro to pick up a ready meal after evening clinic. I’m playing a game. My old student penchant for computer role playing games, RPGs, has not entirely left me. I should probably be doing something more productive, like preparing for my appraisal next month. But then again, isn’t it important to unwind from time to time?

It would be nice to think that all those hours exploring dungeons and slaying orcs were not wasted. And, perhaps they weren’t.

RPG Sketch Pic

Continuing Professional Development, CPD, is an essential part of life as a modern professional. Here in the UK, demonstrating ongoing development is a compulsory part of all doctor’s revalidation process. Over 50 hours of development activity must be demonstrated every year in order for us to be allowed to continue to practice medicine. As I reflect on how I plan to improve myself as a professional, it strikes me that RPGs have some powerful lessons to teach us about personal and professional development.

That RPGs incorporate elements relevant to CPD is not surprising. A big appeal of the RPG genre is the experience of improving your character’s skills and abilities as you engage with increasingly difficult but rewarding stories and quests within the game world.

All RPGs incorporate a system to model the accumulation of experience, skills and abilities. For example, the Fallout series quantifies a player’s abilities using the S.P.E.C.I.A.L. system. Player “stats” are rated 1 to 10 in the attributes of Strength, Perception, Endurance, Charisma, Intelligence, Agility and Luck. Your character starts the game weak and ordinary, but experience points earned through playing the game are spent improving your basic stats, and training in special abilities. Currency can be earned and exchanged for equipment and clothing, which further enhance “stats” and abilities.  

So what can RPGs teach us about improving ourselves in the real world?
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