17 June 2022 – Non-executive directors – Leadership for a collaborative and inclusive future: the Messenger/Pollard report

Mark began by putting the report into the context of a tradition of NHS leadership reports dating back to the 1980s. He said: “The impact of these reports make us wonder if reports like this have had their day – perhaps we need something more dynamic.

“To cut through, the report needed to be compelling, relevant and adding value; it needed to show insight into leadership, governance and organisational development as a package; it needed to embody the world as it’s developing; and it needed to look long-term.”

Main messages

Mark suggested that seven main messages sit at the heart of the report:

1. Targeted interventions on collaborative leadership and organisational values
2. Positive equality, diversity and inclusion (EDI) value
3. Consistent management standards delivered through accredited training
4. A simplified, standard appraisal system for the NHS
5. A new career and talent management function for managers
6. Effective recruitment and development of non-executive directors
7. Encouraging top talent into challenged parts of the system

Critique

Mark said the positives of the report include a good narrative, clarity in recommendations, themes of relevance – including the impact and value of leadership, skills and behaviour, standards and professionalism, and equality, diversity and inclusion – and the currency of cultures and behaviour, collaboration and respect, support for careers and talent, and balancing off acute power.

The negatives, he said, included a sense of being at the end of an era rather than the start of a new one. It also lacked bite, relevance, or energy. There was no compelling vision of collective leadership for public outcomes, it is tone-deaf on localism, there were too many strands left hanging, and it underrepresents what is working well. Most disturbing, he said, was the naivety of the implementation plan, which he feared was too one-sized to succeed.

What’s missing?

Mark noted a lack of detail about required investment levels, and of clarity on core leadership characteristics and values. He also missed any recognition of the impact of changed and changing world of work, the power of the centre and the re-emergence of the regions, live cultural issues such as behaviour, inclusion and duty of care, and of the importance of leadership in primary care and at place. Finally, there was also not enough about the place being the right space to leverage impact.

GGI response

On framing, Mark said governance, leadership and OD must be united and seen as such. There’s a need for a compelling vision for leadership for 2030, and perhaps for reigniting a discussion about what a future board should look like.

On priorities, he said it would be worth looking at what should be meant by whole-system capacity building, to take workforce as a compelling focus, to begin the process of embedding EDI and ESG more into governance, and to spend time on impact measures that can be publicly set.

He also mentioned some of the practical tools and resources GGI has been working on, including whole-board and system coaching, cultural assessment, multi-tier leadership development, and core skills support.

Overheard during the discussion:

“I’m really disappointed in this in many ways. What it fails to set out clearly is that leadership is not something you have at the top of an organisation, imposing itself on everything below it. What we have in a modern system is that we see leaders as the people who do the work of the organisation, touch the lives of patients and their families, working out in communities, changing the health of the local population. And there’s no sense of a board telling people what to do through dictates. The organisation needs to use whatever leadership and influence it’s got to make sure the real leaders have everything they need to do their work well – that’s what makes organisations successful.”

“It feels like a missed opportunity. You can’t disagree with any of it, but the danger is it’s a bit motherhood and apple pie. But I do agree with the priority recommendations. It gives us the basis on which we need to take on the responsibility of addressing those priorities. The big issue that we all need to recognise is that good leadership is key and it’s particularly important at the moment when we have such a challenge to attract and retain people into health and care.”

“I remember a quote from the Griffiths Report 40 years ago that any change in the NHS is like fresh wind blowing on a child's mobile. At first, there is a lot of change but over time, everything settles in its original place. Cynical?”

“I welcome the generality and the key principles, but I was a bit disappointed on the EDI area, as whilst I agree with CQC taking more focus, it should be more explicit as a 'must do' for trusts.”

“A general management training scheme specifically for BAME staff wishing to go advance their leadership career will be helpful.”

“The thing that was missing for me was that there was a military command-and-control view of what leadership is. In the modern world it’s more about everyone being a leader – it’s about delegated leadership. I would rather have seen something about what leadership means in the 21^st century and more of a focus on how to get everyone in an organisation thinking and behaving like a leader.”

“I’d be really interested to know what the Local Government Association thinks about this. We’re just about to get into bed with the biggest melding of management tiers, views and strategies. If they don’t recognise this language and these principles, we’re going to come running out with a complete contrary series of thoughts and actions. So let’s hope they recognise it and use it.”

“Fifty percent of NHS senior leaders have experience racism in their career and that is frankly scandalous. This is a wake-up call to really address this and take the EDI agenda forward.”

These meetings are by invitation and are open to all NHS non-executives directors, chairs and associate non-executive directors of NHS providers. Others may attend by special invitation.

If you have any comments, questions or suggestions about these webinars, please contact: events@good-governance.org.uk