Leadership and Teamwork Development

8/6/2019 Leadership and Teamwork Development

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Steve Onyett.

Leadership and teamwork

developmentEastern Region CMHT Forum

14th December 2007


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Steve Onyett.

The 2006 NHS NationalStaff Survey

89% responded positively when

asked: Do you work in a team?

However this shrunk to 41% when the

survey explored whether the team in

question fulfilled criteria for a well

structured team

Findings consistent since 2003!


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Steve Onyett.

An auspicious time for leadershipand teamwork developmentPerformance management that is stronger on

outcome while being less centrally controlling ispromised.

Stronger local accountability advocated

In a policy context where there is good

alignment of policy imperatives with theexpressed concerns of users and carers, forexample with respect to personalised care,dignity and choice.


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Steve Onyett.

Darzi interim review in the wake ofWanless

Performance is not commensurate with

investment.

Darzi stresses effective leadership and the

creation of stable contexts for service

improvement.No change unless it is an improvement!


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Steve Onyett.

The challenge:

How do we achieveteam role clarity within a

complex local wholesystem?


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Steve Onyett.

Scary graphic coming upon the inter-team

relationships described in

the Policy Implementation

Guides


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Steve Onyett.Primary Health Care

Team

Early

interventionteam

Assertive

communitytreatment

In-patient

services

Non-statutoryagencies

Approved

socialworkers

Continuing care

Services for

homeless people

Psychology

Police

Criminal justicesystem

Acute medical

services

Self referral

CMHT/

Primary care liaison

team

Forensic services

Child and

Adolescent MH

Team

Crisis

resolution/Home

treatment team

KEY

Direct referral route

Referral may be

out of hours

Inter

teamrelation

-ships


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Steve Onyett.

A solutions focused approach todevelopment

Developing shared vision of your

preferred future

Being clear where you are now and

celebrating the strengths that got you

thereTaking the first small steps forward

Affirming each other


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Steve Onyett.

Boundary spanning: Implications Managers may combat ineffective intergroup relations by

enhancing employees identification with their

organization, while acknowledging groups for theirindividual performance

Measures for enhancing organizational identification mayinclude Communication of organizational successes, values, and goals.

Rotation of individual boundary spanners

Promotion into boundary positions of employees with dualidentification

Ensuring that intergroup working is on a groups agenda, in orderto combat silo working

Intergroup social gatherings

Frequent intergroup meetings,

Use of cross-functional teams


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Steve Onyett.

The filling in the sandwich

Middle management the critical layer between

corporate management and practitioners.The most stressed group in the NHS workforce.

Often feel disempowered- so like practitioners

exercise what power they have by saying no or

taking flight from authority.

Thus need to link their development strongly

with neighbouring layers in hosting organisations

From NHS Confederation Report- The challenges of leadership in the NHS. 2007


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Steve Onyett.

Middle management survey by NHSConfederation/HSJ

Who are they?

High levels of stress and a long-hours

culture- worst in mental health.

Generally positive about their jobs but

least so in mental health


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Steve Onyett.

That context re Risk..

..Success is the ability to gofrom one failure to another

with no loss of enthusiasm.Winston S Churchill


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Steve Onyett.

Development to make a difference

Take a longer term view which

encompasses the wider system.

Create more time for really important

issues- such as improving delivery and

staff understanding of the wider strategy[and values of the organisation].

Aim for more stability



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Steve Onyett.

Development to make a difference

Context requires a a much wider and more subtle range

of influencing and persuasion skills than would berequired in some other settings.

Pay attention to the skills required fora much morecomplex world in which thinking, listening and influencingwill become much more important(12).

Develop sophisticated skills to deal with the emotionalside of organisational life that are probably even moreimportant [than the need to improve technical skills]

NHS North West chief executive Mike Farrar



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Steve Onyett.

Some distant reflections from theturn of the century!Goodwin (2000) advocated a move away from a

focus on individual skill development towards alocal leadership mindset.

Leadership development as mandatory, locallyfocussed, based around action-learningprinciples, and concentrated on inter-

organisational and shared leadership betweenorganisations rather than leader-followerrelationships within organisations.Goodwin, N. (2000). The national leadership centre and the national

plan. British Journal of Health Care Management. 6(9), 399-401.


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Steve Onyett.

Observations underpinning thedevelopment of ETL Leadership initiatives sometime fail to focus strongly

enough on service improvement

Service improvement initiatives often fail to take enoughaccount of the involvement of senior managers. Hence the need to integrate the two at local level

Leadership is bound by context, shaped by the task inhand and dispersed

The vast majority of care is delivered by teams and thisis where service improvement and effective leadershipneeds to be enacted.


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Steve Onyett.

Observations underpinning thedevelopment of ETL You cannot assume that the ways teams are

currently configured are real teams In trying to engage clinicians in change in makes

sense to use evidence-based models of changethat they are familiar with from their clinical

work.We often neglect the mental health of staff in

trying to achieve sustainable improvement.


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Steve Onyett.

The ThinkingLeadership is not just the task of a

particular individual or discipline.Effective multidisciplinary teamworking is

the platform for evidence-based

interventions.A focus on outcomes for users and staff.

A focus on you and the resources youbring


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ObjectivesTo increase your confidence and

effectiveness as a leader, managerand/or team member.

To increase your ability to develop

solutions to complex problems.To support you in achieving

meaningful change.


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The essenceBringing teams together in sets- small

groups where learning is achievedthrough action.

Helping you hone your peer coaching

skills so you can better supportcolleagues through action-learning sets.

Introducing new learning on leading-edge research on leadership and

teamworking.


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Steve Onyett.

Key features Working across boundaries

Leadership linked to improvement and the task in handAn emphasis on clarifying shared objectives and values

Developing a shared experience of the users perspective

Using tried-and-tested models for improvement + those

based on clinical know-how- e.g. solutions focus,motivational interviewing

Can be used in concert with other key developments

such as CCTA


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Steve Onyett.


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Steve Onyett.

The learning sets starthere!


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More openness and cohesion

Clearer view of objectives. More insight intointerpersonal interactions

I really do believe the team has benefited. It has madeus all aware of issues we avoid, i.e. conflict, and buildingin innovation

More openness in discussion. Better understanding ofeach other. Development of realisable objectives

Enabled the team to deal with uproar in a positive way.Brought team closer together. A peer group now started.Office environment a little better

Reported Benefits

From Rees and Shapiro, 2005


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A high proportion of the membership worktogether and techniques from the course havebeen evident in the work place throughout. These

include process mapping, problem solving deBonos hats, understanding complexity etc.

In the main, some of the topics were pertinent tothe development of the new team and enhanced

cohesion. Much of the management exerciseshave been noted and used within our team,mapping, systems etc.

Improved leadership with clearer identified goals

A more informed leader

Reported Benefits

From Rees and Shapiro, 2005


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Does it work? To quote:

Overwhelmingly, participants response to the day-by-day experience of their development programmes was

positive. Throughout the course their commentsindicated that they valued the opportunity to interact withother team members away from the work environment,enjoyed both networking and the chance to meet new

people, and find out more about them. participantsselected action learning sets as being particularly useful.They found these covered real issues and problems, hadconnections with their practice, and enabled them tocome away with definite action plans(Rees andShapiro, 2005).

Documents

Leadership and Teamwork Development