Peter Lees, Chief Executive of the intercollegiate UK Faculty of Medical Leadership and Management, was the keynote speaker at our #gooddoctors event in Bristol on collaboration. Here Peter shares his views on how positive leadership can empower change. 

The evidence is overwhelming and yet the message is still not being heard: in addition to technical expertise, the way we behave towards each other, how we function in teams, how we lead and are led has a significant impact on patient experience and patient outcomes!

Peter Lees on the Medical Professionalism Matters panel in Bristol with Professor Maureen Baker (RCGP), Dr Caroline Gamlin (NHS South West), Helen Morgan (University Hospitals Bristol NHS Foundation trust), Jo Osorio (Healthwatch Swindon), Dr Emma-Kate Reed (University Hospitals Bristol NHS Foundation Trust)
Peter Lees (far left)  on the Medical Professionalism Matters panel in Bristol with Professor Maureen Baker (RCGP), Dr Caroline Gamlin (NHS South West), Helen Morgan (University Hospitals Bristol NHS Foundation trust), Jo Osorio (Healthwatch Swindon), Dr Emma-Kate Reed (University Hospitals Bristol NHS Foundation Trust)

Reports are written, very public failures are picked over for years such that Bristol, Mid Staffordshire and now Morecambe Bay assume meaning way beyond a geographical location. Under the guise of ‘something must be done’, detailed action plans are generated which slowly melt away as history and other events do the usual to the collective memory.

What makes NHS staff tick?

It is astounding in a service established to care, that the running of it seems to display so little knowledge of humanity, what makes NHS staff tick, what makes people change!

Lesson one, shouting at 1.3 million people doesn’t work.

Lesson two, at the most challenging time in the history of the NHS, hundreds of additional actions are likely to be unwelcome and it is hard to get people to do things they don’t want to do – any of you got kids?

Lesson three, there is a very simple concept called discretionary effort, the difference between the amount you could put into your job minus the minimum to avoid being sacked.

As we have stopped pay rises and perks don’t exist, I conclude that the increased effort to get us out of the current abyss has to be free, based on goodwill – in other words, discretionary effort. Quiz time: will you get more discretionary effort by being nicer to people or by being horrible to them, making their lives more difficult, making it easier to prosecute them? If you struggle with this concept, Google the Harvard Business School Service-Profit Chain paper.

And, do you know what, the evidence suggests that if we are nicer to staff, they will be nicer to patients – a virtuous circle if ever I saw one!

Learned helplessness

And so to us, the downtrodden masses, as Richard Wells opined: Subordinates do not have the monopoly of fear, doubt, despair, uncertainty or anger and while they are entitled to look to the leader for courage, certainty, optimism and calm, they are not entitled to trap a boss on an emotional pedestal. Learned helplessness is said to be all around us. I am often asked by younger colleagues what they can do without the trappings of high office. There are many answers but one thing we all have control over is how we behave ourselves. Why do some of the people I trained with who bemoaned the way we were treated perpetuate the same poor behaviour of many of our forefathers? One simple action for all of us is to reflect on our own behaviour – can we read the recent GMC report into bullying with a totally clear conscience? When did we last say thank you to someone junior or someone senior? I could go on but you get the point!

As my dear late mother used to say: Peter, if you can’t say anything nice, shut up!

Find out more about the 2015 Medical Professionalism events, and register your interest in a place here. Information on 2016 events will be published shortly.

Peter Lees is the Chief Executive and Medical Director of the intercollegiate UK Faculty of Medical Leadership and Management, a membership organisation with 2,000 members. He also serves on the Clinical Governing Body of West Hampshire Clinical Commissioning Group, the General Advisory Council of the King’s Fund and the NHS Leadership Academy Steering Group.

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