Medicine and positive leadership: be nice, Peter

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.

Related Posts

Russell Cartwright, GMC Corporate Communications Manager, reflects on the first of our series of UK-wide Medical professionalism matters events  on collaboration which took place in Bristol

Elizabeth McGrath, Head of Corporate Communications, reflects on the second of our series of  Medical professionalism matters events in Newcastle. This time, we were focusing on resilience.

Dr Alys Cole-King on Doctors under pressure need resilience, not mental toughness

6 responses to “Medicine and positive leadership: be nice, Peter

  1. Your question above “what makes the NHS tick”. I do not think it does. Do we still have faceless monsters like the old British Rail? No, and we will not be going back there. Look at the deregulation of the UK buses – eg Stagecoach owned by an ex theatre sister and her accountant brother. I remember when buses were mainly empty and subsidised because it was a monster service, hopeless. There are better ways but I see little sign of a will to change. Even the BMA seems to promote more of the same. As you say it is not just about money. To remain a monster is doom. I am in the antipodes where there is a monster hospital sector and another hospital sector (where 63% of ALL elective surgery is polished off to the satisfaction of patients and staff). Look outside the UK shores – and before lefties automatically say US, please look further. I am not a GP but when I speak to GPs here they are content and do not retire asap and they do not earn a fortune – probably on a par with UK +/- and no NHS pension. There are Saturday and even Sunday GP appointments – not forced on them by big brother but voluntarily run; the harder you work, the more you earn. It may be the more junior doctors who man these clinics to pay off the mortgage? I met an Australian GP on an internal flight recently. He told me when he has a really busy day he goes home and tells his wife he has had a great day. I told him when my wife, an NHS GP, has a busy day, she comes home and tells me she has had a terrible day! I think there is a message there.
    If the system was not flawed, there are enough smart minds in the NHS to have long ago found the way to achieve the necessary. They have not. I could go on but enough.

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