Transforming Quality Through Leadership


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eadership has never been more important in the NHS. Leaders at all levels inspire and achieve quality through effective dialogue with staff, colleagues and service users. In this session, delegates will be introduced to a framework for understanding effective dialogue and conversational patterns and will be provided with practical approaches and tools that will enable them to have more productive quality conversations.

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  • Welcome Focus of this session -Transforming Quality through Leadership/Bringing Quality Alive through quality conversations What they can expect - interactive session to illustrate how we might improve quality through improving the quality of our conversations.
  • The National Leadership Unit is responsible for developing and implementing leadership development policy for NHSScotland, to help improve leadership capacity and capability in order to deliver the goals of NHSScotland. The National Leadership Unit is based within the NES Educational Development Directorate and is responsible for delivering national leadership interventions to take forward the commitments of Delivering Quality Through Leadership (the NHS Scotland Leadership Development Strategy) in support of service delivery.
  • Don’t intend to go through all of this – Too small to read – handout on your tables Put it up to show the range and breath of our work – all of which is aligned with Health Board leadership development strategies to support senior leaders achieve three quality ambitions for NHSScotland. 5 Objectives Work with partners to drive cultural change Build OD capability and capacity Develop current leaders and teams Nurture the supply of future leaders Evaluate the impact
  • It’s all about relationships and relationships rely on conversations
  • Hand over to Sharon
  • In a moment we are going to role play a couple of conversations for you. The quality of the conversations depends on the degree of balance between advocacy and inquiry Advocacy is taking a position, speaking what you think, speaking your point of view Inquiry is seeking information by asking questions to look into what you don’t yet know, what you don’t yet understand, to understand your own and others views We are going to role play a conversation which you might be familiar with. While watching it: Focus on the pattern in the conversation rather than the content – watch for advocacy and inquiry Notice the “tone” of the conversation Look for the dynamics between people
  • Then you can discuss what you noticed at your tables. Hand over to Allan or Emma Invite participants to discuss at their tables Take 2 or 3 reflections from the floor Introduce the Kantor model
  • David Kantor is a dialogue practitioner and family systems therapist. He developed the Four Player Model from research into effective communication of a family system. Kantor builds on the key dimensions of advocacy and inquiry and extend them by suggesting a productive conversation balances the four speech actions of Move, oppose, follow and bystand. Two are an aspect of advocacy (making a point) and two are an aspect of inquiry. Kantor suggests that in conversation, some people move – they initiate and provide Direction e.g. through making a point, a suggestion, giving their opinion. Others will oppose – they challenge what is being said, making a counter point or probing, clarifying or providing correction to what has been said Other people follow – they complete what is said and support what is happening, perhaps by building on what someone has said. and still others bystand – they observe and provide perspective on what is happening. To make a bystand, the person acts as a mirror to the proceedings. E.g. why something is said or not (elephant in the room scenario), who is speaking and who is silent. To illustrate the speech actions we are going to run the role play again. Re run role play highlight advocacy pattern - results in stuck conversations Lets see what happens with a little more balance in the conversation. This time look for: Changes in patterns, behaviour and tone Run script 2
  • Transforming Quality Through Leadership

    1. 1. Transforming Quality Through Leadership
    2. 2. Role of the National Leadership Unit <ul><li>Develop and implement leadership policy for NHSScotland </li></ul><ul><li>Improve leadership capacity and capability </li></ul><ul><li>Based within NHS Education </li></ul><ul><li>Work closely with all Health Boards and public sector agencies </li></ul>
    3. 3. Collaboration across Public Services, e.g., Collaborating for Outcomes in Public Services (COPS); Framework for Leadership & Ambition. <ul><li>Work with partners to drive cultural change in support of the delivery of high quality services </li></ul><ul><li>Build leadership and organisational development capacity and capability </li></ul>Supporting development of leadership qualities & behaviours. NHS Scotland Executive Coaching Register. Leadership Qualities 360  Feedback Tool. Cross-public sector Mentoring Service. Directories of development resources. Working with NHS Scotland OD Network. <ul><li>Develop current leaders and teams </li></ul>4. Nurture the supply of future leaders 5. Evaluate the impact of leadership development Development support for implementing NHSS Quality Strategy. Delivering the Future , strategic clinical leadership programme. Sustaining development of strategic clinical leaders. Management Training Schemes. Identifying and developing leadership talent and succession planning. Framework for Chief Executive Development. Framework for Executive & Senior Manager Development: Managing for the Future , senior manager development. Framework for Developing Boards. <ul><li>Raising Your Game. </li></ul><ul><li>Dialogic practice development. </li></ul><ul><li>Inquiry into Action think tanks. </li></ul>Frontline Leadership & Management Development programme. Support to clinical leaders, e.g., ACF Chairs. Managers’ Development Network. Development support for Finance community. Development support for senior HR & OD community. On line leadership & management resources. Remote & Rural Leadership Programme. National Leadership Unit Personal qualities (“being”) Service excellence Future focus Strategic context Leadership role Role-specific knowledge & skills (&quot;knowing&quot;) Service objectives (&quot;doing&quot;)
    4. 4. We are moving from… <ul><li>OLD WORLD </li></ul><ul><li>Low complexity slow change </li></ul><ul><li>Learning has a long shelf life </li></ul><ul><li>The senior ones know most </li></ul><ul><li>Somewhere ‘someone’ knows </li></ul><ul><li>Doing more of the same is the rule </li></ul><ul><li>I MANAGE </li></ul><ul><li>My team reports to me </li></ul><ul><li>I have a hierarchical role </li></ul><ul><li>I understand what is happening </li></ul><ul><li>I have fixed objectives </li></ul><ul><li>I manage by fixing things myself </li></ul><ul><li>I manage from knowledge and experience </li></ul><ul><li>NEW WORLD </li></ul><ul><li>High complexity fast change </li></ul><ul><li>Learning has a short shelf life </li></ul><ul><li>Knowledge is scattered </li></ul><ul><li>No individual ‘knows’ </li></ul><ul><li>Innovation is the rule </li></ul><ul><li>I LEAD </li></ul><ul><li>We are part of a virtual network </li></ul><ul><li>Influencing is the way forward </li></ul><ul><li>I manage projects </li></ul><ul><li>I cope with ambiguity </li></ul><ul><li>I lead teams to fix things </li></ul><ul><li>I lead without knowledge and experience </li></ul>
    5. 5. It’s about relationships <ul><li>Relationship with </li></ul><ul><li>self </li></ul><ul><li>Relationship with others </li></ul><ul><li>Relationship with organisation and beyond </li></ul>
    6. 6. <ul><li>At the conclusion of the study, the following findings were evident: </li></ul><ul><li>Engagement and relationship skills are fundamentally important in leading improvement. </li></ul><ul><li>These skills feature more prominently in reported patterns of leadership behaviour than task-related or conceptual skills. </li></ul><ul><li>Health Foundation, 2011 </li></ul>
    7. 8. Advocacy and Inquiry advocacy advocacy inquiry inquiry
    8. 9. Questions <ul><li>What is the balance between advocacy/inquiry? </li></ul><ul><li>What impact is this having? </li></ul><ul><li>What is the “tone” of conversations? </li></ul><ul><li>What is your own natural style? </li></ul>
    9. 10. Kantor 4 Player Model advocacy advocacy inquiry inquiry Adapted from David Kantor's work, Kantor Institute Move Intent: Direction Follow Intent: Completion Oppose Intent: Correction Bystand Intent: Perspective
    10. 11. Questions <ul><li>What is the “tone” of this conversation? </li></ul><ul><li>What changes did you notice? </li></ul><ul><li>What impact did these have in the quality of the conversation, relationships and outcome? </li></ul><ul><li>What changes might you make in your own conversations as a result of this session? </li></ul>
    11. 12. In summary: <ul><li>Advocacy clearer and more skilful </li></ul><ul><li>More inquiry and seeking to understand </li></ul><ul><li>Balance of advocacy and inquiry </li></ul><ul><li>Conversation took longer but was more productive and ended the stalemate </li></ul>