The criticism in the news around targets in the NHS is given fresh impetus today with the story about A&E targets and it’s effect on patient safety. 

BBC NEWS

Once again, the public sector, seem to have tied themselves in knots with more measures that are clearly driving the wrong behaviour. Cut through the variously spun political messages and you get down to the core issue that tick box targets don’t add value to an organisation.

Unfortunately in this case, it’s people’s lives that are being used as the gaming pieces of this argument.

The Chairman of the College of Emergency Medicine, Dr John Heyworth is on record saying that he has nurses in tears and Senior Consultants threatened with disciplinary action over this target.

In his words “This is an outrageous misuse of the standard” is a perfect summation of all that is wrong with target driven behaviour.

The staff placed under immense pressure to meet these targets find themselves bending the rules to massage the figures. When you are producing “Widgets” this can be put down to sharp practice, but when it’s people and their care it’s criminal.

Now these targets were all conceived with good intentions in mind. They were always meant to be about improved service, reduced cost, greater efficiency and improved patient care. However they were looked at far too simplistically. An holistic systems thinking approach to patient care in the UK would have produced a very different look to the NHS. I’m sure that targets would still have been the outcome, but maybe these targets would all be complementary to each other.

The pressure to dispatch people from A&E within 4 hours has knock on effects throughout the whole of the NHS. You may show improvement in this one area, but what does that improvement cost the rest of the organisation?

If by rushing people through one department you end up with people who are inadequately assessed, then the whole treatment regime they may be heading for could be incorrect. This will cause increased cost, resource drain, inefficiency, not to mention the fact that this sick human being is not being cared for. Isn’t this the core job of the NHS, care?

Of course the worst case scenario is people dying. There we have different knock on effects. Reputation damage (Look at Stafford NHS trust), public trust shattered, increased checking by inspection bodies, lack of staff motivation and engagement, all leading to organisational paralysis.

It is not just the NHS that is plagued by these methods of performance analysis. The whole of the public sector is beset by targets that drive the wrong behaviour. The frightening aspect is that the pressure to achieve, backed up by a Command & Control approach from the top to ensure they achieve forces people to shelve their principles and better judgement and cheat.

Who would have thought that a tick in the wrong box could cost a life, but it could. If you were able to confront that member of staff with that reality, how do you think they would feel?

When will our public bodies listen to the constant stream of advice from people like John Seddon and apply a “Systems Thinking” approach to our public services.

We’re quite literally dying for it to happen.

Matthew Scott, Dip. Management, Cert. MCE.

The views expressed in this article are solely those of the author and do not necessarily represent the views of the IBC.

This year’s Masterchef has been exciting viewing. As ever the food has been the star, but in a close second the various contestants. The really striking point has been the sheer number of contestants from all walks of life, Company Directors, Plumbers, Doctors, Solicitors, stay at home mums and unemployed have all wanted to be this years Masterchef.

I understand the people who say that they want to change direction after redundancy or make a new start for themselves moving out of unemployment, but what has gone so wrong in the world of work that makes people in occupations traditionally viewed as high value, highly vocational “made it” occupations like Doctor, Solicitor, Director, to want change their lives so completely for the tough world of a busy, fast paced, perfectionist kitchen?

The other interesting feature of the contestants has been the two tribes that they can be divided into, the cool, calm focussed tribe, and the “donkey on the edge” tribe. This second tribe are recognisable by their facial tics, profuse sweating and in some cases, slightly scary glint in their eye that makes me fear a little for John Torode’s safety.

Has the workplace become such a rotten place for people from all walks of life that pushed to their limit, rather than fall into the abyss, they stick two metaphorical fingers up to all that has made them miserable in work and aim for their dream job that has the three critical ingredients, a) doing something that they love b) a generous helping of creativity and innovation c) being their own boss where they control the work.

The frequency of contestants expressing these sentiments should in my opinion be a cause for concern for those in charge of organisations. These feelings of disengagement are backed up further by recent news items, the first that the rate of resignations particularly in management positions has remained at a constant rate despite the recession, and in the past week appalling rates of engagement and satisfaction reported by the HMRC Employee Opinion Survey.

Has the pursuit of “efficiency” and “performance” driven all that was challenging and engaging about the work that these people have chosen, to humdrum, empty existence where they are prepared to risk it all for their dream?

What a lot of frustrated, disappointed people we have created in the workplace. We know that more often than not those efficiency/ performance drives have delivered neither. Yet we also know that there can only be so many great Bistros too.

When confronted with such a diverse group of people, showing such enthusiasm for something they love to do, we should channel this in the work place. So why don’t organisations do it?! As an economy we are at very great risk of sliding backwards due to apathy on the part of business who simply don’t believe that the talent will walk out the door.

A personal anecdote if I may, although cooking wasn’t my dream, when I followed my dream the people I worked with, including my superiors openly refused to believe that when the date came I would walk out of the door. The look of shock on their faces on that last morning was something to behold, it was even said “so you’re really going to do this then?”

Its no secret what people value about work; needing to feel that their contribution matters, that what they do links in some way to the overall achievement of the business, just some control over the work and the opportunity to be even a little creative without fear of punishment if the outcome isn’t quite what we all expected.

I guess what I’m saying is have we gone so far down the control route, we’ve forgotten that it’s all about managing risk?

Jane Pound, MCIPD.

The views expressed in this article are solely those of the author and do not necessarily represent those of the CIPD.

Nigel Farage’s now rather famous rant at the EU President Herman Van Rompuy ended with a resounding “Who are you”?!

Whilst Mr Farage’s outburst was mildly amusing as a news clip, his challenge “Who are you?” does open into a wider debate about the nature and style of leadership in organisations.

Clearly Mr Van Rompuy did not measure up with Mr Farage’s expectations.

Let me explain. Mr Farage, fiercely anti- European, argues that the Euro administration is seeking largely by stealth to strip the various nation states of Europe of any power over their business to create a “United States of Europe “under a central administration run from Brussels.

The “bank clerk” didn’t match up to the perception of an all powerful “star”, perhaps Obama like cult of personality that Mr Farage might have expected of the post holder of such a powerful position. Equally though, neither did the quiet administrator (although Mr Farage was rather more brusque in his description).

In a leadership role, whether in a small business or national administration like Mr Van Rompuy, there are many examples of stars and administrators to be found. Experience has shown that usually leaders adopt these roles naturally, often replicating behaviour that has led to their success in the first place. That there is no conscious choice about what kind of leader they will be is not surprising, they just do what they know best about performing.

Maybe there should be a moment when a leader decides “who are you…. going to be in this role?” but more importantly, maybe Mr Farage’s question was wrong, not “who are you” but “how are you … going to make a success of this?” perhaps then some of the traits he so openly ridiculed might have been rather more palatable.

Being so firmly pigeonholed as a star or administrator has its problems for the person in the leadership role too. Both lead to an expectation of a decision making style that have direct implications for the way risk is managed and the business is controlled and the way the rest of the team behave.

Working with a star can be extremely high energy, motivating and focussed since there is no conflict or debate about what to do. We’re all doing only and exactly what the star leader wants done. In the way that they want it done, to their timescale. This can mean that when our team objectives get set they are jolly well achieved, because we are all working hard to please the star, which is great – hooray! We’re all achieving our objectives!

The cult of the star can mean that there is no room for new ideas, no innovation and for others to shine. What if the star isn’t so focussed? What if they are firing off in all directions about what they want and how they want it? The people working below to please that star can find themselves working hard on many wasted activities, stuck in quagmire while decisions get made and then unmade, direction is set and then changed, a very dissatisfying and confusing place to work.

Finally, what happens when the star leaves? A vacuum, where no one knows quite what to do, how to get the work done, no one responsible for anything, the only person who made any decisions about anything is now gone. This is extremely dangerous for risk management, no one responsible for anything, and no one really knowing how to achieve anything.

So what of the administrator? This is someone who likes rules, following procedures. Working for an administrator can be very reassuring, the systems and procedures are in place, everything as it should be. Decisions are made driven by the “way we work around here”, predictable, dependable. Others are consulted over decisions, the administrator has already checked what the rules are, reflected on what previous results have been achieved, but they just want to sound out their co senior colleagues before going ahead.

The Administrator lives where they belong, in their office. Which means that they trust and believe that everything is happening as it should be, but as we know, trust is not a control. We don’t know that the work is being done as it should. There is also the issue of visibility. Administration by its very nature is a continuously demanding thing. The administrator necessarily spends lots of time at their desk, which means that without a concerted effort, they don’t spend much time away from it, out on the floor, where the work of everyone else is being done. This can give the impression of being remote, detached and even a bit clueless about the reality of the business. No matter what the reality of the Administrators knowledge of the business and their ability to take the temperature, it’s rather uninspiring, so wedded to rules and procedures, innovation is stifled, effecting change is really tough. This is another place where it is difficult to shine. This approach is dangerous for risk management too, opportunities aren’t spotted, or if they are the business is too slow to respond. Developing the business is slow because innovation is stifled.

Maybe Mr Farage was too black and white in his expectations, perhaps instead he should have looked for shades of grey.

Mr Van Rumpoy kept his counsel during the rant and afterwards, perhaps he couldn’t think of an amusing quip in response. Or maybe what he wanted to say was something like “I am many things to many people during any one day, but never mind that let me tell you how….”

Jane Pound, MCIPD, MIIA.

The views expressed in this article are solely those of the author and do not necessarily represent those of the IBC.

The recent case of Amanda Carrington and the £450,000 that she managed to siphon off from her employer over a 5 year period, should give us all pause for thought.

BBC News

It is not just the corporate giants of this world that are prey to the fraudulent employee. In fact, in this case, the fraud was very simple. Inflating invoices and top slicing the remittance. Admittedly, it was this simplicity that eventually caught her out, but how many small to medium businesses can afford to lose £450,000? In the current financial climate, more so than ever before fraud is an unacceptable risk.

I am not entirely sure that there is an increase in workplace fraud because of the current financial climate. If you look at Amanda Carrington, she has been convicted of a crime that went back to 2004. This was a time when “Credit Crunch” and “Global Financial Crisis” were not the every day topics they are now. I think what has raised our level of awareness is that businesses are now taking far more interest in where their money is going. My question though is why now? Why is it so much more unacceptable to be the victim of fraud in tough times than in flush times?

Surely this is all about your risk management and governance structures. If you adequately protect yourself against this risk at all times you will be richer in the flush times and less squeezed than your competitors in the tough times.

Adopting a sound governance structure backed up with a comprehensive investigation programme doesn’t make you a “Police State”, it just shows your customers, competitors and staff that you take revenue protection seriously.

If you have an Amanda Carrington, it is up to you to ensure that you close down their opportunities to de-fraud you. If you let one through, more will follow. How many can your business afford before the administrators come calling?

Matthew Scott, Dip management, Cert MCE.

The views expressed in this article are solely those of the author and do not necessarily represent the views of the IIA.