Leadership by example

Leadership by exampleYou come into work, you drink your coffee, and you stay in the office, hospital or lab for the next eight hours or so, likely spending most of your time either rushing between meetings, rushing between wards or filling out piles of paperwork and then you go home again. It’s not hard to see why we all start to feel like small cogs in a machine.

In the healthcare industry, no matter whether from the NHS, pharmaceutical industry or a patient group, we all have the same goal. We want to improve quality of life so people can live longer, healthier lives. We are not cogs in a machine – we can all see the bigger picture and arrive collectively at this goal.

In our daily lives, we all too often focus on short term goals – the monthly target we need to meet, the cuts we need to make, the financial gains we can achieve. These short-term goals can trap us in a system where progress is merely measured in monetary terms with no consideration of our progress towards a common vision.

Leadership by example is one of Aurora’s key Access All Areas dependencies to affect positive change in medicines access. We need leaders who can realign priorities and encourage us to reclaim higher goals. If we can recognise and embrace this we can make better decisions which will improve medicines access.

A leader doesn’t just mean those at the top of an organisation though – we all have the capacity to make positive changes. We need leaders who can learn to accept ambiguity and unpredictability as the norm, and adapt accordingly. Who can embrace models built on relationships, interdependency, collaboration, flexibility and responsiveness. Who have the willingness to give up long-held beliefs, and the courage to try and to sometimes fail. Leadership by example can encourage us to do the same. This will require a strong personal vision and the ability to defend this vision to their superiors and peers across the system.

We could all be better leaders and the following recommendations will help us to ignite change:

  • Ask yourself, what can you do in your team to shift beliefs and behaviours?
  • Consider what progressive leadership will cost in the short to medium term.
  • How can we make managing upwards a reality?

To find out more about this dependency and the other dependencies, read our Access All Areas paper, ‘Creating opportunities for improving patients’ access to medicines,’ available for download here.

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Recent mainstream social science books such as Steve Hilton’s ‘more human’ and Luciano Floridi’s ‘the 4th revolution’ highlight that bureaucratic processes are a legacy of industrialised societies. In our post-industrial age, technology is disrupting every element of our social structures, challenging (positively) democratic processes and shifting power.

So what does this mean for leadership? Many businesses in our sector have restrictive ways of working. This is partially attributable to compliance, but only partially. A perhaps more compelling explanation is that health businesses tend to be large, and large businesses need to be managed. Management is believed to be more efficient if it is achieved via processes.

Processes take a while to form and a while to bed in, so developing and implementing processes is resource expensive. This means decision makers are likely to think that challenging processes is at risk of ‘throwing the baby out with the bath water’. And so processes become ingrained, the outputs of these processes become the expectations of senior leaders, and the behaviours the processes try to drive become instinctive.

If you are a process designer, you might well think this sounds all good – the process is working as was intended. But the challenge is adaptation. Our world works faster, has more variables, more stakeholders, more opinions that ever before. A leader must make sense of these issues on a daily basis and adapt the work of their team (this is managing ambiguity). But if they are constrained by a process (that might be annually reviewed), the extent to which they can adapt is restrained. The leader actually becomes disempowered. They may want to lead by example but the system constrains them.

So what can we do? Two things. Firstly, we need more inclusive and more frequent strategic planning sessions. Secondly, we need to move from workflows to processes and enable our ‘day to day leaders’ to adapt these workflows.

If teams are crystal clear on the strategy of the business, and the implication of that strategy for their team, then they are able to discern if an activity is driving that strategy – they are less likely to get lost in a process and more likely to make decisions that fulfill goals. Of course teams need to be ‘given permission’ to do this and that is where enablement comes in. Senior leaders need to trust their day-to-day leaders (and live with uncertainty) but some of the potential anxiety can be removed if we start using data better.

As said at the top, technology is disrupting bureaucracy but it is also helping innovation. One key part of this is the opportunity to gather multiple types of data, analyse them and extract learnings at near-time speeds. If we help teams to access metrics and interpret metrics, then we can rest assured that they can make course-altering actions that are positive. This is obviously dependent on the data we are gathering being the right data – which links back to the point about strategy.

When planning out how we are going to solve problems, it is so tempting to be reductionist in our analysis and to simplify – after all, it makes it easier to write a PowerPoint and present it! But the world is messy and plural. Leaders should add a final step to planning activities, which forces us to step away from the cold, hard analysis and look at it with human eyes – and this step is vital for collecting the right data and using it as means of empowerment.

So, to summarise, to drive leadership across the business, we need to create a desire for flexible workflows that can quickly adapt to new inputs and constraints. This is not the same as a bureaucratic process. And it requires engendering a particular mindset to make it happen. If we can create this mindset, then leadership can be shared.


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