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Why Culture Matters The leadership challenge to adopting innovation in the NHS

Dr Yi Mien Koh, Chief Executive Harnessing Innovations Conference, The King’s Fund

19 June 2013

Heading NHS Innovation requirements

Financial Sustainability

Operational Excellence

Quality

Culture

Copyright : Yi Mien Koh

Heading Key challenges

• Engaging our workforce for excellent outcomes • Immediate & sustained improvement in operational

performance • Meeting our CIPs and maintaining financial sustainability • Implementing joined up systems & processes that support

quality delivery • Giving stakeholders confidence in our ability to perform

Heading Schein on Culture (reference can be downloaded on Google)

Heading Problems of external adaptation and survival

• Strategy: Developing consensus on the primary tasks and core mission

• Goals: Developing consensus on goals, reflecting the core mission

• Means for Accomplishing Goals: Developing consensus on the means to be used in accomplishing the goals – for example, division of labour, organisation structure, reward system etc.

• Measuring Performance: Developing consensus on criteria to measure performance against goals and targets

• Correction: Developing consensus on remedial or repair strategies as needed when the group is not accomplishing its goals

Heading Problems of internal integration

• Language: Common language and conceptual categories.

• Boundaries: Consensus on group boundaries and criteria for inclusion and exclusion.

• Power & Status: Consensus on criteria for the allocation of power and status.

• Intimacy: Consensus on criteria for intimacy, friendship, and love.

• Rewards & Punishments: Consensus on criteria for allocation of reward and punishments.

• Ideology: Consensus on ideology and ‘religion.

Heading Barriers to integration in the NHS

• NHS culture vs social care/private sector • Performance management framework from the top • Hospital/Community/Primary Care/Voluntary

Sector/Carers/Self care • Sub cultures within organisation – divisions/departments • Tribal – professional groups and sub groups • Environment/technology • Power/status/control • Politics

Heading Culture and employee engagement

Employee engagement levels correlate with: • Better financial & operational performance • Better outcomes in the public sector for patients/citizens

Other benefits include: • Higher levels of innovation • More employees advocating their organisation • Lower rates of absenteeism • Improved change programme outcomes • Discretionary effort - up to 30 per cent more productivity

£

Perform

Absence

Successful

change

Heading Innovation correlates with employee engagement

Employee engagement is the sine qua non of innovation. In my experience you can have engaged employees who invest their time in multiple directions (such as servicing clients, creating quality products) but you cannot foster true innovation without engaged employees.

Professor Julian Birkinshaw, London Business School

In our business with almost 150,000 people, engagement is a key concern. In businesses of our scale, you don’t even get started without engagement.

Justin King, CEO Sainsbury’s

Heading Excellence award and the Orthopaedic team

Heading Nurse and AHP leadership development celebration 2013

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Heading Ambulatory Care Centre Design (1)

Heading Ambulatory Care Centre Design (2)

Heading Ambulatory Care Centre Design (3)

Heading Ambulatory Care Centre design (4)

Heading Leadership skills to encourage innovation

Stephen Taylor, former Chief Executive of the Leadership Centre for Local government, offers a useful and simple working definition of leadership as creating a space in which people can do and want to do what needs to be done ……. (Leaders need to) understand oneself, the team, the organisation and the operating environment in order to address the more practical tasks.

The Acas and CIPD report identifies these practical tasks simply and

clearly as: managing work now and in the future; managing the team; managing the individual; managing conflict and difficult decisions and lastly managing yourself.

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Thank you

yimien.koh@nhs.net