I shouldn’t start by blaming the NHS for this, as, I imagine chess is played across the world by people in all sorts of management positions.
If I do this; reduce here, shift that; increase A, stop B or C, then, they can go there and things will happen.
There is a cause and effect assumption within health and likely, social care, that if you go through the process; start with a good idea, you will end-up with a result.
The latter is true. You will always have a result. As to whether it is the outcome you intended is another matter.
The mechanistic – probably minimalist assumption that strategic gameplay with people and services is as straightforward as chess, remains a cornerstone of healthcare reforms, changes and developments.
The concept that the minimal viable resources available – aka our staff, are pawns is consistent throughout the system.
I don’t want to labour the analogy any further – I’m sure you get what I am saying.
No matter the degree of sophistication of the management in any organisation, the notion that people can be shipped around, moved or reallocated without consequence or repercussion is flawed.
First, because people don’t like it.
And, secondly, because most of the movers and shakers – the game players – strategists – senior managers, have so little understanding of what it is the pawns do, there is a huge underestimate as to the complexity of relationships and of role, to the extent that people are minimised to modules. Pawns.
The only meaningful strategic planning that I have seen and can conceive is where the management shift. Where they don’t do to, but do with, when they take-off their (bowlers), suits, roll-up their sleeves and join-in. When they in effect become pawns. When the work alongside the doctors, nurses or therapists. When they are faced with the good and the bad. When the time they would have spent in meetings is deconstructed – pulled apart into something more serviceable.
When the managers have undone themselves to such an extent that they are unidentifiable from the rest. And their job no longer becomes one of scrabbling for position or results (achievement of targets), but one of facilitating, coaching, maintaining and sustaining.
I have written before about Chauncey Gardiner. The character in Jerzy Kosinski’s ‘Being There’ – the gardener who becomes a candidate for US president. His approach to management and leadership is one of tending his plants. Making sure their basic needs are addressed; the right soil, light and water, and beyond that just being there. Being available, nurturing, supporting, comforting, understanding.
This is all to say that the problems faced by those providing the care, support and treatment are problems that can only be solved by those inside. That the management support can only be determined by those inside the work.
This is teal.
This is having a sense of purpose, accepting the responsibility to grow, adapt and evolve and being able to self-determine.
This is the hope for the Wellbeing teams (see advert) and likely, the hope for any services operational in health, social care or whatever area of our society that helps, supports, works-with and involves people.
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