Professionalism under
pressure
#profpressures
Welcome
#profpressures
Welcome
Nigel Clarke
Chair, GPhC
#profpressures
Opening remarks
Professor Nairn Wilson
#profpressures
Keynote address
Professor Michael West
Head of Thought Leadership,
The King’s Fund
#profpressures
Nurturing Cultures of High Quality and
Compassionate Care
Professionalism under Pressure
Michael West
6
Compassion
Compassion
•
•
•
•
Paying attention to the other – ‘listening with fascination’
Finding a shared understanding of the situation they face
Being empathic
Taking thoughtful, intelligent action to help
7
NHS cultures for high quality care
1. Prioritising an inspirational vision and narrative
– focused on quality of care
2. A commitment to effective, efficient
performance - Clear aligned goals and objectives
at every level with helpful feedback
3. Good people management and employee
engagement – compassionate leadership
4. Continuous learning and quality improvement
5. Enthusiastic team-working, cooperation,
partnership and integration
6. Via a values-based, collective leadership
strategy
People management and engagement
• Patient/service user satisfaction highest where staff have
clear goals
• Staff views of leaders linked to patients views of care
quality
• Staff satisfaction/commitment predicts patient/service user
satisfaction
• High work pressure - patients/service users
report too few staff, insufficient support,
privacy, respect.
• Poor staff health and well-being, high
injury rates, audit ratings
• Good HRM practices - low patient mortality
http://www.dh.gov.uk/health/2011/08/nhs-staff-management/
Staff Stress Levels
Lowest:
• Royal Wolverhampton Hospitals
• St Helens and Knowsley
• Bedford
• Frimley Park
www.nhsstaffsurveys.com
10
3. Employee engagement success factors
www.kingsfund.org.uk/publications/staff-engagement
A compelling strategic
narrative
Inclusive leadership and
management styles
Putting staff in charge of
service change
• Successful Trusts
develop a clear
narrative on their
purpose and aims
• Successful Trusts have
invested in retraining
staff to adopt inclusive
management styles
• Successful Trusts give
staff responsibility for
leading service change
• Salford aimed to be
the safest hospital in
England
• For example, Oxleas has
introduced a substantial
programme to retrain
middle managers in
facilitative leadership
• The happiness of all
our staff, through
their worthwhile,
satisfying
employment in a
successful business
• Notts Healthcare NHS
FT develops leadership
aligned around strategy
and values
• Wrightington, Wigan
and Leigh works with
Unipart to support
staff-led change
• Salford’s quality
directorate supports
teams of frontline
staff in testing
improvements
Values and Integrity
• Staff survey evidence
highlights importance
of values and trust in
senior leadership
• Perceptions of
unfairness are our
best predictor of
intention to leave
• In particular, fairness
of procedures,
bullying and
discrimination.
Stable senior leadership
Many of the Trusts with highest levels of engagement have had the same senior leaders for over a decade: CEO of
Oxleas in post since 2002, CEO of Salford in post since 2002, CEO of Frimley Park in post since 1998, in
comparison with an average CEO tenure of less than two years.
Staff Engagement
Best performing trusts
• Wrightington, Wigan and Leigh
• Northumbria
• Frimley Park
• Guys and St Thomas’
• Salford
Based on www.nhsstaffsurveys.com
12
13
Positive emotion and culture
• Leader positive affect, climate and performance
• Processing negative emotion – ‘affective shift’
• Dealing with quarrelsome or disruptive behavior
and poor performance
5. Team working, cooperation and integration
Team Leadership
• Offer an inspiring vision and clear direction
• Ensure regular and positive team meetings
• Encourage positive, supportive relationships
• Resolve and prevent intense conflicts
• Positive group attitudes towards diversity
• Be attentive and listen carefully to the team
• Lead inter-team cooperation
• Nurture team learning, improvement & innovation
16
Collective Leadership
• Leadership the responsibility of all - anyone with expertise
taking responsibility when appropriate
• Shared leadership in teams and across teams
• Interdependent, collaborative leadership - working
together to ensure high quality health and social care
• Leaders and teams prioritising quality of care across the
system/organisation
• Consistent approach to leadership within the leadership
community – continually improving, high quality and
compassionate leadership
http://www.kingsfund.org.uk/publications/developing-collective-leadership-health-care
West, M. A., Lyubovnikova, J., Eckert, R., & Denis, J.L. , (2014),Collective leadership for cultures of
high quality health care. Journal of Organizational Effectiveness: People and Performance, 1, 240
– 260. http://dx.doi.org/10.1108/JOEPP-07-2014-0039
‘Compassionate leadership for
compassionateCompassion
health services’
•
•
•
•
Attending: paying attention to staff – ‘listening with fascination’
Understanding: finding a shared understanding of the situation
they face
Empathising
Helping: taking intelligent action to help
18
e.mail m.west@kingsfund.org.uk
Twitter @westm61
@astonod
Thank you
Modern professionalism
and regulation
Presented by Hugh Simpson
Director of Strategy, GPhC
What is professionalism?
Professionalism under pressure:
a regulatory perspective
Learning from research
New Public
Management
Quality
Hybridity
Employee
relations
Autonomy and
professionalism
Performance
management
and targets
Literature Review (a
sample)
• Reay and Hinings (2009) on competing organisational logics
• Bush et al (2009) on corporatisation
• Elvey, R., Hassell, K., Lewis, P., Schafheutle, E., Willis, S., & Harrison, S. (2015).
Patient-centred professionalism in pharmacy
• Watson et al (2016) Factors predicting the guideline compliant supply (or nonsupply) of non-prescription medicines in the community pharmacy setting
• Paudyal et al (2013) On substituting minor ailment services to reduce burdens
• Jacobs et al (2013) Managing workplace stress
Quality
Quality gaps?
95%
83%
81%
64%
Privacy
maintained
83%
68%
88%
86%
80%
79%
72%
76%
80%
77%
77%
67%
Asked
Treatment Enough time Information Accessible Experienced
Clean
questions with respect
and advice
services
team
pharmacy
Outcomes pharmacies believe they are delivering
compared to public experiences
Sources: ICF 2015, Ipsos Mori 2014
Closing the gap:
November to December
2016
Some questions we will
pose
• What does quality mean to you? Are you measuring
it?
• What does quality looks like in your environment?
• What has helped you delivery quality?
• What are the barriers?
What we are doing
• Crowdsourcing end October to December: everyone
we have an email address for
• Public engagement (January-March)
– Targeted research with users of pharmacy
services, to explore their experiences of the
quality of pharmacy services.
• Reviewing our regulatory model for pharmacies:
how we can focus on quality
• Updating guidance on raising concerns
• Guidance to employers - non-registrant staff
THANK YOU
Modern professionalism and regulation
email hugh.simpson@pharmacyregulation.org
phone 020 3365 3400
web pharmacyregulation.org
twitter @TheGPhC
facebook.com/The GPhC
linkedin.com/company/general-pharmaceutical-council
Workshop discussions
Feedback from workshop
sessions
Professor Nairn Wilson
#profpressures
Closing remarks
Duncan Rudkin
Chief Executive, GPhC
#profpressures
Thank you!
•
•
•
•
web pharmacyregulation.org
twitter @TheGPhC
facebook.com/The GPhC
linkedin.com/company/general-pharmaceuticalcouncil