Wednesday, 27 June 2012

A Long Smooth Handover

The Cheltenham Ladies College had Mrs Vicky Tuck as the Principal for 15 years. Mrs Tuck left her post on Saturday 9 July 2011. Her successor is Miss Eve Jardine-Young.

That in itself is just a routine thing - one principal replacing another.

But hear....

Miss Eve Jardine-Young was appointed as Principal (in waiting) about 8 months before the actual transition date to enable a very thorough, detailed, induction and hand over (including equal or higher role in strategy formation, new appointments, etc) .

No surprise the school is able to state confidently that they are they are ready to face the future, financially secure and have excellent leadership. All of which is of course true.

CLC, they are just a school, though with a reasonable claim to being the best girls boarding school in the world, we in healthcare are in the business of saving lives. Any lessons for us in the NHS?

At the managerial level
An 8 month hand over/induction process! With about £23 million income which is really small compared to an average NHS trust, for a school to do this is truly remarkable. It reflects a culture of cooperation and shared values that enables organisations to gain from the past and progress to a new future at the same time. I have heard no hospital do this. Well, I am sure that there must be organisations in healthcare that do have overlap between outgoing and in-coming heads at the level of CEOs or senior medics but I suspect long smooth hand-overs are not the norm. We live in a world where one senior person clears their office to be occupied by another one; this gets reflected as an abrupt change which percolates down the organisation, that cannot be good.

I learn that when the health service have tried such an overlap there has been either acrimony or the new appointment muscling into everything too early. It reflects the very autonomous individualistic approach we bring to healthcare delivery. We may not have yet found an ideal balance between continuity and change; I would argue to some extent that continuity is a pre-requisite for successful change. I would like to see senior appointment overlaps in healthcare of at least 6 months with some crucial questions in mind that if you are not able to agree with your predecessor how are you going to find agreement with his/her organisation and on the other side if you cannot work with your successor is your organisation ever going to find success? Clinical medicine changes slowly for good reasons, why should managers change abruptly especially in non-crisis situations? We know for instance that there is a long transition periods for Royal College presidents which is a form of induction, we should be doing it in the NHS and other health service organisations.

At the clinical level
We need to begin by taking very seriously the induction of staff, especially clinical staff into hospitals. Perhaps we can learn from the army about immersive simulation techniques for induction of junior doctors; surely it will be a shade more interesting than the sleepy afternoons with a series of mandatory lectures. Hand overs by junior doctors to other junior doctors at the end of their duty periods is another crucial area which could be made into more than a session where the sceptical in-comer curses everyone for the volume of jobs left over and the out-goer who is desperate to leave the place. In truly sharp acute situations the handover can still be good, perhaps we can learn a fast yet perfect synchrony like that of F1 pit crews; you could enquire what Ferrari did at Great Ormond Street. 

Induction and hand overs need not be a tick box. It could be lovely long and smooth like a warm summer's afternoon. There are specific methods to achieve this, the question that remains is if we have the will do it.

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PS: I am an in a situation of self-validation, bias towards CLC but the topic seems to make sense despite that.

1 comment:

Anonymous said...

but where do we have the money in NHS is to pay two nhs managers for 8mths?