NHS chief executives will be facing many challenges over the next year. Leadership agendas will need to shift to ensure the delivery of more with less; and at the same time, employees will need to be motivated in this context of scarce resources.
Now is a good time for chief executives to reflect on their own capacity to meet these challenges and to plan how they will lead their staff in a way that enables their organisations to deliver the most testing objectives they have faced for years.
To achieve these goals, it is essential for a chief executive's own wellbeing and personal resilience to be in a positive state. Not surprising and no mean feat given the many pressures faced at the top of NHS Trusts, where there is always a risk of them resorting to a reactive style of management and leadership.
Behaviour will be mirrored by other staff
The first step is for NHS chief executives to realise their behaviour is likely to be modelled by their immediate executive team and then by employees in the organisation. So if they panic in response to a new demand from the Department of Health, the foundation trust watchdog, Monitor or the strategic health authority or make decisions without appropriate consideration, their behaviour may well be mirrored by their executive team and then ripple outwards to other staff.
If sustained, this kind of behaviour can threaten the wellbeing and engagement of senior colleagues, which in turn cascades down through the organisation.
However, the key is not just for them to avoid stress and burn out - although that is obviously important - it is about creating an environment where positive wellbeing and engagement is generated throughout the workforce.
The work of positive psychologists such as Martin Seligman and Barbara Fredrickson demonstrates that people who experience positive emotions regularly at work (eg feel inspired or determined) tend to broaden their capacity to meet difficult challenges and cope with them effectively.
The creation (or not) of this kind of wellbeing climate in NHS Trusts usually starts with the chief executive.
Keeping pressure positive is one of the most important aspects of creating a well-being climate in NHS organisations. There are two types of pressure that can be applied by leaders – this means that they need to understand how to create challenge pressures and minimise hindrance pressures.
While challenge pressures drive people on towards higher performance and well-being levels, hindrance pressures create barriers and potentially develop into stress. Critically, it is the response of leaders that determines whether new pressures or requirements become challenges or hindrances.
For example, a chief executive may respond to the Quality, Innovation, Productivity and Prevention agenda by challenging senior managers and clinicians to find innovative ways of improving patient services in a climate of increasing resource constraint.
However, if this is done without clear goals or without considering the workload involved, it may be interpreted as a hindrance. If this is the case, the management team is likely to be apathetic in response, rather than motivated by the challenge.
The chief executive needs to understand how to harness work pressures positively, while minimising the likelihood burn out - both for themselves, their senior teams and the workforce in general.
Generally, chief executives are very resilient – it comes with the territory. However, there is a risk that they take this resilience for granted because different people deal with pressure in different ways at different times in their lives.
While many at this level recognise that the pressures they face require them to raise their own game in response, they may not be able to easily draw on their existing experience to meet these demands.
Until now, very little investment has been made by chief executives to look after their own health and wellbeing. However, given the acute challenges ahead, now is the time for chief executives to examine their own resilience and learn new techniques that will enable them to develop their resilience to ensure they can lead and motivate their workforce in the face of new and unique challenges.
Gordon Tinline is a director of business psychology company Robertson Cooper
