Great leadership and management skills within the NHS cannot exist devoid of compassion.

Just shy of 100 years ago you could have been shot for treason for telling the truth regardless of whether the truth was a justified ‘truth’ or not.

Everyone’s truth is different and so ‘truth’ as a yardstick is not necessarily an exact gauge on whether telling it is for good or for bad. Yet there have been recent instances where telling a perceived truth, perceived by the individual that is, or ‘whistleblowing’ has led to justice being done.

So when is it right to whistleblow and is the government’s crusade in favour of whistleblowing a knee jerk, politically populist, reaction to investigative journalism.

It is worth noting that NHS managers in general are highly trained individuals in public sector management. They are trained in management strategy where a lot of current practice evolves around strategic tools, theories, targets and measurement charts.

The NHS buzz phrases are; ‘patient first’, ‘waiting unacceptable’, ‘waste reduction’, ‘cost minimisation’ and ‘end to end process’.  Lean charts and critical success factors measure better value, value being determined by the customer (the patient is now the customer), and process should be consistent around a ‘core value stream’ that leaders must be able to quantify.

All this is fine but it will never change the culture of the NHS into an organisation with an overriding social mission that drives every NHS worker regardless of what they do or what level they work at. And the root cause of whistleblowing is about the lack of that social responsibility somewhere in the system.

NHS managers have dual roles in much greater quantities than managers in other sectors need to have.. They require skills in persuasion, negotiation and influence to achieve a balance in the ‘NHS the business’ role and ‘NHS the carer’ role.

The NHS business manager will use strategic management tools and techniques, and the lean six sigma strategies to plan, measure and manage what is a complex operation yet this cannot be done in isolation of the NHS ‘care manager’; two egg twins that share the womb but with different genes and different personas. Lean six sigma theories have their place and may have worked for Toyota and a plethora of other business types but the product of the NHS is distinctly different and a great deal less predictable than a car production line.

Great leadership and management skills within the NHS cannot exist devoid of compassion. Managers must have the emotional connection that stops them in their tracks if the ‘production line’ simply does not meet the social mission, no matter how challenging to change. They must not allow themselves to be anesthetised from the practices of others or from mandates coming down through a series of hierarchies. 

On balance no one can deny that whistleblowing has led to much progress.  Exactly what that progress is, in this context, is open for debate but the overriding social mission of the NHS must make it clear to leadership that doing their job is about taking social accountability as much as it is about crafting the core value stream, and that social accountability must be the main thread that runs through each and every one of their actions and decisions that they make. This is not rocket science or car aerodynamics.

Truth though has context too and the Doctor who was sacked by the mental health trust for raising concerns with her employer and the care worker who pushed the alarm about mistreatment both clearly spoke out against a deep belief that the system was not right.

But why did they have to whistleblow? - Because no-one was listening and the culture of fear stopped others from changing the system, or there was no system in place that allowed a voice to be heard and investigated. Of course trying to control whistleblowing is tantamount to ‘gagging’ but somehow the NHS must  have a robust process in place where front line staff in health and care roles are heard and taken seriously without fearing for their jobs and it’s only the managers who can do this.

At Morgan Hunt we strive to seek out candidates who can demonstrate leadership with a mission consistent with NHS values because we know that the future of the NHS is in the hands of the people that our clients employ. We’re all ‘customers’ of the NHS and if there is one thing that almost everyone agrees upon and that is we all want our NHS.

For more information on healthcare management jobs email

"Getting your message across is all important for your career" -
8 tips on how to do this when everyone else is talking

Meetings come in many forms and guises; there are those which are formal, incredibly well organised, everyone knows their place and is given floor-time equally or proportionately and then there are the more informal, disorganised meetings which appear to be more like free-for-alls.

Whichever of these you attend you know that in order for your career to progress you need to participate. After all it's a dog-eat-dog world and if you sit on the side lines like a wall flower you're not going to notch-up any brownie points. In fact non-participation is often viewed as a failing, a weakness, a chink in your armour.

So how do you make your voice heard when everyone else is talking? Here are 8 tips to help you get your message across.

Grab air space when you can

Air space, or floor-time, is the crux of the matter. When everyone is talking over each other this chaos may seem impenetrable; as soon as there's a lapse in the conversation, no matter how small, grab the air space. Stand up if necessary so that everyone knows you've got the floor.

Use body language

Use positive body language to show that you have something to say. Shy away or stare out of the window and you'll be ignored. Look at the speaker, raise your eyebrows if you don't agree or are surprised at what they're saying, they might then ask for your thoughts giving you the opportunity to have your say.

Make a statement

Sometimes being tactful isn't the way to go. Making a bold statement such as “I've got a very different opinion on that” in a very loud voice may just silence your colleagues for that split second you need to grab the air space.

Pump up the volume

In disorganised, rowdy meetings it's acceptable for you to pump up the volume as much as the next person, within reason, just as long as conversations don't end up as shouting matches. Raise your voice in a polite, but authoritative manner; showing your assertiveness may gain you recognition as having good leadership skills.

Be succinct

Once you've got your air space and the floor-time be succinct; get your point or message across as quickly as you can, because someone else could interrupt and start talking across you within a very short space of time.

Start a side conversation

Often disorganised meetings have a tendency to break into sub groups. Take the lead and begin a side conversation with others who look as if they're being left out of the main discussion. Again this will show good leadership skills, it will also show that you have good awareness and social skills. However, make sure that the conversation you start is in-keeping with the topic of the meeting.

Use good social skills and assist others

You can also use your good social skills to assist others who appear to be struggling with the chaos. Say in a loud voice “what are your thoughts on that?” to encourage them to join in. You do need to be tactful when assisting others as you may be seen as interfering or playing mother-hen to those who would rather do things their own way and in their own time.

Repetition, repetition, repetition

You could try the age old trick of repetition. By repeating your opening statement over and over again until you're heard or taken notice of may seem a little out-dated but sometimes the oldest tricks actually work.

The next time you're in a meeting and it feels like you're trying to cross a busy motorway at commuter time just to get your voice heard, don't stand startled by the headlights like a rabbit, judge when the time is right, put your best foot forward and go for it.

Challenging was the word for central and local government finance professionals. In contrast the NHS, education and charity sectors held up well with finance managers, controllers and head of finance roles the most popular in the more buoyant areas within the public sector. Despite a backdrop of more cuts to public sector funding, the outlook for opportunities for finance professionals looks improved.

How does this influence what type of financial leaders charities and public sector bodies are looking for in 2014 and what are the potential challenges facing them?

Charities & Membership Bodies

Charities that relied on local council funding and those that provide disability assistance were squeezed, with some charities merging and 1600 organisations closing down altogether. 

Large charities which relied heavily on donations have struggled over previous years. However, more recently, they have seen an increase in charitable donations in the past 12 months reflecting a more positive mood in the private sector. The result is a more commercial sector increasing headcount in all areas of support staff, in particular, an increase in demand for financial professionals.

Education and training providers

The education sector continues to become more commercial.  As a result, more organisations were dedicating time to finding finance business partners, management accountants and commercial VP’s of finance.  However, attracting candidates from the commercial sector to education remains a challenge from a salary perspective.

We expect the sector will see continued budgetary changes as public sector funding is reduced and replaced by private tuition fees. The rise in student tuition fees and increased competition with international institutions means next year we will see more higher education institutions having to cut cost and merge roles.

Government

Finance professionals in local and central government faced a tough year as the demand for senior part-qualified and newly-qualified accountants decreased substantially. This trend looks set to continue, with only a few areas recruiting finance staff.

Increased public scrutiny in large corporate affairs after the GFC has resulted in regulatory bodies increasing hiring of finance professionals.

Housing

We anticipate a drive in the housing sector to get more value for money. Finance candidates will need to clearly demonstrate this to potential employers. Management accountants will continue to be in constant demand as housing associations aim to keep tight control on budgets and forecasts. Seasonal fluctuations will predictably occur around half and full year-end.

With many housing associations not having extra staffing capacity, this will probably lead to high interim demand.  The G15 and other larger national associations will continue to recruit finance staff at transactional and middle-management level.

NHS

We saw an increase in interim and temporary recruitment within the NHS.  We found that the primary reason for the increase was due to the cuts at management level – an unsurprising development in light of ‘an aim for £15 billion in efficiency savings’.

The subsequent knowledge gaps across NHS Trusts and hospitals have in turn increased demand for interim cover to bridge these gaps. Financial skill sets that were particularly sought after during the last year include financial planning and analysis and financial modelling to accurately monitor long-term costing and expenditure of a ‘moving feast’ in many situations. Candidates with these skills were able to command significant increases in their rates as they were in constant demand and still are today.

Management accountants with pricing and costing experience were also highly sought after as budget management was of particular importance within the NHS. Technical financial accountants were also very much in demand. Furthermore, as the NHS sought to improve efficiencies through improving financial systems, finance professionals with ERP systems experience were also sought after – Oracle the most frequently requested by hiring managers.

As the Clinical Commissioning Groups (CCG’s) and Commissioning Support Units (CSU’s) continue to evolve, finance professionals with specific experience in these areas will be in demand.

2014 looks set to be a busy year for interim and contract recruitment in the NHS.  Cuts to permanent staffing budgets set to continue until at least 2015, will increase the competition for specialist temporary staff with NHS Trust, CSU or CCG experience.

Finally...

Public sector saw some tough times in 2013, with further cuts and a further decline in jobs.  In contrast to this, the NHS, education and the charity sectors have held up better and have seen a demand for finance professionals. however, with these cuts we can expect to see a demand in finance professionals with the capabilities to ensure organisations see ‘bang for buck’ across the board.