In any large organisation like the NHS there are going to be times when things go well and other times when there are performance. The reality is that a lot of the time things do go well. On the other hand it is the performance issues that get publicised and as a result the feeling is created that it is all bad.
Performance issues can arise in a whole host of ways. It might be related to a certain group of staff. It could just as easily be related to emergency activity, delayed discharges, finances, quality or safety.
Some will need immediate and decisive action. For example you don’t want a clinician continuing as normal if there are genuine concerns around patient safety.
Others will still require decisive action but only after there is clarity on the problem, open discussion of the options, a plan to test actions on a small scale and measure the impact.
Surprisingly the challenge is often to get people to acknowledge in the first place that there is a problem. It is all too easy to go into denial, perhaps in the false belief that the issue will somehow go away. It never does in my experience.
So is all lost?
I don’t believe so. In many ways there is a lot you can do ahead of issues arising. One of the most valuable is to agree some form of protocol or process for systematically reviewing performance issues.
Whenever you have potential issues relating to performance it is all too easy to jump too quickly to problem solving mode before you have properly diagnosed the issue.
Clinical staff take the time to ask questions, listen and learn before determining the next steps.
This approach could easily be taken by non clinical staff too. Of course it is going to take a bit of time and potentially some change in behaviours. Rather than jumping straight in with solutions, there may be a need to ask more questions, listen, openly discuss and decide before taking action.
The truth is that performance issues will arise. It’s how leaders and leadership teams respond that makes the difference.
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