NHS – Vogel Wakefield

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I’m not a great one for introducing theoretical models in my work with clients, however much my practice may be informed by theory. One that I frequently reference, though, is the leader’s framework for decision making devised by David Snowden and Mary Boone. This is the clearest and most usable articulation I know of what it means to lead in complex situations.

Snowden and Boone argue that leaders often come unstuck because they misconstrue the nature of the scenario they are dealing with. Typically, often without realising it, they are informed by an ideology of management that likens organisations to machines. So they fall in with expectations that most problems can be subject to linear solutions of command and control. Unfortunately, they are likely to be putting unreasonable pressure on themselves and, ultimately, setting themselves up for failure.

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Current events

Different kinds of truth in health care

By Martin Vogel

The unharmonious sound of an establishment closing ranks could be heard last week when an NHS hospital attempted to discredit the account by the MP, Anne Clwyd, of the death of her husband while in its care. While conceding that Ms Clwyd’s husband, Owen Roberts, died of hospital-acquired pneumonia, the University Hospital of Wales said it had no evidence to support Ms Clwyd’s assertion that Mr Roberts had died “like a battery hen.”

Cardiff and Vale University Health Board released a summary of an independent inquiry into Ms Clwyd’s allegations but declined to release the full report. So it’s impossible to assess what evidence it evaluated before reaching a view that Mr Roberts didn’t die like a battery hen.

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Current events

Purpose and values in the NHS

By Martin Vogel

It was only last month that we were asked whether a hospital, of all things, would ever need to consider its purpose and values. To those outside the NHS, it is self-evident that a hospital exists to treat people’s health problems and to save lives. Yet today both Robert Francis QC and the Prime Minister have dispelled any notion that the NHS can currently be trusted to deliver such a purpose.

Introducing the final report of his inquiry into the Mid-Staffs hospital scandal, Robert Francis spoke of an NHS trust that “put corporate self-interest and cost control ahead of patients and their safety.” Responding to the report, David Cameron condemned “a focus on finance and figures at the expense of patient care” in the culture of the NHS.

The facts of the Mid Staffordshire scandal were already established, in part by Robert Francis’s earlier inquiry but also thanks to the campaigning efforts of relatives of some of the hundreds of patients who needlessly died because of negligent and inhumane “care”.

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Leadership

Health care and the dignity of humans

By Martin Vogel

The Health Service Ombudsman’s report on how the NHS is failing to treat elderly people with care, dignity and respect begs the question of how a service whose raison d’être is to look after people can so dehumanise them.

The report highlights the cases of ten people who suffered grievous neglect. Many of them were fit, active and healthy before treatment but all but one died during or soon after the events they experienced in the care of the NHS, and in circumstances which caused distress and anger to the patients and their families.

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