Theory and Practice of Leadership

Theory and Practice of Leadership

BH3319 Theories and Practice of Leadership Assignment 2 A year into the 2010 General election and major reforms were being seen across the public sector. With an estimated £10 billion in savings needed to help with the budget deficit and national debt, the NHS reform hit hospitals, GP services and other allied professions within the health service hard. In 2011 Boxgrove hospital in the South East of the UK was under major financial difficulties. The hospital was failing to meet Government targets, such as the 4 hour waiting time, and was being heavily fined as a result. The hospital was in serious danger of losing its ‘Trust’ status and had been placed under special measures following a serious case review into poor practices and high patient mortality rates. After 15 years in the role it was decided by the hospital’s board of directors that the current CEO, Alan Scott, should step down and something drastically different was needed. After much deliberation, the hospital appointed Camilla Kato for the role. Camilla is Japanese but has been working in the UK private sector for the past 20 years. Camilla is known for her tenacity and has worked tirelessly to move up the career ladder and, until her recent appointment, was Chief Operating Officer (COO) for a large company within the Oil and Gas industry based in Aberdeen. After 20 years in the private sector Camilla was keen to take on the challenge of the hospital, despite the pay cut, as she finds herself wanting to more meaningful work. Camilla has built a reputation for being confident and ambitious which has been to her favour while working in the fast paced, masculine culture of oil and gas. Often this is mistaken for arrogance but Camilla is not bothered as she does not feel you should be anything other than yourself. Camilla had a clear view on what she wanted to achieve and set a target of being classified as a high performing trust rather than a failing one by 2013. She communicated this mission in a compelling way to the organisation and the board of directors on her first day. Her determination to accomplish the mission she set out for the hospital was challenged by a lack of endorsement from senior managers who viewed Camilla as unnecessarily aggressive, dogmatic, and lacking in competence. Camilla however has never been known to question herself. She knew she could achieve it and would stick to her word. In order to diagnose the problems within the hospital Camilla hired external consultants to run focus groups with employees at all hierarchical levels (from the ward cleaners to the surgeons) to gain a more objective idea of the issues. Following this period of consultation it became clear to Camilla that there were systemic problems which went back many years revolving around a culture of bullying where people did not feel able to speak up about issues or voice concerns. There also appeared to be a concentration of power hungry middle management who often slowed down process, coupled with a complete lack of communication across the organisation with all decision making being centralised and rarely consulting anyone beyond the top management team. This left the staff feeling in the dark, thus degrading trust. The whole organisation was driven by very traditional views of hierarchy, which characterises the public sector in general, and there were major divides between the medical and nonmedical staff. Following a review of the hospitals accounts it was clear to Camilla that Alan had not made the difficult decisions when it came to the budget, often leaving this task to others or avoiding it altogether. As a result major cut backs were needed across the hospital. Camilla immediately set up a series of cross-functional teams, across both medical and non-medical staff of all levels, in an attempt to get these two professional groups talking. Each team was tasked with identifying three ways in which they could meaningfully reduce costs in the hospital. Camilla summoned the teams in a meeting, briefed them on their task and emphasized that they only have two weeks to devise their action plans which she would then review with the rest of the top management team. Many of the staff were resistant and complained that this was insufficient time and not in keeping with how things had previously been done but Camilla did not budge. Camilla had actually already devised her own major change programme, based on her feedback from the external consultants, however she wanted organisational members to take ownership for the problem and give them the opportunity to come up with their own solutions. Camilla believed that all staff had the potential to do this and just needed encouragement, something which had not previously been there. Indeed, at the end of the two weeks, an orderly came up with a highly innovative cost saving idea around training and this was actually taken up. It was found that the hospital was wasting hundreds of thousands of pounds on ineffective training programs. As a result the training of all non-medical staff was reviewed and significant changes were made straight away, thus immediately reducing costs. Camilla set about reducing layers of management so to help streamline process and improve communication. Major redundancies took place particularly within middle management. Camilla tried to implement these clearly and as soon as possible as she did not want people to be in a state of uncertainty for too long. Efforts were made to redeploy staff either within the hospital or to other nearby trusts where possible. One year in and Camilla felt confident and thought she had achieved her plan. Camilla had distanced herself from other senior members and did not interact much with lower level staff as she felt that was not appropriate. If she had done so she would have known that dissent within the senior management was mounting. Camilla’s efforts to install a flatter structure, not bound by red tape, which allowed for decisions to be made quickly and efficiently through decentralisation were not well received by some as they felt the cuts made were too drastic, threatened their power and went against the ethos of the organisation. She was repeatedly accused of being dogmatic and pushy. Nevertheless, Camilla stood her ground in the midst of all accusations. Camilla was keen to highlight that all staff were in this together so when caps on pay rises were implemented in order to reduce costs they were rolled out across all levels. This was very unpopular with senior managers and as a result a few of them left the hospital. This gave Camilla the opportunity to implement a new leadership development programme to identify young talent in the organisation so that a new senior management team, who were committed and believed in her mission, could be established. She hoped this would set a precedent at the top for how the organisation should conduct itself. Importantly to Camilla, the recruitment and selection (R&S) process for this programme was blind wherein the demographic characteristics of the applicant were not disclosed until the interview. The initiative was a success and the hospital now boasts one of the more diverse management teams within the UK and this blind approach was then rolled out across all future recruitment. Finally, a zero tolerance bullying initiative was implemented and improved reporting procedures were put in place so that staff felt confident to speak up and voice concerns. In addition, Camilla appointed an ethics officer who only represented the interests of the trust and was an impartial person people could approach if they had concerns. By the Summer of 2013 the hospital was in the process of applying for re-accreditation as an outstanding trust. This is largely attributed to the self-belief Camilla’s leadership instilled in others. Camilla has maintained her visibility since taking up her position through monthly drop in meetings with all staff and she now writes a weekly blog which is available via the hospital intranet where she delivers news and welcomes comments and questions.

BH3319 Theories and Practice of Leadership Assignment 2 Questions 1. Which of the three performance determinants from Flexible Leadership Theory does Camilla focus most on? (10%) 2. Using theory and research to guide your answer, describe some of the key changes made by Camilla and critically discuss why they were effective (40%) 3. Choose which of these leadership styles best describes Camilla’s leadership approach (authentic, transformational or empowering) (20%) 4. How does who Camilla is help to explain her successful strategic leadership? (30%)

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