188体育

70 years ago, a visionary leader took on one of the mightiest empires the world has ever seen.

He didn鈥檛 have an army. He didn鈥檛 fire a single bullet. He won independence for his people through advocating non-violence, and by his personal example of self-restraint and sacrifice.

Now, I鈥檓 not saying Gandhi would have been any good at negotiating NHS procurement contracts 鈥� they really are tough.

But what it does show, is the difference visionary leaders like Gandhi can make.

The difference between achieving a target and transformative change. The difference between a manager with a plan, and a leader with a vision.

Now, I was going to come here today and talk about the difference between managers and leaders, and how we need to see more leaders in the NHS, but I鈥檝e been thinking about what you do and that doesn鈥檛 do it justice.

It isn鈥檛 the full picture.

What you do isn鈥檛 just the difference between success and failure, it鈥檚 the difference between life and death.

Outside of the military, outside of a warzone, being a leader in the NHS is one of the few roles that mean dealing with life and death decisions every day.

And I think that鈥檚 hard for people to grasp outside of the NHS. The stress and responsibility that comes with the job. It鈥檚 not a missed sales target 鈥� it鈥檚 a child dying.

So as important as it is to talk about improving performance, spread best practice, and import the best ideas from outside, I think we also need to have an honest and frank conversation about how we need to get much better at learning from our successes and from our failures.

Because, despite our best efforts, error is unavoidable, and what matters is how we respond to it, and how we learn from it.

And only a culture that, not just welcomes, but requires open learning can deliver that.

So that鈥檚 the first thing I want to talk about: the NHS needs a leadership culture change.

I have spoken face-to-face with many of you in this room about this, because 鈥� and it may come as a surprise to hear this from a Secretary of State 鈥� I know I don鈥檛 have all the answers.

I know I always have to keep learning. And what I鈥檝e learnt, the thing I鈥檝e heard again and again is: we must learn not blame from error.

We all make errors - I think it was Alexander Pope who put it a bit more eloquently.

鈥淭o err is human; to forgive divine.鈥�

You can be a great surgeon and make a mistake, that doesn鈥檛 make you a terrible surgeon. We鈥檙e all fallible.

Any surgeon who says they鈥檝e never made an error isn鈥檛 telling the truth. And the truth is more important than any one error.

What matters is how you respond: open, honest, talking about errors and complaints and what needs to change to stop them happening again.

Now, this is where it relates to leadership, because the other thing I鈥檝e heard again and again is that: leaders create the culture.

Good leaders create a culture where staff can challenge without fear. Good leaders create a culture where complaints are an opportunity to improve, not a need for cover-up and denial. Good leadership is about encouraging whistleblowing, listening to patients, and shared learning through training in teams.

Because great leaders aren鈥檛 afraid to give away a little bit of their power to empower others. Great leaders take risks and encourage their staff to take risks so they can keep on improving.

They don鈥檛 settle for the status quo because of a fear of failure. They don鈥檛 penalise staff who speak up about mistakes or problems because great leaders know that speaking up takes courage.

Great leaders are honest about the challenges they face and what they need to do to meet them. And, I鈥檓 going to let you into a little secret here:

If something goes seriously wrong, and you happen to find yourself in my office having to answer for it: don鈥檛 tell me everything鈥檚 fine because we did it by the book. Do tell me this is what went wrong, and this is what we鈥檙e doing to learn from it.

If you can have the courage to do that, then we鈥檒l create the culture across the NHS we all want to see. Everyone makes errors. Making mistakes is acceptable. But bad behaviour is not acceptable.

I want to see the highest standards of behaviour that underpin empathetic leadership: integrity, honesty, transparency.

And what you can expect from me is this:

You won鈥檛 find me beating up on NHS managers and leaders for the sake of the TV cameras or a good headline.

I don鈥檛 believe less management and fewer leaders is the answer to our problems in the NHS. I think we need to celebrate leaders and leadership, and do much more to nurture and support.

What鈥檚 important, is that it鈥檚 the right leadership. Because the right leadership determines performance: operationally, financially, motivationally.

The right leadership is the difference between life and death, and I want you all to succeed. I want to cut the turnover rate at the top. I want to remove the Sword of Damocles hanging over the boss鈥檚 desk.

Because we can鈥檛 expect a chief exec to empower and set free their staff, if they鈥檙e too afraid of losing, or don鈥檛 have enough time, in their job.

So, you need to have the right support, training and development, which is the second thing I want to talk about.

Now, there are some fantastic leaders within the NHS at all levels 鈥� some fantastic leaders within this room. As good as any in the public services or the private sector.

I鈥檝e seen it myself on visits, on night shifts, out with the ambulance service, and every time I visit my local hospital in West Suffolk.

But I want them better supported and more inspirational leadership. We need more talented people, who possess the qualities of great leaders, rising to the top. More from clinical backgrounds and more from outside the NHS.

Today, I鈥檓 publishing the review of the Faculty of Medical Leadership and Management into removing obstacles to clinicians becoming managers.

And I want to reduce barriers for people who can serve our NHS who have experience outside. We now know what some of those obstacles are:

• lack of a clear career path into leadership roles.

• lack of exposure to management and leadership responsibilities as people progress.

The need for more porous borders and more support for people bringing their experience into the NHS from outside.

The insecurity and challenges of operational leadership, compared to the tenure and recognition that comes with clinical roles.

But what struck me most in the findings, what is perhaps the biggest obstacle is the perception that being a leader, and being a clinician are 鈥渋ncompatible鈥�.

The view that if you step out of clinical practice, there is no return. It鈥檚 nonsense. Some of the best leadership I鈥檝e seen comes from nurses turned managers or doctors leading organisations.

In some parts of the NHS, there is a 鈥渢hem and us鈥� culture between clinicians and managers, when the only culture should be 鈥渨e鈥�.

Because only together can we build an NHS that is there for everyone in their hour of need. Only together can we build a sustainable NHS fit for the future, one that delivers for patients and staff.

That鈥檚 how the best trusts operate and that鈥檚 how all trusts must operate.

So that culture must change. Because it doesn鈥檛 make sense.

One clinician working on their own may be able to help, 10, 20, even 50 people in a day. But that鈥檚 only possible because of the team, the resources, the system around you. It鈥檚 only because of the right leadership. And we know the importance of the right leadership, because we all notice it, when it is absent.

So the 鈥渢hem and us鈥� culture must change. The perception that leadership doesn鈥檛 matter, isn鈥檛 as important as what clinicians do, must change. It鈥檚 not helping 10, 20, 50 people, it鈥檚 helping 10, 20, 50,000 people.

Combining your frontline clinical knowledge and experience with leadership skills and vision to benefit the whole team, benefit the NHS, and benefit the nation.

So, we need to see more clinicians at the top. But not exclusively so. Because outsiders bring something that is very important, and something that is often lacking: diversity. And to borrow a phrase from Idris Elba I like: diversity of thought.

Now, one of the most obvious form of diversity is what people look like. And if we look at racial equality, our leadership within the NHS looks spectacularly un-diverse, uniform in fact.

40% of hospital doctors and 20% of nurses in the NHS are from a black or ethnic minority background. Yet, BME representation on NHS trust boards is only 7%.

More than half of all NHS trusts in England have no black or ethnic minority staff at the Very Senior Manager (VSM) level.

Over 75% of the NHS workforce are women, yet at board level that figure is just 40%. We need 500 more women on boards to make them gender balanced.

Change is happening. And I know that is down to the leadership in this room.

Because it鈥檚 not just a question of fairness and justice. Diversity of leadership is a diversity of experience, a diversity of perspectives.

Different ways of thinking. Fresh ideas, new solutions to old and seemingly insurmountable problems.

Diversity of thought is essential to the future of the NHS. It is essential to make the best, and most intelligent use, of the 拢20 billion a year extra we鈥檙e putting into the NHS.

And this applies to outsiders coming in, as much as it does to insiders moving up. Because, at the moment, we don鈥檛 have enough leaders.

At the moment, nearly 1 in 10 chief executive positions in the NHS aren鈥檛 permanently filled. That can鈥檛 continue. We need stability. We need to be able to plan for the future with confidence.

We need to find 20 more people right now with the skills, grit and ambition to be an NHS CEO, and 30 more people to be a Chief Operating Officer, just for us to stand still. So, we must embrace more clinicians and more outsiders at the top.

And here I want to draw on the inspirational leadership of someone with a very different dress sense to Gandhi: Gareth Southgate. Because the next generation of leaders coming through is very exciting.

The first group of doctors, nurses and Allied Health Professionals on the Clinical Executive Fast Track scheme are about to graduate.

There鈥檚 been a huge increase in the hugely successful Graduate Management Training Scheme 鈥� up to 500 a year from 2019.

And with the Leadership Academy moving to NHS Improvement, we will be able to better match our funding and resources to developing leaders in the areas where we most need them.

Outside the system, charities like The Staff College are taking the best of what the military, business and education do on developing leaders and adapting that training for the NHS.

I want to learn from The Staff College and embed it much more in how we develop our leaders.

And then there鈥檚 people like Professor Stefan Scholtes at Cambridge University鈥檚 Judge Business School, running a hugely popular MBA programme taking mid-career clinicians and turning them into top tier leaders - other business schools are available.

Learning from trailblazing companies, like this little known tech firm, that was on the verge of bankruptcy before a visionary leader turned things around and made it the world鈥檚 most successful 鈥� that鈥檚 Apple by the way.

So, we need a diversity of training just as we need a diversity of leaders.

And we need to keep training, and keep learning, throughout our careers. Whether you鈥檙e a consultant, or a clinical director, or a secretary of state.

We have a duty to ensure our skillset is up to date. That if we don鈥檛 understand, we find out. Not least because there鈥檚 a tech revolution coming and the speed of change is only getting faster.

Which brings me to my third point: why we need more leaders in the NHS.

Because the NHS is changing. Society is changing.

We鈥檙e putting in the single, largest cash injection to the NHS in its history, and we鈥檙e creating a long-term plan to take us into the next decade.

The health and social care system of the future is going to more joined up, and better integrated.

It鈥檚 going to be less command and control. Less top down. Less hierarchy.

More autonomy. More about relationships and building a transformative culture. More about us, than me.

So, what we really need in the NHS are leaders who feel comfortable with more autonomy, and I mean at all levels.

When Kennedy visited NASA as president after setting them their mission of reaching the moon, he stopped to talk to a janitor. And he said: 鈥淭hank you, you鈥檙e helping to put a man on the moon.鈥�

Leadership in the NHS means valuing everyone at every level, as part of the team that saves lives every day. To do that we need leaders who feel comfortable with empowering their team and taking risks to improve things.

Leaders with the ability to articulate a vision whether it鈥檚 on a ward, a surgery or a whole hospital.

This is where we are. This is where we鈥檙e going. And this is how we鈥檙e going to get there.

Inspiring. Communicating. Delegating. Empowering. Empathetic leadership. Not afraid of change. Embracing change. Driving change.

That鈥檚 what we need from good leaders at all levels.

Grit. Determination. Sticking it out when things get really tough.

And let鈥檚 not forget it took Gandhi more than a quarter of a century to realise his vision.

So, let me ask all of you, every one of you, my question, my challenge, is what are you going to do to change the culture of the NHS for the better? To empower, not direct? To learn, not blame?

To build the health service of the future?