New NHS England guidance: the expectations of line managers in relation to people management

New guidance has come out this week from NHS England on the expectations of line managers. You can find it here.

It’s quite a lengthy list of expectations, broken down into sub-themes (my team will tell you, I love a good sub-theme). On first review, it can feel quite overwhelming.

But on a second review, your average manager (like me) will be thinking that there’s nothing new on the list and they attempt every day to meet those previously unwritten expectations.

The introduction states that the framework will “explain the role of the manager in relation to people management”. But I don’t think it does. It is list of expectations, and “what managers need to know and understand”. It isn’t an explantion. A list is not sufficient in ensuring that managers truly understand what is expected of them.

Words have different meanings for different people. One of my favourite exercises is asking a group of staff what their understanding of “professionalism” is, which always results in a myriad of different responses. There will be some similarities from participants, enough to get a consensus. But it always surprises me how many different ways someone judges another person’s professionalism.

So, when the NHS England framework states “handle personal data and information in a professional and confidential manner”, what does this actually mean? It’s wrong to assume that we all know what it means. Test it out, ask your colleauges, and see what answers you get. And if you find disparities in interpretation, you know that a team discussion needs to be held to develop a shared understanding.

To emphasise this point further: when we undertake Cultural Reviews with teams, we always ask “how do you know that you’re doing a good job?” What we’re trying to find out is whether individuals recieve feedback on their work – both positive feedback and feedback that enable them to perform better. We want to know the source of that feedback. We want to know whether clear and tangible expectations are set, against which an individual can measure their own success.

After undertaking hundreds of Cultural Review meetings, our key finding across every team we have worked with, across every Trust we have worked with, across different healthcare settings, is that it is rare to find a manager who provides good feedback to their staff. Most participants talk about the value of patient feedback, or rely on self-validation. But nothing is more motivational than a manager recognising their employee for their work, and telling them.

In the NHS England’s line manager framework, it states that managers should “have regular one-to-ones to check in, provide feedback, and discuss their wellbeing”; and this is achieved through a manager’s contribution to “creating a culture of trust and encouragement”. The managers we’ve met through our Cultural Reviews believe that they are doing this, but the feedback from their team often suggests the opposite. Some managers are insightful in knowing that they are not doing it well enough.

At this point of the framework, there is a handy link to NHS England’s Culture and Leadership programme. Towards the end of the webpage is a directory of all the supporting documentation and developent programmes available which underpin the Framework. Whilst it’s positive to see this level of resource, it is, again, almost overwhelming. How does a manager navigate this plethora of information and determine what’s suitable for them?

Whilst this post might appear that I’m being critical of the Framework, I have not underestimated the amount of work that has been undertaken to produce it. Upon a closer read, you can see the level of thought that has gone into developing it (it’s tightly written yet comprehensive). I just don’t think that it’s enough to change the current management culture in the NHS. I’ve only touched on two small parts of the framework where I feel that there is a gap between reality and what is expected. This gap can only be bridged through significant investment in management training and targetted interventions at a local level.

Where do you stand on bullying?

I’ve been talking a lot about bullying recently. It started a few weeks ago when I participated in the weekly Twitter Talk #nhssm on the topic of cyber bullying.

Then a friend of a friend contacted me as they are being bullied at work because (she believes) she’s just agreed a flexible working arrangement so she can support her husband who is having on-going treatment for cancer.

And a BNI colleague called me as his daughter started a new job six weeks ago and is finding the workplace too “aggressive” and wants to leave.

What I found interesting in the #nhssm chat is that one participant was surprised to hear that there was bullying in the NHS.  But it is a fact – as the annual staff survey shows – that there is  bullying the NHS .  (Unfortunately) Bullying within the NHS generates a substantial income for me as I frequently undertake complex investigations into bullying and harassment.

I still remember my first investigation in 2000 – a case of a nurse bullying a patient; I’ve also seen staff-on-staff, managers-on-staff, staff-on-managers. I’ve investigated a fair share of senior Doctor grievances about being bullied.

Last week I met up with Andy for a drink and he started to tell me about recent developments at work. His boss, Darryl, has always had a strained relationship with one of the General Managers, Derren. However, he hadn’t realised how bad until he attended a meeting recently when they were both present. The atmosphere was hostile, the dislike between the two parties tangible. Andy came out of the meeting thinking “What was that about?”

The next day Andy was in an informal 1:1 meeting with one of Derren’s junior managers when he learnt the true extent of the situation. Allegedly, Derren and Darryl fell out about 8 years ago and have never sorted out their differences. Derren however has recently been saying that he believes Darryl is “absolutely useless” and is on a personal mission to drive Darryl out of the organisation. Apparently “everyone” knew about this.

Andy was in shock to hear this, but as he absorbed the information past events that he’d not fully understood now seemed to make perfect sense. For example, over the last two years Derren has actively sabotaged projects and instigated investigations into areas of HR where he felt there was any impropriety. Andy has been an innocent bystander but  has indirectly felt the impact of this behaviour.

Andy was now wondering what he should do.  Like me, he feels quite strongly about bullying & harassment.  Having seen the awful psychological damage it can do, I like to think that I stand up to bullying:  a few months ago I was in a meeting with a client and one of the participants swore a number of times.  Whilst the colourful language was used in jest, it wasn’t appropriate.  In fact, one of the other participants made a passing comment about it as we left the meeting.  I spoke to him about it a few days later when the opportunity was right.

However it’s not as easy as that in Andy’s case.  I’m not going to detail what Andy decided to do after our chat, because everyone deals with such situations differently.  But there were three key things I felt he  needed to think about:

a) his relationship with his boss,

b) his reputation within his organisation,

c) what he might say when he gets to an Employment Tribunal (when, not if).

I don’t think it’s always clear exactly what we, as HR professionals, should do when we see such deep entrenched bullying behaviour.  Striking that balance that ensures Andy maintains his integrity, his professionalism and his job as an HR professional isn’t going to be easy.  I just hope he doesn’t get caught in the cross-fire.