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What makes a good manager?
Managers in Partnership Master Class 24th November, 2009
‘If you feel well you will work better than if you feel ill’
•78% with poor mental health find it difficult to concentrate at work •57% say it takes longer to do work•46% say they are less patient with customers or clients
•41% say poor mental health interferes with their decision making•26% say their mental health is moderate to very poor•56% of these state the reasons are both home and work related
•CIPD Employee Outlook Survey 2009
Wellbeing and Performance The definitions of wellbeing and performance follow two models shown below.
Wellbeing is a personal sense of wellness. You can feel well and energised whilst being diagnoses
with illness; equally you can feel unwell without any illness for example a hangover. If you feel
well you will be able to concentrate better on your work that when you are thinking of
The are are many signs of the impact of stress. Overtly, levels of stress cause about half the reasons for people going off sick, and more than half the reasons why people leave their jobs for another somewhere else. Leaving jobs is a method of coping with stress. In the following slide, taken from the survey of the Top 100 Companies to Work For the turnover of staff in ‘successful’ organisations is higher than truly successful organisations that are in the range of 1-6% staff turnover annually. In this slide it is seen that about 46% of the apparently good organisations have staff turnover of greater than 16% the costs of this to the organisations and individuals is massive.
5
10
15
20
25
30
0-5 6-10 11-15 16-20 21-25 26-30 Over 35
Numberof
companies
Percentage of all staff turnover pa
7
14
31
22
11
4
8
Turnover of staff 2006, 2007 and 2008
‘Top 100 Companies to Work For’Source: Sunday Times March 2007, 2008 and 2009
5
13
40
14
17
1
7
2006
2007
31-35
2
6
2008
42
9
11
23
30
15
The impact is, also, on compliance with HSE Management Standards, the costs of insurance premiums for staff medical insurance, the costs of manager time and costs of tribunals and litigation, as well as the haemorrhaging costs to the organisation.
The impact of stress at work
Individualmisery
The Law and
Tribunals
Insurance premiums
Sickness absence
staff turnover
money.
HSE Management
Standards
Complexities of the NHS The NHS is a complex organisation largely because of the multi-professionals delivering its prime
product, but, also, because of the extensive background services that are largely in support of
the foreground activities, and in a recent observation, the same size as the foreground
operations. There are different cultural foundations relating to foreground and background
activities – the foreground is highly influenced by professional cultures based on individual
responsibility towards the patient or client. The background cultural foundations are based on
bureaucratic principles of targets, procedures, processes and political accountability.
These cultures can clash at the delivery level of the NHS where there is an existing conflict
between the professional and the bureaucracy – where the professional focuses on the needs of
the individual whilst the bureaucracy focuses on the needs of all individuals. This tension needs to
be managed effectively for both aims to be satisfied together.
Healthcare organisation
foreground background
Threats to quality
Professionals and bureaucracy
Threats to quality
professionals bureaucracy
Typologies of organisations that reflect wellbeing and performance, and,
therefore, quality.
The following slide shows some generalised examples of organisational characteristics that link
wellbeing, performance and output/outcome.
Look at your own organisation to see if parts of it relate in any way to any of the typologies.
High personal wellbeingGood business performance
Average personal wellbeingPoor business performance
Poor personal wellbeingAverage business performance
Poor personal wellbeingPoor business performance
Characteristics:Clear purposeCommitment, Trust, EngagementEffective recruitment practicesGood terms and conditionsTeam working; staff involvementAdaptive leadership and managementCustomer and staff focusLow sickness absenceLow staff turnoverLow costs/high profits
Characteristics:Ambiguous purposePoor recruitment practicesAverage terms and conditionsMismatched skills to jobsLaissez-faire management practicesFew company wellbeing programmesAverage company benefitsAverage sickness absenceHigh staff turnoverHigh costs/ low profits
Characteristics:Clear purposeAverage terms and conditionsLimited alternative employmentTransactional managementIncentive and bonus schemesHigh levels of sickness absenceHigh number of tribunalsLimited wellbeing programmesAverage staff turnoverVery high costs/Minimal profits
Characteristics:Ambiguous purposePoor terms and conditionsLack of Commitment, Trust, EngagementCoercive, competitive and bullying cultureHigh level of presenteeismHigh numbers of tribunalsHigh levels of sickness absenceHigh staff turnoverHigh costs/Low profits
The iceberg effect or presenteeism Many people remain in work whilst feeling unwell and lacking in focus and concentration. They
feel lethargic and unenthusiastic about their work, and essentially go through the motions
without being identified as unfit for work. Such people may under-perform and may be counter-
productive. The overall cost of the iceberg effect and presenteeism is far greater than the costs
of sickness absence and staff turnover.
Costs of the ‘Iceberg Effect’ as a percentage of total costs of psychological distress at work
sickness absence
staff turnover
reduced productivity at work
58%‘Iceberg effect’
32%
10%
Tackling these problems The first step is to listen to your staff. There are many ways of achieving this – open space
discussions, learning sets, workshops and staff surveys. The best approach is for managers to
listen to their staff, and to help with this there are a number of tools that can be used. The one I
would like you to complete now is below. It will take you less than a minute and provide you with
a good idea of how people are feeling at work.
Health and wellbeing at work questionnaire
We want to find out if you are feeling good about your work, and about your working situation. To help us find out we would like you to complete this questionnaire. It focuses on how you feel now and over the recent past (say a couple of weeks). Please try and complete all the questions. Thank you very much for your co-operation. Have you recently: Been unclear about what you are supposed to do at work? Found that others have been taking decisions that prevent you from performing at your peak? Become irritated by the behaviour of your manager? Found yourself idling the time away? Been spoken to by someone you thought was being rude, unhelpful and thoughtless? Found it difficult to get involved in your work? Felt under pressure at work? Spent longer than your normal time at work? Experienced sexual innuendo or verbal abuse at work? Felt you have been unfairly treated? Been feeling energized at work? Taken a decision that has been acknowledged as a major step forward at work?
Not at all No more Rather more Much more than usual than usual than usual
Not at all No more Rather more Much more than usual than usual than usual
Not at all No more Rather more Much more than usual than usual than usual
Not at all No more Rather more Much more than usual than usual than usual
Not at all No more Rather more Much more than usual than usual than usual
Not at all No more Rather more Much more than usual than usual than usual
Not at all No more Rather more Much more than usual than usual than usual
Not at all No more Rather more Much more than usual than usual than usual
Not at all No more Rather more Much more than usual than usual than usual
Not at all No more Rather more Much more than usual than usual than usual
Not at all No more Rather more Much more than usual than usual than usual
Not at all No more Rather more Much more than usual than usual than usual
If you circle either of the two right hand answers for the first ten questions or the left two
column for the last two questions you are experiencing something that may amount to strain,
and you need to tackle the causes.
Next, you need to establish a framework as a strategic outline for your overall approach to
reducing and eliminating psychological distress at work. The following includes five strategic
purposes:
Prevention – to prevent psychological distress from happening in the first place.
Prevent deterioration – once someone is identified as under strain the purpose here is to stop
that situation from deteriorating further. This requires interventions of various kinds, the most
effective of which is good man management. However, often managers abdicate their
responsibilities and expect HR, Employee Assistance Programmes or Occupational Health to
solve this problem for them.
Restoration – once someone is off work due to psychological distress the purpose here is to
restore the person back to their normal level of independent life and beyond. This requires
sophisticated arrangements for rehabilitating people back into the environment that causes the
problems in the first place.
Palliation – once someone is off sick for 6 weeks or longer it is more difficult to restore them
back to their normal level of independent life. The purpose here is to use sophisticated skills to
bring people into any form of work, voluntary or paid, as this is known to improve their
wellbeing.
The next generation – once you have developed a culture that prevents psychological distress
from occurring the purpose here is to maintain that culture whilst staff change and managers
move elsewhere.
Prevention Prevent
deterioration
Restoration Palliation
Nextgeneration
Strategic purposes
Next: take a look at the influences on wellbeing and implement programmes that address these.
This talk cannot go into these in any detail other than the headlines.
Mental
Social
Spiritual
Emotional Physical
Environmental
Components of wellbeing
Next: is taking the strategic framework above and identifying the kinds of programmes that help
to populate the framework. The following slide provides some ideas, but again, time prevents
any exploration of these in any detail.
Wellbeing and Performancestrategy
PositiveWorking Culture
Derek Mowbray 2009
Getting down to the nitty gritty
We are all actors We all act. We act according to our understanding of the situation we are in, and respond with
the behaviours we believe to be correct under the circumstances. We are not very good at this in
a culture that is hostile, and where the cultural foundations are not based on virtuous intent
towards wellbeing and performance of staff.
We behave according to the meaning we place on specific situations
Threats to wellbeing and performance There are three levels of threat. The most significant is our behaviour and the behaviour of
people towards each other.
Organisations are controlled communities, and the people who control the communities are
normally called managers. A prime threat to wellbeing and performance is often the behaviour of
controllers.
The second level threat are life events that each of us can expect to experience at least once.
These can be, therefore, predicted and managed. They are foreseeable and common. Much
depends on our personalities and levels of personal resilience as to how we cope with these
events. For example, the difference between J’s and P’s on MBTI proves insight into why some
people find change difficult compared to others. J’s like events to be well planned and any
alterations causes anxiety, whilst P’s are more flexible and can adapt to change very quickly.
Other personality influences include ‘conscientiousness’ and ‘extraversion’ which help in
resilience.
The third level threat are most familiar as they are the describable effect of failed interaction at
level 1 threat with events from level 2 and are packaged in HR policy terms and can be presented
for arguments in court or tribunal.
Threats to wellbeing and performance
Coping, resilience and prevention I want to briefly touch on three types of activities that help to tackle the problems of
psychological distress.
Coping strategies:
Coping with your own stress
laugh
The most effective coping strategy is laughing.
Other strategies include self cognitive behaviour therapy, shouting at yourself in the mirror with
positive thoughts and determination to overcome the misery you are experiencing. You’ll feel
great after doing this each morning! It’s more complicated than this sometimes, but doing this
will raise your adrenalin and get you going in the morning.
Others include:
Imagery with deep breathing
Self hypnosis
Meditation
All of which will calm you down and provide th thinking space you need to regain personal
control in stressful situations.
Resilience strategies:
There are eight resilience strategies to adopt. Time prevents me from any detail but there are
exercises to be undertaken within each of these headlines that will strengthen your personal
resilience.
Building resilience
Wellbeingand
Performance
Self-assurance
Flexibleand
adaptable
Problem solving
Socially connected
Personal vision
Organised
Active
Interaction effect
Controlling oneself
Prevention The third activity I wish to introduce is prevention. As part of my efforts to introduce prevention
programmes to the NHS I have been involved, and initiated, the new Code of Conduct for
Healthcare Management that is receiving support from MiP, IHM, HSE, BPS, RCN, BMA, DoH,
Health Foundation. RCGPs, and Welsh Assembly Government.
Code of Conduct for Healthcare Management
The context within which managers are expected to behave
The behaviours they are expected to exhibit
The actions they are expected to take
Wellbeing and performance
Download draft copy from MiP web site
This is about creating a Positive Work Culture based on wellbeing and performance. The overall
aim is to build organisations with the following characteristics:
•a clear, unambiguous purpose, expressed as a simple ‘big idea’, an idea which all the staff relate to closely, and are proud to discuss with friends and colleagues.
•an atmosphere of confidence, where all the staff are interested in each other, support each other, and project this confidence towards clients and customers.
•staff who behave respectfully towards each other, value each other’s views and opinions, work in teams which are places of mutual support, where anything is debated without a hint of humiliation, where the critique of individual and team work is welcomed, discussed and where lessons are learnt and implemented.
•staff who ‘go the extra mile’ by providing unsolicited ideas, thoughts, stimulus to each other, and where their interest in their customers offers something more than is expected, beyond courtesy, and beyond service, offering attentiveness and personal interest.
•challenges for their staff, that provide opportunities for personal development through new experiences, and which treat everyone with fairness and understanding.
•staff who are personally driven towards organisation and personal success - intellectually, financially, socially and emotionally.