(More) Leading through a Crisis

An NHS perspective, Helen Blanchard

It feels as though good leadership has never been more important than it is today, in our strange and worrying new reality, so this brief piece focusses on leadership during times of crisis, drawing on my own experience of working in the NHS.

The theory bit

There are many leadership models out there and lots of them actually make a lot of sense. The one that sits best with me is Bill George’s Authentic Leadership Model, shown on the diagram below. George’s model focuses on the different qualities an authentic leader has (or can develop). If a leader demonstrates these qualities or characteristics, they will be a more authentic leader; their followers will respond positively, and the organisation will benefit. The model was further developed by Northouse.

The five dimensions shown in the diagram are each associated with an observable characteristic and this is summarised below[i]:

  1. Authentic leaders have a sense of purpose, knowing what they are about and where they are headed. Purpose manifests itself as passion. Passionate leaders are interested in what they are doing, are inspired and care about their work. They can clearly describe their purpose to others.
  2. Secondly, authentic leaders have values, can describe what they are. They don’t compromise on those values. This quality is shown through the leader’s behaviour, with authentic leaders acting in accordance with their values.
  3. Thirdly, authentic leaders build relationships with others and have connectedness with their team and their colleagues. They are willing to share their experiences and listen to others’ experiences and are communicative.
  4. The fourth dimension of authentic leadership is heart, which shows in their compassion. Authentic leaders are sensitive to others’ needs and are willing to help them.
  5. Just in case this is starting to sound a little ‘fluffy’, the final dimension of authentic leadership is self-discipline. This gives leaders focus and determination: ability to focus on a goal and move forward towards that goal even in the face of setbacks. This is consistency. Self-disciplined leaders remain cool, calm, and consistent in stressful situations.

The reality bit

Any model is only useful if it helps us to understand and manage our day to day work and life. I’ve spent some time thinking about the best leaders that I have worked for during my own NHS management days and have considered where they have demonstrated the characteristics of authentic leadership. I’ve come up with a few real-life examples.

Behaviour and values: ‘I’ve got your back’

Back when I was a general manager my acute hospital had a really tough run of bed crises, a norovirus outbreak and several weeks of being at red or black alert. Our Chief Executive called the senior team together to rally the troops, and I can still remember her saying ‘If you are on call at two in the morning, trying to direct the traffic in A&E, all we can expect you to do is to do your best. Decisions won’t always be perfect, but I have got your back and I will support you’.  This stayed with me, and it really helped at times when I was desperately trying to do the right thing. What made the difference was that I knew she meant it and she was utterly consistent in how she supported her staff and in her values.

Relationships and connectedness: ‘The soft stuff is the hard stuff’

I was lucky enough to work for two really good Chief Executives early in my career, one from a background in industry and one from the military. Despite their diverse backgrounds what they had in common was a strong focus on building relationships (‘the soft’ stuff) in order to get everything else done. Both led from the front, and pretty much everybody in the hospital knew who they were and had come into contact with them. One of them found me, late at night, washing down the shelves in an about to be occupied new A&E department (long story). He went and got me a coffee, had a chat and an impromptu tour. It probably took about ten minutes out of his day. I would have followed him into battle.

Passion and purpose: ‘If I had a penny for every time they said we wouldn’t build it’

I worked on a hospital redevelopment scheme, where it had taken almost 20 years to get from ‘we need a new hospital’ to turning over the first turf. The project was largely driven by the passion and vision of one Consultant Surgeon. He kept this project moving when all around were giving up, and he got there in the end.

So, what next?

We are frequently told that we are living in unprecedented times, and I have certainly never had to manage services in this situation. But if I were to draw together the lessons that I have learnt both from authentic leaders and from my own experience of managing or supporting others to manage major incidents [which has included the SARS epidemic, a major incident following a train crash and manning the ‘phones for some very distressed patients and families after a major screening service failure] my suggestions would be:

  • Don’t pretend you have all the answers, but do have a plan to get to the answers
  • Communicate, even when the news is ‘no news today’ or when it’s bad news
  • Listen – really listen – to what people are telling you, particularly the more challenging people giving you unpalatable messages
  • Don’t underestimate the impact on your team and colleagues of your taking the time to check in on how they are doing
  • In the absence of clear rules and guidance, or if the rules and guidance really don’t make sense, then don’t be afraid to make your own rules. This clearly doesn’t apply to the good stuff like WHO guidance but it in my experience it can certainly be applied to the endless cycle of pointless reporting and updates to the next level up the NHS hierarchy with a reasonable degree of impunity
  • As the folk wisdom goes, ‘you can’t pour from an empty cup’. Even the strongest leaders need to take time out to recharge their batteries
  • Have your team’s backs and let them know that they have your support. If you only do one thing today, make it this

Helen Blanchard

[i] Northouse, Peter G. (2016). Leadership: Theory and Practice (7th ed.). Thousand Oaks, CA: SAGE Publications, Inc.

Pennsylvania State University. (2017). Lesson 12: Authentic Leadership. In PSYCH485: Leadership in Work Settings: Spring 2017. Retrieved from: http://psu.instructure.com