Can Sir Stuart Rose unlock frontline leadership?

Sir Stuart Rose has an impressive resumé. Credited with the transformation of Marks & Spencer during his six years as chief executive, he has now been handed the task of advising the Secretary of State for Health on transforming leadership within the NHS.

Having a high-profile private-sector background has led to his appointment being viewed with suspicion but, on further research, there are interesting aspects of his tenure that have escaped recent media coverage.

Amongst his many achievements he implemented ‘Plan A’, which reportedly led to saving £8m from reducing Marks & Spencer’s clothing packaging and spearheaded a collaborative project with Oxfam which prevented 1,400 tonnes of clothing from going to landfill. Efficiency and social good are values that align with the NHS and are certainly welcome in an organisation where previous reports have highlighted eye-watering examples of waste, such as the procurement of an identical box of blankets ranging between £47 to more than £120 between hospitals.

Sir Stuart’s remit, as stated by Jeremy Hunt, includes advising ‘on how we can attract and retain the brightest and best managers into the NHS’. However, the unabated competition amongst our most talented students for a place at medical school suggests that we already recruit some of the brightest people, but for some reason we aren’t being effective in recognising their potential or turning them into leaders.

Jobbing junior doctors – at the sharp end of delivering care to patients, and suitably placed to suggest improvement – face a number of barriers to leading change. Colleagues who valiantly pursue a career in emergency medicine report that the exhausting rotas and a disruptive shift pattern gives them little opportunity to explore leadership opportunities.

Those in other clinical specialties are often on short clinical rotations, requiring them to move on before they can see the fruits of any improvement project that they have implemented, heightening a sense of apathy and helplessness towards our places of work. The benefits of experiencing the delivery of care at a number of hospitals needs to be balanced against the loss of continuity and perceived lack of personal development and mentorship for junior doctors.

Comparisons between the NHS and consumer industries are somewhat hackneyed but world-leading customer service has been attributed to unleashing ‘frontline leadership’. This begins with listening attentively to employees and acting on their suggestions.

In the ‘era of the checklist’, healthcare staff sometimes fear thinking for themselves, stifling creativity and maintaining the status quo. We can encourage new leaders by giving them room to experiment and breaking down hierarchies. The NHS Hack Day and NHS Change Day, which have unleashed the creativity of our workforce, are excellent examples of this being achieved. 

Doctors and other frontline staff are small cogs in an increasingly complex machine. It would be simplistic to suggest creating more chiefs would solve all of our current problems. However empowering those that have daily interaction with patients with the right skills, resource and freedom to make change will bring us closer to achieving our aspiration of being a patient-focused organisation – 1.4 million employees with that shared purpose is an exciting prospect.

Sir Stuart may not have far to look in finding bright people, the challenge remains on how best to use them.

Dr Na’eem Ahmed is a Radiology Specialist Registrar in London and Clinical Fellow to Professor Sir Bruce Keogh, NHS England, www.twitter.com/DrNaeemAhmed