An alternative to achieving the plan?

A target in the sky

Focus. Clarity. Methodology. Discipline. Determination. Overcome the barriers. Success!

When we need to make improvement, what we need to change or create can often seem obvious. We need to clarify what we want to achieve. When that’s done, we must define how we are going to get from where we are now to where we want to be. Then we need to rise to the challenge. We have to get on with the tasks – along with the conflicting demands of everything else that is expected of us – if the planned change is to become real. But it can all go so wrong.

In fact it can go very wrong in many ways for numerous reasons. On our Practical Leadership & Management Course for Doctors we consider the problem with trying to achieve what we planned! Consider these two extremes: rigidity versus being too reactionary.

The problem with rigidity

Some of us find it easy to become fixed in our thinking. We start by considering the information and the options. Then we make our decision. “This is what we are going to achieve.” or “This is what we are going to create.” We then set about our task with determination and resilience.

But the medical world is a very dynamic place. New information comes to light. Resource availability changes. And when it comes to other people… don’t expect them to want the same thing this week that they did last week! Ignoring all these factors and sticking to the plan can easily mean that we end up with something that’s not fit for purpose.

The problem with being reactionary

Some of us respond in a very different way. We may have been equally diligent in defining what we going to change or create. Yet, with every new piece of information, with every shift in opinion, priorities or availability, we happily amend and re-define the plan. The problem here is that we can easily lose sight of what we were trying to achieve in the first place. Our project either loses momentum or we end up somewhere entirely different from the expectations. The original issue that we wanted to address persists. In some cases, it has got even worse.

Dido Harding’s tractors

What have tractors got to do with anything?

Dido Harding, Chair of NHS Improvement, recently described the mistake of applying a “Soviet style tractor production” approach to NHS workforce planning. It is entirely possible to calculate how many and what type of tractors a country needs for its agricultural purposes by this time next year. A bit of research, then you set about building exactly what you require. But how many “ologists” from each of the hundred or so sub-specialties do we need in any particular part of our country by 2027? Previous efforts at planning have resulted in problematic shortages in some areas with excess supply in others.

The solution

Clearly defined, fixed goals are ideal for projects with short time-scales. Examples include creating a regular team-meeting format, training for a new piece of equipment or a short research project.

However, long-term projects and programmes work best when they have agility built in from the start. They do create end-goals. But to avoid rigidity, these goals are defined just enough to begin the task and maintain focus. They deliberately keep options open with the shape of the end result given ever increasing clarity as the work progresses. In Harding’s workforce planning example, this means creating more generalists who can be deployed to increasingly more specific tasks as the need becomes more apparent over the coming years. The plan is still there but created with an attitude of conscious, disciplined flexibility.

What are you working on at the moment and how agile should you be in your planned outcome?

Stephen McGuire – Director of Development