My previous blog on this subject was very popular. Many people seemed fascinated, but some folks suggested to me that while the analysis was interesting, they would love to read a narrative version, so as to better understand the content of each engagement.

 

Then, I got a letter from an academic who was conducting a study on healthcare CEOs – how they used their time, how they made decisions, that sort of thing. Would I be prepared to host him as a ‘shadow’ for 3 weeks ?

So I did, in September. We got to know each other, he went everywhere with me, listened to my phone calls, watched me teach, and speak, do my post, and chat informally in corridors. He sat in on one-to-one discussions, he attended events, he even observed our meeting with Monitor! I became able to forget he was there, as indeed did most of the people I met with!

When he publishes, I will write something here and include a link. I’m fascinated to know what he makes of my scheduling and the way I operate in comparison to others. I expect that will be some time though, so in the meantime I thought I would use the same 3 weeks as a basis for my ‘narrative’ time utilisation audit. Who knows, there may be a fascinating comparison to be made in due course!

Looking over the record, shown separately below as it is quite long, it was a varied period. There were quite a number of relationship meetings with colleagues, 121 sessions with my Director team, mentoring, teaching, strategising, and meetings to plan and prepare.

Again, there were perhaps relatively few formal ‘management’ meetings? It is interesting how talking, communicating, relating, coaching, encouraging, accounting, and explaining form the majority of what I do. Managing in the strict sense is not a large part of my role?

I hope the log is of interest – maybe for teaching or management development courses? As always, I’d be interested in what you think!

 

 

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WEEK 1

 

Monday:

Travelled to Burton Hospital Foundation Trust with our Good Hope Managing Director to meet with the CEO and COO, for the first time, to discuss future plans – my aim being to meet all ‘neighbours’ to share issues and get a sense of the strategic thinking that is going on. Helps create context for us in these unpredictable times! Back to Heartlands (where my ‘shadow’ joined me for the first time) to a lengthy progress meeting of Directors, HR team and lawyers over a consultant exclusion. Then a 30 minute phone call about new national leadership training arrangements, followed by two transformation meetings. The first with the Medical Director and IT Director about informatics, job planning and consultant scheduling, the second with five Director colleagues to do some future financial planning. How are we going to manage the 5% year on year financial challenge?

Tuesday:

Early 121 with Director of Strategy, followed by a very pleasant hour with our new Director of Infection Prevention and Control, a Consultant Microbiologist who I have worked with as a colleague in a previous Trust. Then a meeting on Comms strategy, then a pre-meet before the first meeting of the new Local Education and Training Council for Birmingham and Solihull, which I chair. Then the meeting itself – well attended and a good start to the new system! (In the West Midlands we have five Councils supporting the Local Education and Training Board). Then office time to attend to my part of the Staff Notice Board (it is important I do this myself), followed by a dinner in the city centre hosted by one of the large consultancy firms. A precious evening sacrificed but a good opportunity to get a sense of what is going on elsewhere and how current thinking is progressing.

Wednesday:

Early meeting with Corporate Affairs Director to finalise my AGM presentation, which she has very kindly drafted for me, and then our informal Exec Team meeting which lasts a couple of hours. Then a 121 with my Estates Director (car parking on the agenda – inevitably), a telephone 121 with the Managing Director of Solihull, then a meeting with my Corporate Affairs team about a volunteering initiative we are planning as an Olympic legacy (very exciting, see here). Then a telephone reference for a manager I once worked with, and then an NHS Change Twitterchat. Then catch up on post, emails and other paperwork.

Thursday:

Started with a telephone call about a conference on Mergers and Acquisitions – a request to speak and an opportunity to chat about what is happening elsewhere in the country. Then a quiet morning of office work and informal chats along the corridor. Annual leave in the afternoon – riding the Way of the Roses with my wife!

Friday:

Annual leave – Way of the Roses Day 1 of 3: Morecambe to Burnsall (excellent day!)

 

WEEK 2

 

Monday:

Annual Leave – returning from Bridlington to collect car from Morecambe (we did it!)

Tuesday:

Exec Management Board (we hold this off site) until 3pm, followed by the Annual General Meeting / Governors Council from 4pm to 7pm at Good Hope Hospital. Good turn out – our Governors are a lively and constructive part of our organisation nowadays. My presentation is a review of the year just gone, and a look forward to the one ahead.

Wednesday:

Exec Team meeting for 2 hours, really an informal discussion, followed by a catch up on the actions from the LETC meeting last week with the lead manager. Then a meeting with Comms to plan the Team Brief, followed by a 121 with my HR Director. Finished at 5 today to change, pick up my son, and catch the Leicester City evening match (v Burnley, we won!)

Thursday:

Started by recording some film footage for Abbott, our pathology partners who are holding a conference in the US this autumn. Not going but I’ll be there on screen! We are in it for the long term so keen to build a good relationship. Then a meeting with the FD, Chair, and the NED who chairs our Finance and Performance Committee to go through the information we have prepared for the up-coming meeting with Monitor. Then a 121 with the Chair, and a follow up meeting with the Chair and Board Secretary to discuss changes to our Board Committees. Then down to London for a discussion about integrated care over dinner with colleagues, and stayed over because of the meeting with Monitor in the morning.

Friday:

Pre-meet in House of Lords with Finance Director and Chair (in his office) – fascinating, such a sense of history in the building! Then walk across to the Monitor offices for a 90 minute meeting to talk about our risk-sharing contract, our Annual Plan, and our sense of the future. Always get a mild sense of foreboding walking into the Monitor offices but it was a good meeting and I think we provided the necessary reassurance. We had a coffee to de-brief and then walked back to Euston. Passing Downing Street we saw a BBC presenter doing a piece to camera about the Chief Whip story – he is one of our local (and very supportive) MP’s. Then back to Birmingham by train, and a drive across the city to meet with a GP colleague who is chairing one of the CCGs. Then home to catch up on emails which accumulate alarmingly when I’m out of the office all day!

Saturday:

HEFT Annual Community Fair in Birmingham. Well attended, good fun, and incorporated an all-comers meeting for Members and public with the Chair and myself. Many staff give their time generously to this event, which I am pleased to support. I got to carry a real Olympic torch too!

 

WEEK 3

 

Monday: 

Missed new staff induction for the third week running – a shame as I like to welcome our new starters. But caught the early train to London for an HSJ Round Table event on the future of hospitals.  Interesting conversation though perhaps no radical new insights this time. Then back on train to meet with the FD and clinical managers from those parts of our organisation who presently have vacancy controls imposed (because their budget is off trajectory), with a telephone call from a recruitment company squeezed in between.

Tuesday:

Exec Team meeting for 2 hours, then a meeting with Corporate Affairs Director to plan the Board Away Day (coming next week). Then a meeting with Directors of Strategy and Research, and a local university professor to plan our appointment of two academic Public Health specialists (very exciting). A very good meeting, then a meeting with Comms to finalise Team Brief for this month, and then a session with a young and promising manager who I mentor (works for us I’m pleased to say). And then, in (too) quick succession, meetings with two GPs about changes to the support we provide to their lunchtime meetings, with the visiting Pathology CPA (Accreditation) inspector, and with one of our consultants who wants help to promote stress-reducing meditation sessions for staff! And then, off to Medical Illustration to film a podcast as an intro to our new e-learning programmes, which we are very excited about. Did it in one take I’m getting used to these! And then, to finish, a 121 with my Medical Director – always a great discussion that ranges over many and varied issues!

Wednesday:

Drove up to Keele University first thing to lecture on a management course for SpRs in Pathology and Radiology – spooky as I attended this course over 20 years ago! It was my first ever management course as a doctor in fact! I well remember our insecurity over the future and found that it is still evident today. Then back to Heartlands to deliver the Team Brief in the lecture theatre – slightly late but ok as the team put our staff video on first. My community Team Brief visit was cancelled so had some office time, prior to taking part in the NHS Change Twitterclub.

Thursday:

Over to Good Hope Hospital first thing, for a 121 with my Managing Director. Very pressured at the time with A&E attendances and acute admissions. Then, still at Good Hope, a visit to our excellent Simulation Centre that is going from strength to strength thanks to an enthusiastic team, a visit to our Radiology Department to see their new facilities (impressive and always amazed at what colleagues in radiology can do for patients nowadays), and then delivered the Good Hope Team Brief at midday. Then, back in the car to drive to Solihull Hospital to deliver the Team Brief there (a good turn out as always). Then back to Heartlands for our Chairman’s lecture. Guest this time was the excellent Peter Carter of the Royal College of Nursing. Followed by an enjoyable dinner with Peter, the Chairman, and our senior nursing colleagues.

Friday:

Started the day with a 121 with the FD to discuss the financial challenges – need to keep close to this. Then a brief catch up with some management consultants we recently worked with on breaking down and analysing our mortality rates in detail, followed by an introductory meeting with a new Consultant in Sexual Health who started recently. I like to meet all our new docs if possible (assuming they want to meet me!). The afternoon was taken up with a nursing event known as our Senior Sisters Challenge, in which we heard some excellent feedback from our trial of ‘supervisory status’ for Ward Managers. We must find a way of implementing this. Afterwards, had some office time which included informal drop-in chats with my Medical, Corporate Affairs, and Finance Directors at various times! Off the cuff, end of day discussions are always enjoyable, and fruitful!