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Brian James on... Gerry's legacy

Updated Wednesday, 10th January 2007

What lessons were learned by Chief Exec Brian James on how he runs his NHS Trust Hosptial and what lessons were there for the wider NHS? Brian James gives us his perspective on the impact and legacy of Gerry's managment approach.

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What was your biggest surprise during the project?

How important it is for the chief executive to actually be visible so as to give people permission. The power of that simple message – giving permission - because I didn’t really do anything, it’s down to other people to do it, all I did was ask and give permission. I asked that it be done and I said “you have my full support, go away and do it”, and they went away and did it.

The project I take on in the programme resulted in staff implementing a new service in about seven weeks, which probably otherwise would have taken the best part of a year, because we would have gone through a whole range of committees and getting agreements from all parties involved. You know, it would have just gone through a process that would have taken an awful lot longer, and I just used Gerry’s advice to cut straight through it.

I simply called a meeting saying, “Look you’ve been talking about this for a while, I now want to see it done. What do you need to do it? Can you go away and sort it out? Come back and tell me if you’ve got a problem.” And largely they didn’t, they just went away and did it, and did something that they’d been planning to do for quite a long time, I have to say, and they did it in a matter of weeks, and it’s been very successful.

What will the legacy of this project be at the hospital?

We’ve been using the exercise to do a complete review about how we’re going to improve productivity in theatres. So we’ve had an experiment going. One of the theatre anaesthetists wrote to me saying he’d got an idea about something, and so I waded in behind him and said, “Right, let’s try it”.

So we’re now trying a number of different ideas out in theatres to reduce the downtime between theatre cases and it looks like it’s going to be successful. So we’ve got a solution now that looks like we’re going to be able to increase efficiency and productivity through existing theatre sessions, and that was always my number one ambition when it came to theatres.

So your personal attention in this way can make a real difference?

That was the biggest lesson for me. It was about how important it is to give people permission. To say, “It’s okay to do that”. You know, it’s as simple as that. Now, why it would take me to do that, why is it that a chief executive has to do that otherwise it doesn’t work, I’ve no idea. But it clearly does work, and, as Gerry would quite rightly say, it’s the result that counts.

What’s the biggest practical outcome of the project for you?

Well, in two areas we have seen a reduction in waiting times, so that’s been a success. In Paediatrics, the waiting time for an outpatient appointment, came down from eleven weeks to two weeks. That’s a great result from our perspective. It didn’t actually take a lot to do it, but it doesn’t matter really, the important thing was that it was achieved.

The other area where we’ve had a significant result was with people waiting to come in for an Endoscopy. Again it was a simple change, getting the consultants to change from their tradition of running their own lists to pooling them. As a result we’ve managed to take that waiting list down from about seven weeks to about three weeks.

What lesson should the NHS learn from this project?

Well, I do think that the chief executive has a right and a duty to be much more demanding than perhaps we are. I think that the big lesson I get from this and from Gerry is don’t underestimate the power of the chief executive, don’t underestimate your own power and position as a chief executive, press for change, push for it, encourage it, and it is actually more likely to happen much more quickly than you think.

That is something that I really hadn’t appreciated until Gerry really showed me the difference. It’s one of the reasons why I put three consultants on the board, because if I can ask of people extraordinary things, then I think that consultants should be able to demand it as well. It’s got to be my biggest learning experience from the exercise, and for which I am eternally grateful to Gerry for teaching me.

Did Gerry raise issues which the NHS can learn from - and what do you think needs to be done? Share your views in the comment area.





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