Rage against the Machine!

As I have alluded to in the past I am an NHS employee. I actually work for small NHS organisation in London, and am responsible for good governance.



You can read my handy guide to the UK's national religion in the new page I've created or follow some of the links on the right. As for governance, if I were in a prosaic mood I should describe my role as the keeper of all the unloved virtues. Ultimately I am responsible for the systems and processes that ensure we manage risks, take timely decisions, manage patient information securely, take into account the needs of the whole community when we do design services, etc.



I've done it for a while and I'm good at it. "Good at it" means I work hard to ensure governance is not a necessary evil, or a set of reins to hold back unruly children. Instead I would sum up the corporate culture I work to create as one that that helps and supports staff make the right decisions, take the right actions, and if - if - a mistake is made we acknowledge it, support each other, learn from it.

I am delighted to have been given relatively free rein to build systems as I saw fit. For example, the organisation I work for inherited over 100 policies averaging over 100 pages each. For an organisation of 30 odd people this seemed like overkill, In fact, that struck me as a tool for the PCT to punish its staff should things go wrong. "It was in the policy" they'd say "they're part of your terms and conditions. You should have read them". Crap: no-one could, rationally, do other than pay the minimum lip service to that pile of paper required to get on with their job. That, after all, is what they want to do.



Instead I've rationalised all these policies into a couple of dozen, all no more than 10 pages long each, including cover and glossary/reference. Underneath each policy is detailed guidance that is drafted and adopted by the teams themselves and is proper guidance on how to do their jobs - with the policies setting out key principles, organisational attitudes and accountabilities.


The reason I'm writing about this is because a few weeks ago I, and representatives from other organisations were invited to come together and discuss governance - or rather, invited to meet a challenge. If you were able to run your organisations as you would want, without the existing restrictions or 'received wisdom' of how things have been done before, how would you do it?



What an inspiring challenge! I've set about getting opinions and holding workshops to see what people could imagine for a better, more responsive organisation. Being a dry topic I was slightly apprehensive about the level of engagement I'd get in governance but I was blown away by how much people had - and wanted - to contribute. It seems a lot of people have ideas about making things better, which is very pleasing. I look forward to working with colleagues and front line services to make some changes. I wonder if you have any pet hates about the way organisations or public services are run?