Governance

As I have mentioned I work in governance in healthcare. This is a real challenge, but very worthwhile work (most of the time).
 

Governance is critically important to leadership and is hugely difficult to get right. All of the scandals we have seen like Mid Staffordshire Hospital (where, put simply, a lot of patients died unnecessarily because the hospital was poorly run and the leadership refused to acknowledge concerns) can be explained in terms of bad governance.

 

How good governance can be applied is poorly understood. Governance is not a tool in an arsenal of weapons that you can apply to this situation or that; and it is not a stage in a process. It is in many ways more a state of mind - it should pervade the culture of an organisation and inform any activity or decision.

 

I'll bet your bosses are very careful to keep good records or make a note of something when things look a bit dodgy, or they apply very high standards of behaviour when things have gone wrong and a situation needs rescuing. I'll also bet conversely when things are going well, or seem to be going well, they are very lackadaisical and almost laissez-faire in their approach.

 

That’s not really good governance; they should be consistent behaving in a way that means things are less likely to go wrong, and if they do very little special effort needs to be made to put things right. Part of this helping people take responsibility and crucially are empowered to take actions. Too many projects, especially in the public sector, devolve into politicking where so long as no-one can be blamed, and no-one's sense of entitlement is offended, it will be OK.

 

That's tough to deliver, especially from the ground up. I strongly insist with my employers that my role is NOT to do bits of other people's jobs they don't want to do; or to charge in to rescue people when things go wrong.

 

That isn't enough of course. There is still that traditional approach of governance being a basket of unloved virtue and you are expected to be the keeper of those virtues in order to let people get on with important stuff; and you get let out of your box when they need you - particularly when things get difficult. That's especially important because of that sense of entitlement.

 

Let me illustrate:

 

Project Manager: "I need access to patient data to do finish this well-advanced project"

Governance lead: "Sorry, but without a clear legal basis for having it I can't give it to you"
Project Manager: "But without it my project will fail"
Governance lead: "I can help you work out what you need and the best legal route for getting enough information to help you deliver your project even if the scope needs to change a bit"
Project Manager: "Oh that would be great, thanks"
 

All reasonable. Except the two parties now have two different understandings. The Governance Lead thinks the Project Manager will work within a system of information governance to manage his project properly. The Project Manager thinks the Governance Lead will make it OK to have what he wants. Uh oh.

 

What should have happened is the Project Manager should have talked to the Governance Lead when he was starting his project. It’s the job of the Governance Lead to make that happen – automatically if possible – but ideally without putting bureaucratic chains around getting things done. 
 

Tough job. I’ll let you know when I start getting it right!

Wet February, sunny October

I know we’re not that far into the year, so the Christmas break should still feel relatively recent, but the truth is I really feel like a holiday.

Husband and I and haven’t really done big holidays over the last five years. Christmas is (his) family, which can sometimes be a chore. If we go abroad we usually need to consider visiting my family. We’ve been to Paris a couple of times and we’ve had our lovely honeymoon in August just gone.

The last time I went abroad for the sake of it was with my ex, but that was right at the start of our relationship and it turned out he was embarking on an affair with me behind his proper boyfriend’s back (it’s complicated – he said they were finished, then that they were in an open relationship, etc – strung me along for a while. I was fine with it and wasn’t monogamous when with him either but that was then).

So…. Well, it occurred to me that Husband and I should bite the bullet and have a nice holiday somewhere sunny this year. Admittedly, late this year but still. Hire a villa, hire a car, and here we come sunny Corfu. In October. YESSSSSS!!! 

There are lots of reasons why not: we’re looking to buy a house so need to save every penny for deposit and the horrendous costs involved. I loath flying to a degree difficult to comprehend. We’ve never gone in for lazing around in the sun. 

Nevertheless, I was really taken with the idea and I think we deserve it. We work hard and between the saving for our civil partnership, and the saving for the much talked about house-buy we’ve not gone for extravagance much. Plus Husband really loathes his job so anything that helps keep us both sane will be good.

We already have a short break in April with friends, on a canal boat of all things. It will be great fun but again it’s not the same as the two of us on a break of our own.

Another things is this holiday is a good excuse to continue on my diet! I want to enjoy that infinity pool stark bollock naked and I wouldn't do that in my current frumpiness! Since the end of Dry January I have put on a little weight but in January I lost 8 lbs so I think wet February is going to have to become damp at best - all in a good cause.

Email to UKIP

Today Pink News published this article. Suffice it to write that I found it so galling I felt I had no option but to send my own comments to the subject of the story. I have posted it below.

Dear Councillor Silvester,

I am writing to add my voice to what must be by now a loud chorus of opposition to your published views on the cause of the recent floods that have affected some parts of the country. Frankly, it simply beggars belief that you could exploit human misery to attack a minority. You complain about crocodile tears whilst performing two acts of cowardice in one. You seem, unaccountably, to have ignored the fact that opinions must be informed.

So, let us consider:

·       This country has a strong recent history of flooding that goes a lot further back than any link with the fight for equal rights for LGBT people. What caused the floods of 1953, for instance, when (put very simply) homosexuality was illegal?

·       Many countries around the world have enacted equal marriage for same sex couples. Please could you set out the humanitarian disasters that have affected these countries? I am unaware of them – and I avidly follow the news so it is remiss of me if I have somehow missed them.

·       There has been widespread reporting for many years around the risks of building on flood plains, the dangers posed by global warming/climate change etc. Are you going to blame that on the gays as well?

·       You comment on a petition, 600,000 signatures strong, against equal marriage. Well, you ignore the tens of millions in favour. Why?

 

I could go on but suffice it so say I do feel you are very much putting yourself forward as a standard bearer for this nation’s greatest affliction – a staggeringly uninspiring generation of local and national leaders who have nothing to contribute and can only blame the manifest problems we face on scapegoats and easy targets. We have real problems; if you can’t help, and are incapable of making things better, then get out of the way. You should not put yourself in the same political spectrum as radical Muslim fundamentalists, fascists, and tinpot third-world dictatorships.

 

Finally, and this is a message for all your party: if you single out a group of people to point fingers at and call names then you will never have their votes. Consider the wisdom of alienating millions of LGBT people who, because of the struggles they face, are far more likely to vote than the average voter. Make no mistake, that is us, voters, taxpayers, citizens too. The same as and equal to you in law and before God. We are also sons and daughter; brothers and sisters; uncles and aunts; nieces and nephews; employers and employees; volunteers and church goers; and great companions to our many friends. How else can we respond to these attacks with our own voice –  ceaselessly reminding to all of the many people we know and love never, ever, EVER to vote for UKIP. Because of the way that you have behaved.  

I don’t expect a response. I am confident you will not even read this far. I do hope, however, you will learn from what I suspect is a lot of negative feedback about your article and adopt a more rational tone and some political sensibilities in your future conduct.

 

Regards,

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?

Dry January

Five days in and all is well so far. It’s not a huge amount of days compared to a whole month but a couple of important milestones have been passed.

The first weekend has been got through without any hitches. Normally I would enjoy a small sherry or two (by that I mean my favourite tipple of a glass of dry white wine or three) of a weekend at home so it was a bit unusual to consciously choose not to have one when, frankly, I was in the mood. However, I persevered and feel all the better for it.

Secondly, my first night out with friends in 2014. Now, most if not all of my friends are not unafraid of spanking it hard so I was a little apprehensive for three reasons. Temptation; the chances of enjoying watching half a dozen people get a bit tipsy; and not being on my most scintillating form. However, I surprised myself on all the counts and I very much enjoyed myself to the point when I got home rather later than I had intended.

Why am I so keen and anxious about sticking to my guns on this one? Well, the truth is my love affair with ethanol has been a passion that has lasted more than 20 years. I’m not talking about getting hammered each night for all that time but I’ve probably, on an off, been quite unhealthy in my consumption. This has in part led to a tolerance for the booze that leaves my spanking friends impressed.

Also, about 15 years ago, I was attacked in my home by an intruder and I started drinking at home as a way of calming my nerves, which can’t have helped.

Being someone who indulge his pleasures as and when, the long term effect has been weight gain and I will admit to having body issues that prevent me from doing things I’d like to do – meeting new people, buying nice clothes etc. Dry January will, I hope, get me down towards a trimmer figure.

The health benefits of this exercise are quite clear; but if you need any convincing I found this lovely diagram online recently.

 

I want me some of that action!

Then in February I want me a small sherry. But just one.