Alwen Williams, CEO, Barts Trust.
The last NHS chat with young Roy Lilley of 2017. And what a fine send off the year had.
Alwen is patently well suited to her role, and has most definitely inspired me. She was calmness personified under the usual Lilley onslaught of contentious questioning. I especially enjoyed her almost complete blanking of “so what does a Chief executive actually do?”. Ignore impertinent questions! Not a bad start…
37 years in NHS. Barts trust will be her last job, she said. Lived in East London all her life; honoured to be involved in making the most important local employer better. Been through all the “reforms” from Griffiths, to Lansley, to Austerity. After languages at uni, decided it wasn’t for her. Looked for management training scheme, and found the NHS one suited. Been in operational management for a lot of her time in the NHS. Her first contentious statement. Which I totally agreed with, (as did Roy…Christmas love-in?), was when she said most of the reforms only created change at the margin. So all that messing about, like getting rid of RHAs, competitive tendering, FPC becoming FHSAs morphing into PCTs then CCGs , with a soupçon of fund holding…only had effects at the margins. And I bet 5% of the budget went on management consultants fees to try to explain to everyone what was going on! It doesn’t really work…
In NE London and The City, she was there when 7 PCTs were amalgamated, and she was the overarching boss. Sorry, accountable officer. It was a bit easier to be strategic, when at least the NHS boundaries were co-terminus with the local authorities…
“Having an Internal Market is not the panacea for service improvement”. Alwen quietly kept hitting us between the eyes like that. I guess her teams know this already. Not a quiet assassin. Just a highly committed people person.
Roy asked her more about what she did and how she did it. Deep seated core values just flooded out. Here’s a flavour:
- They have 200 leaders in their trust. These can be Chief Execs or Porters. All equally important.
- The leaders need to define the needs of the organisation, then make that happen.
- There has to be continuity of purpose, and everyone needs to know it, live it and share it
- “I make sure I have great people around me” It is simple isn’t it? Simple to say, but hard to keep doing…
- You need to pay attention to what staff are saying, and act on it
- If you espouse Safe and Compassionate as your core reason for being, you have to recognise it, do it, support it, laud it, praise it and kick out those who can’t or won’t do it! (I added the past bit. always is too polite to say that!)
- You have to nurture and develop people. Not command and control. No Ivory Tower.
- Everyone is respected. There is no hierarchy espoused. Everyone is as important as each other.
- Leaders set the direction
In the end, it was all about engaging the staff. Operational imperatives emphasised this, for me. Like the following:
- Make joint appointments so that the prestige St Barts post also had sessions in difficult to recruit parts in their area.
- Whistle blowing – encouraged and protected ( and I assume vindictive claims equally stamped on?)
- Have a great Occupational Development team, to make sure the big conversations happen.
- Move away from Agency cover to home grown Bank cover. (Please, steal this idea, everyone…)
- Huddles – for specific communication purposes. Like, Safety: or Cyber Attack coordination (which she says she never wants to live through again…which is very understandable.)
- Take your services to the people…don’t make them travel miles to you if they are ill, infirm or very worried.
16000 staff and 2.2 million people covered in the area. It feels big. It feels very accountable.
It feels in good hands. Calm and effective.
Gives you a bit of confidence, and a lot of pride, yet again, in the standard of leadership we witness within the NHS. I’m smiling whilst writing. There’s no need to grieve for our NHS yet.
If you missed the chat, you can view it by clicking here
Soft Skills for Hard Times 
Excellent Roy.
True leaders are those who love people and get the best out of people. For them fairness means a lot and they inspire, motivate and get the best out of people.
Great leaders are with great experience and learn every day and they are clever and they see what others do not see and they inspire, motivate. They are the role models and always stay true to their values and they smile often and have self confidence and self belief and they create great team and they win.
Good leaders know their purpose and it is their purpose which drives them to do what they do.
I have no doubt Alwen will turn around Barts but what about rest of NHS? Sadly NHS has management driven culture where they focus on targets and focus on finance and put staff under pressure.
Culture of bullying is very common and this creates poor team working and many staff are frightened to speak up and those who speak are punished, disciplined, bullied and harassed.
BME staff face huge amount of discrimination and differential treatment. Bullying, blame, harassment, victimisation is common in many Trusts. This results in poor team working and patients are put at risk and patients staff and NHS suffers.
In 2010 I joined Wrightington Wigan and Leigh FT as the Medical Director and with the help of amazing staff, the Trust Board, wonderful doctors, nurses, GPs, CCGs and Mental Health and Community Trust and the CEO, transformed the Trust.
By 2016 there was 90% reduction in harm to patients, the Trust received 45 awards and for staff happiness the Trust which was bottom 20% in 2011 became the 3rd best place to work in the NHS!
NHS needs good leaders like Alwen from top to bottom. NHS must have more clinical leaders, need good medical leaders and needs good accountability. NHS must create a culture of staff happiness and must get inclusion and diversity in leadership right and NHS must learn how to hold bullying staff in to account.
NHS staff are being bullied by doctors, managers, nurses, midwives and also by Board leaders and no one has been held to account!
I am happy to be interviewed and tell what is wrong with our NHS and how to make it safest and the best NHS and social care.
Simon Stevens needs all of our help and support to make NHS and social care the safest and the best and only clinical staff can do it by working with patients, staff and public of this great nation.
Thank you, Umesh – I write up the summaries for Roy’s health chats on this site – and agree with a lot of your comment. Thanks for taking the time. Phil Hawthorn