Outstanding leaders must be positive and confident

Outstanding leaders maintain a positive, “can-do” sense of confidence, which enables them to be shapers rather than followers, Elaine Way, Chief Executive of the Western Health and Social Care Trust (Northern Ireland) told a packed HMI West Forum in An Clochar, Ballyshannon, Co. Donegal. Maureen Browne reports.

Elaine Way
Elaine Way

“In a challenging environment, you require resilience, you need to maintain your composure in adversity, manage relationships, be loyal to your staff and draw on personal support.   Managers have to keep a balance. Making judgments is the most important job of senior leaders and making good judgments is the most important part of this… It is Ok to make bad judgments in areas that don’t matter so much, but if you make a poor judgment in an important area then you have to question your ongoing ability as a leader.

“In a challenging environment, you require resilience, you need to maintain your composure in adversity, manage relationships, be loyal to your staff and draw on personal support.”

“I would list energy, enthusiasm, openness, communications abilities, resilience and self belief,” as the qualities which senior managers and leaders need.

“Those of us in leadership positions have to build upon success and learning in a broad range of varied situations.   Over time, grab opportunities for new roles and new learning. Quoting Shakespeare’s Hamlet ‘There is nothing either good or bad, but thinking makes it so,’ she suggested to the audience that it was not so much what happened but how people reacted to what happened which defined them as leaders. “I have learned that you should react with calmness and serenity. Don’t panic, get through the situation and learn from the experience.

“In 20 years as a Trust Chief Executive I think I have been through every imaginable challenge, and probably one of the most personally challenging was the withdrawal of acute medical services from Tyrone County Hospital in Omagh in 2009. That met with tremendous opposition at the time. However, some years down the road, we have a magnificent new hospital being built in Omagh which will be the model for community hospitals across Northern Ireland, with GPs working at its centre and with diagnostic and outpatient services, palliative care and step down beds.”

Ms. Way, who was speaking on “Leading Through Change, Changing My Leadership,” has been Chief Executive of the Western Health and Social Care Trust for almost 10 years. She participated in the graduate management training programme which fast tracks staff through management training into leadership positions.

She explained that the Western Health and Social Care Trust had responsibility for the delivery of all acute, community and social services for Derry, Tyrone and Fermanagh. The Trust serves a population of 300,000 people in three District Council areas and covers 17% of the Northern Ireland landmass. It has 12,500 staff and an annual budget of about 600 million pounds.

It makes sense for us to cooperate. It is more cost effective for the HSE in the West to buy primary percutaneous coronary intervention services from Derry rather than establishing a PPCI centre in Letterkenny.

“Our aim is to provide high quality, patient and client focussed services through well trained staff with a high morale. If we put client and patient at the centre of all our work, staff feel inspired and motivated, but their eyes tend to glaze over if you talk about meeting budgets! Evidence shows that if staff are happy at work, there are better outcomes for patients and clients.

“Every patient and client is entitled to fair access to high quality safe services. By giving permission to people working on the front line to improve their service, transformation follows.

“Part of my job is about creating confidence in the organisation. Whether or not the organisation can deliver cannot be down to any one individual. I can go to Belfast and try to get investment in our services, but if I don’t get all staff working with me, I will not make progress.

“Over the last decade, we have made great progress in the West with creating one organisation, one culture and we have a strong track record of performance, balancing quality and safety issues with balancing the finances. Quality and safety must always be the main priority. I cannot allow a patient come to harm because we are more concerned about money.

“I see part of my job as influencing Ministers and the Department about targets. There is not enough money in the system to meet every need and we have to be completely honest with the public that we cannot do everything and be honest about our priorities. One of the things which drives me is a real belief in integrity, openness and honesty.

“Everyone would like immediate access to health services. Demand in primary care in our Trust area is so high that it cannot be met with immediate GP appointments which results in people going towards hospitals for unscheduled care. In Altnagelvin, for example, we have had a 16% increase in attendances and we cannot cope with this without additional resources.

“The Trust receives 450 complaints annually and I read them all and sign every response. While some deal with deficiencies in the care of patients, the single most common complaint is delay in accessing services – followed by car parking!

“One of my main priorities at the moment is building further on cross border co-operation. We are the furthest West part of the UK and as such are vulnerable, as I think our friends and neighbours in Donegal are also, so it makes sense for us to cooperate. It is more cost effective for the HSE in the West to buy primary percutaneous coronary intervention services from Derry rather than establishing a PPCI centre in Letterkenny and it suits our Trust to have more patients coming through so that clinicians can keep up their skills. This is a win win situation for both of us”

She commented that she felt some of the new hospital groups in the Republic had particular difficulties because they had to relate to more than one Community Healthcare Organisation and there would have been benefit had they been co-terminous.