Picture everyone in the NHS with 'strategy' in their job title. Now imagine picking them all up and removing them from the NHS, all at the same time.
How long would it take for anyone to notice they were gone?
Some people are cynical about strategy – much more so than other NHS functions. We don't doubt how quickly building maintenance staff would be missed, or receptionists. But strategy...?
I'll skip to the end. I'm a big strategy fan. It's what I've done in a range of not-particularly-popular organisations (Department of Health and Social Care, Care Quality Commission and more), and what we now spend a lot of our time doing at Kaleidoscope, a social enterprise consultancy bringing people together to improve health and care.
I think strategy is key to the future of the NHS. Having a clear direction, rooted in purpose and values, and with people and resources aligned behind it, is an essential part of being a high-performing organisation. This is especially the case now as local authorities and a plethora of NHS bodies grapple with how they work together as systems.
Developing strategy is a chance to have – highly energising – conversations about where an organisation is going and how it can learn from its past.Strategy and Engagement Expert
But I have sympathy with the cynics. Because, let's be honest, strategy work, however well intentioned, can sometimes have little impact beyond producing a document. In our work with a whole host of trusts and integrated care systems we always start by asking for people's past experiences of strategy. It's uncanny how common the stories are: decisions ducked, expectations dashed, too much happening in darkened rooms, documents forgotten as soon as they're PDF'ed.
There is a better way. And it's a conversation I'm looking forward to being part of at the NHS Providers Strategy Network event on 22 September (if you're a member, do join us.)
For me, the answer comes in two parts:
It starts by focusing as much on the process by which strategy is developed as it does the output. Developing strategy is a chance to have – highly energising – conversations about where an organisation is going and how it can learn from its past. This presents a rare opportunity to involve as many people with a link to an organisation as possible: staff and communities, patients and partners, friends and foes.
In our work, we've seen this generating huge cultural, as well as strategic benefits. For example, we've seen big increases in staff engagement at Oxleas NHS Foundation Trust, while Imperial College Healthcare NHS Trust have used strategy work as opportunity to demonstrate the values they care about, showing how they want to be in the future by acting like it now.
So if not 'strategy' what's a better alternative? Why not start at what strategies seek to achieve: organisations which are more resilient, more equipped, more agile in order to meet their purpose in an ever changing world.Strategy and Engagement Expert
But this points to a second, somewhat deeper, point: maybe it's time to rebrand strategy all together. That the very way we talk about strategy leans towards a model which has served its time.
Without turning this too much into a Greek lesson, the word strategy comes from strategos, meaning a general in command of an army. It's a concept based on seeing the future as something which can be predicted and controlled, with your people as pawns to be deployed in a set pattern. That's simply not the world we live in. The future is not predictable, change is a constant, and healthcare is as people-centric, as deeply human, an industry as they come.
So if not 'strategy' what's a better alternative? Why not start at what strategies seek to achieve: organisations which are more resilient, more equipped, more agile in order to meet their purpose in an ever changing world. While 'director of organisational agility' may struggle to fit on a nation's worth of NHS name badges, it's a better way to think of the necessity of strategy to the NHS each and every day.
Rich Taunt is part of Kaleidoscope Health and Care, a social enterprise consultancy that brings people together to improve health and care. Find out more about how Kaleidoscope works with NHS organisations to develop strategy that works.