Weeknote: 11 to 15 March 2024

What did I enjoy?

A long but rewarding day on Wednesday. I got the early train to London to discuss shared objectives with my colleagues in the new NHS England Product and Platforms senior leadership team. Each of us has our own portfolio-specific objectives for 2024-25, but in this session we focused on the things we need to move forward together across our whole team of teams.

I got back to Leeds in time to join leaving drinks with Marc, who is taking up a top job with an ambulance trust. I’ll definitely miss Marc’s calm and decisive approach, but he leaves a great team who I’m sure will keep up the good work.

What expectations did I set?

My colleague Helen and I spoke as part of a panel discussion in a new NHS England Transformation Directorate leadership forum. The theme was “boundaryless teams” and we used the opportunity to explain to our colleagues in the wider directorate how we have implemented a multidisciplinary team model in Product & Platforms, aligned around shared outcomes.

I reflected that working this way means I don’t have direct line management oversight of everyone who works on my portfolio, which makes me dependent on the choices of other leaders. That vulnerability will be worth it if we benefit from the combined strengths of the specialist functions, such as clinical and data, who committed during our organisation design process to embed their people in our multidisciplinary teams.

What was hard?

The cognitive dissonance that I mentioned in last week’s note continued unabated. This week my team faced extreme uncertainty about our ability to sustain vital live services beyond the end of the financial year. I understand that there are business processes to work through but in one case my desire to assume positive intent in the teams that are here to support us was stretched to breaking point. Reviewing a case that had been stuck at a preliminary approval step for a number of weeks, I concluded that, despite the best intentions of the people operating it, one particular part of the new NHS England’s set up needs a complete reset. I will pursue that next week.

What did I learn?

I felt a lot better after reading this paper by Janet Vertesi and danah Boyd: The Resource Bind: System Failure and Legitimacy Threats in Sociotechnical Organizations

Referring to case studies from the US Census Bureau and Nasa, the authors find that:

“the very mechanisms put in place to perform efficiency toward agency stakeholders in many ways continue to undermine that same efficiency, making true savings increasingly difficult to achieve”.

What do I wish I could have changed?

I had a tetchy email exchange with a colleague that would have been better as a conversation. Ultimately we’re trying to achieve the same goal but seemed to have quite different assumptions about our roles in making it happen. Hopefully I can make amends next week.

What would I have liked to do more of?

Much FOMO when seeing colleagues’ LinkedIn posts from the Digital Health Rewired event. I’d have liked to have been there, but given my team’s escalation of a number of issues I couldn’t really justify being out of the office.

What am I looking forward to next week?

I really hope that some of the issues that have been escalated are resolved early in the week so we can lower the anxiety in the team and focus on what we’re here to deliver for patients and frontline staff. The Easter weekend is a time when the urgent and emergency care sector needs its digital services to run smoothly and without drama.

I’m also treating myself to an afternoon outside my organisation thinking about the longer term (out to 2040!) future of digital in the UK.

PS – I was flattered to be included as an example in Giles’ brilliant new guide to doing weeknotes. I got the questions I ask myself from Sam Villis’s ‘weeknote styles‘ post, so it’s great to see that linked to as well. Also a shout out to my boss’s boss John Quinn whose internally published weeknotes are helping colleagues through a long-drawn-out and often frustrating post-merger integration process.