Public Health Leadership 2…on being useful

Helen Wilding, a colleague from Newcastle, kindly sent me an article on  preparing leaders in public health to work in a flatter and more distributed world. It’s a good read. And I think it chimes well with both my previous blog on this and the research I’ve been doing, summarised on powerpoint, for our public health leaders of the future at the University of Hertfordshire.

It prompted me to blog the learning I have had from a fantastic peer learning/mentoring set, which has now had its final meeting.  A small number of local govt officers with two private sector folk and some third sector people met every month to work through our strategy and challenges with each other. We did it quietly, and it worked. This, along with being asked by my boss to be the Sponsor from our Strategic Management Board on one of the new cohorts of our own LEAP leadership programme, have been amazing experiences.

The last two months we worked through the special feature on Influencing in the Harvard Business Review from July 2013.  Not what you’d think our usual reading but actually it explained

We each presented our challenge, our strategy and our ambitions for our services and there followed 90 minutes of critical and helpful feedback from our peers, once we had all read (before attending) and then spent 90 minutes discussing the section and especially a really good article on how experts gain influence by Annete Mikes et al (HBR,July/August 2013,pp 71 – 74.)

Members and senior officers often say to me that if all Public Health does is commission what it did in the NHS and no more then we have missed the biggest opportunity in over thirty years. I agree. The big question is, given how small public health functions are, how do we influence across big organisations and wider stakeholders and partners effectively?

We’re not the only ones facing this dilemma. Auditors, housing staff, lawyers, safeguarding, HR, equalities and facilities people all face similar challenges. So we fell on this article with interest and worked through it to see what we could glean.

Time Four Ts: the four competencies of successful expert influencers

Basically, the article looks at some financial institutions and suggests that experts (like lawyers, public health people etc) are good at gaining influence by using four competencies, all starting in T:

  • Trailblazing – finding new opportunities to use expertise
  • Toolmaking – developing and deploying tools that embody and spread expertise
  • Teamwork– using personal interaction to take in others’ expertise and convince people of the relevance of your own
  • Translation – personally helping decision makers understand complex content.”

Those most effective, unsurprisingly, were those experts able to combine these four competencies into useful products and outcomes for others in the organization.  In other words – they added value.

The opportunity for Public Health from this model

This strikes me as a key opportunity for public health, because this kind of stuff should be tailor made for us. But I so often heard colleagues in the learning set and people not in the set but in an outside public health in other areas talk about how public health is not influencing, isn’t getting purchase or indeed is seen as having lost its way or “advising not helping.”

But there is a another side needed to this model

But one thing our learning set reflected on, was on how to be effective in doing this, you really need to get yourself inside the head and mind of the organisation you find yourself in. One of the things we all had in common was that each of us had had a great and clear boss who knew what they wanted, some training or mentoring on specific things, things, knowledge and content about our sector which, in combination with leadership training, made us essentially “armed” with a clear sense of what we needed to achieve and a very clear sense of the tactics, mechanisms and tools we needed to get there. (Hence my working with others to co-produce a strategy, bringing in a four engines of public health model,  identifying the existing system leaders [my amazing partners] and getting work going with partners.)

Armed and dangerous in local government?

I was lucky to go on a series of introductions to local government constitution, finance, procurement and law over the past few years. I was also lucky to go on the Public Health Leadership Programme. And my doctoral studies group is immensely helpful in helping me work through the technical challenges of projects (what do I do about physical activity? What works?) and the tactics of getting it done.  There is a blend I am trying to get to of the science of public health and the art of getting it done.

Leadership programmes for Directors of Public Health are coming, which is great. Colleagues at the Local Government Association will also tell you about the Commissioning Academy and the LGAs own productivity and leadership opportunities. Not many DsPH on these so far, it seems. This will do one facet of helping and supporting us.

To do my small bit towards some of the other stuff (content, mechanisms, tools) I’ve been really luck to work with the good folks ADPH, LGA and LFPHWM to create the first two of  what I hope will be a small series of events to help DsPH become “armed and dangerous” – the rough guide/ boot camp introduction on local government law, one in London and one in Birmingham. These two law seminars are being offered pro bono by two senior local government partners of Bevan Brittan, a law firm which has a justly good reputation. They saw the opportunity and the need immediately when our lawyers approached them, and I have to say I have been impressed by how Bevan Brittan, Herts CC lawyers, and the indefatigable trio of ADPH, LGA and LFPHWM have seized this.

So, what did I learn about the four competencies?

I learned obviously that you need both sides of the coin – the four competencies and the “armed and dangerous” stuff.  On the four competencies I learned enough to create four objectives for my next year’s work. Some of this I am still planning.  I also learned enough so that my Monday early morning “what am I doing this week?” and my Friday evening “how did I do this week?” reflections have changed to incorporate these, and I have used them with some of my team.

Immediately, here are some of the things we have done and are doing:

  • Trailblazing – finding new opportunities to use expertise – applying public health skills to the JSNA, the health and social care integration agenda, helping spread behaviour change tools across the organization, and improving the health of children and older people – these are just some of the opportunities we are trying to deliver
  • Toolmaking – developing and deploying tools that embody and spread expertise – developing easy to use guides to finding and using evidence, running roadshows and helping people be confident in using it,  easy comparators to compare local areas on health outcomes. We need to do more. Pathways and tools for health across the lifespan (early intervention on self harm and mental health, for example) need to come
  • Teamwork– using personal interaction to take in others’ expertise and convince people of the relevance of your own – we get better results when we do this. For example, countryside walks funded by public health are being run by the countryside management service. Who better?
  • Translation – personally helping decision makers understand complex content – an easy guide to public health, explaining what it means, explaining what can be done.

This is just a snapshot. Essentially the whole public health strategy is an exercise in trying to be useful not just commission exactly what we commissioned in the NHS and no more.

And it also reminded me that being useful needs to understand the context one is working in, so that I can understand not only what is useful but how it can be useful.