a view from the coal face
I've worked at Connecting for Health for a few years now. My observations from the coal face are thus:
- Permanent staff are not always managed properly e.g. many don't have annual objectives or development plans. There are many hugely skilled CFH staff but their efforts are not always formally recognised. A culture of absenteeism and "flexible" working has developed with the result that attendance is not managed properly if at all. Together, these things serve to erode the enthusiasm and commitment of the very members of staff CFH should be trying to retain / keep motivated.
- CFH represents a very difficult operating environment for permanent staff and suppliers. Clinical leads are often constructive, insightful and supportive but this is not always the case. It's hard to engage some clinical leads due to their busy diaries and trips to conferences overseas with the result that programme teams don't always get the input they need when it's needed. This results in assumptions being made by people who don't want to see programmes slip any more and Clinicians in the NHS sometimes slating people's best efforts when they've tried to keep things moving in the absence of timely input from subject matter experts.
- There's too much complexity. The scale, ambition and delivery timetables for programmes means that it's often difficult for CFH staff (and suppliers) to get definitive answers to questions. This can lead to confusion and a reluctance by suppliers to do the right thing where doing the right thing significantly increases their delivery schedule and the associated costs.
- The plurality in the provider / supplier model leads to inefficiencies. Work packages are given to different suppliers and new teams each time. This means that time is wasted getting new supplier teams up to speed on basics, when retaining suppliers / teams that already have the basics would ease the pressure on CFH staff and reduce risk of non delivery.
- CFH often itself overlooks the challenge of the programmes being delivered. CFH staff (and most of the time its suppliers) work very hard and seldom get any recognition (not least due to the constant slating in the press). CFH could help by making more of a deal out of the CFH permanent staff who do a great job in often very trying circumstances. The leadership of CFH is strong, but not always visible - this would also help matters.
Here's what I'd do:
1. Implement proper annual objectives, line management and attendance management. There's too much sickness absence, coming in late, going in early, or in some cases, just not turning up at all.
2. Clinical leads need to be better managed and work the same days each week.
3. CFH needs to manage knowledge better for the benefit of staff and suppliers
4. Look at the way suppliers are engaged / managed / integrated into CFH programme teams
5. Get the CFH leadership team to celebrate success and individual achievements more frequently.
n.b. Paris - because she'd brighten the place up a bit and give us all something to laugh at.