The Stroke Association, servant leadership, and Transformation

1. The Stroke Association, servant leadership, and Transformation Cass Business School Master class Lecture 21 April 2010 Jon Barrick

2. Management styles…only last week…. • “A new survey of 5,000 staff highlighted the three most common management styles within UK workplaces as: • authoritarian (21%), • bureaucratic (16 %) • and secretive (13 %). • Only 10 % describe their bosses as accessible • 7% per cent think senior staff within their organisation are empowering.” 50% Chartered Management Institute survey April 2010

3. Openness, Transparency, key characteristics of the servant leader • Understanding followership • People first • Accountability and responsibility • Foresight • Strength • Openness to Knowledge • Entheos

4. From Robert Greenleaf “servant leadership” Superior, most productive organisations “Are those where there is: • the largest amount of voluntary action, people do the right things, things that optimise total effectiveness, • at the right times- • because they understand what ought to be done, • they believe those are the right things to do, • and they take the necessary actions without being instructed .”

5. Where were we 5 years ago? • 337th in charity rankings • Below 1% prompted, and 42% prompted awareness • Never been in Britain's most valuable charity brand list • A place where people started charity career then moved on • The England and Wales bit left over from the breakup of Chest Heart Stroke in 1991

6. 2004 Challenges • Needed Government and public to take notice of Stroke being number 1 cause of serious long term disabilities, which is also the 3rd biggest killer • Senior Trustees wanted to be UK wide • Senior Trustees wanted big improvement in Stroke Care • Senior Trustees wanted more funding for Research

7. Positive Resources • Stroke Experts were supportive • Fantastic Chairman and grouping of good Trustees • 320 staff • Networks with other organisations • Reserves, financially solvent • Regional structure, • Good reputation for research • Provided services to 1 in 4 stroke survivors • A cause that was crying out for attention

8. Tactically to achieve dreams; • Would need everyone in and around the association to work collectively and to a plan. • Would need bigger mass than the Association alone to drive improvement • Would need to raise profile of stroke as a prerequisite to a leap forward. If we could do above then would have competitive advantage over slow , silo working, bureaucratic organisations

9. People First • “Would need to ensure everyone in and around the association was working collectively and to a plan”

10. Good People want great purpose and meaning • followers follow because leaders serve a purpose for them. The essence of servant leadership is to understand that and engage on that basis • leaders serve followers • Google search found; Leadership 108 million references Followership 117,000 • Great leaders deliver because of the quality of followership

11. Followership • Followership can confer or withhold the power to act • All are leaders or followers at different times in the process we had to unite all people in the association in a unified vision around a radically different culture. • Without these changes the other huge issues would not be addressed.

12. People first? • Get everyone to understand their importance • Get everyone to understand their part to play in the big scheme • Get success underway • Get Trust growing • Make it personal, values….

13. What do we want from others, respect • To be heard and understood • If you disagree don’t humiliate me • Acknowledge my possibilities • See that I act from good intentions • Give me feedback , the truth, with compassion

14. little training and development, only 30% of people had appraisals, pay and rewards were in the lower half of charity salary ranges, no colleague consultation mechanisms, Progress by leaving loose teams or no teams in place some staff felt out of control of their own situation No clear collective goal 100% Appraisals Pay and rewards moved to above average Meaningful colleague consultation underway Success means more talented people wanting to work for us, sickness and turnover figures consistent downward trend Staff conferences Staff newsletters CEO blogs and emails Centrality of team Celebrate success

15. People First • Passion and right values. Value driven organisation, value driven people. • It’s not just a job, there is a spiritual refreshment in each achievement towards the goal. Many colleagues had this sense of passion and strength, but it wasn’t something that was talked about or seen as a primary competence or factor in the organisations calculations about recruitment or promotion. • Disempowering cultures

16. Arrogance Not facing the facts, believing you are right and everyone else is wrong yet again Melodramatic Flamboyance and style, you need to be the centre of attention Volatility Mood shifts are unpredictable Who’s going to turn up today Excessive caution you’re afraid to make decisions – churn instead of movement Awful leadership Behaviours From “Why CEO’s fail”, Dotlich and Cairo, publisher Jossey Bass

17. Distrustful The world of us and them, the leader focuses on the negatives Aloofness Disengaged and disconnected. Don’t show weaknesses. Leave others to deal with conflict Rule Benders Taking pleasure in provocative ideas, think rules don’t apply to them and usually don’t see through plans. Mischievous Eccentricity A workstyle to be different for the sake of it, refusing to collaborate in expected productive manner, confuse and confound others with your approach

18. Duplicity Private agenda, Public illusion. What you say is not what you believe saying one thing publicly and doing another Perfectionism Focus on small detail and don’t grab the big picture Mr Popular No backbone, aiming to please. So flexible no one knows where you stand, or consequently where they stand.

19. Everyone working collectively and to a plan • We united everyone around our compelling reason for being, our cause - consultations on Vision, Mission, • Open Transparent plan and open consultation, with performance expectations • New Processes and structures to enable transparent organisation

20. Reinforcing loops • Delivered some quick wins related to colleagues suggestions • Feedback on progress of plans and discussions (Incl Balanced scorecard) • Stress Unity across the association • The psychological distance from top to bottom shortened • Created teams where before they hadn’t existed

21. The glue of Trust has to be earnt • Hard to be a servant leader if there is no trust • The glue between leader and follower • The glue that enables people to be followers and also leaders at different points in the delivery cycle • The glue that enables difficult discussions to happen, be resolved, and to grow people stronger in the process

22. 4 dimensions of enabling trust as a leader • Likeability- which arises from humour, vitality, caring, kindness, sensitivity, personality, warmth, compassion, fallibility, • Personal Power- which arises from self confidence, charisma, appearance, self control, ruthlessness, authority, personal positioning, gravitas, presence • Capability- Good Judgement calls, relevant knowledge, dedication, track record, reliability, experience, wisdom. • Respect - which arises from courage to pursue the right thing, integrity, honour, loyalty, honesty, clear understandable values. Framework developed by the Leadership Trust

23. Rules Information Process Known Hidden self knows but hides from others Open to others and to self The Johari Box Self Unknown to self, to others Blind to self but others know Disclosure Unknown To Increase interaction increase the open and shrink the hidden. Have to seek feedback to shrink the blind box. To shrink the unknown have to try new things, or expose status quo.

24. Rules Information Process Known Open to others and to self The Johari Box Hidden Self Disclosure Unknown Unknown Blind To Increase interaction increase the open and shrink the hidden. Have to seek feedback to shrink the blind box. To shrink the unknown have to try new things, or expose status quo.

25. Trust, Systems thinking • Instead of individual blaming look for the fault in the system • root cause detection will show up links and loops to other parts of your work system • solutions lay in developing fool proof systems and enhanced team play • consideration and dialogue between teams and alterations to assumptions and systems.

26. Expressing Love, support, affection • Time, • Touch, • Gifts, • Tasks, • Talk

27. Accountability and responsibility • leaders should think, speak, and act as personally accountable to all who may be affected by your thoughts, words and deeds • THINK Power relationships turned upside down, altered, • the leader is answerable to the followers

28. Making leadership accountable • Not only to Trustees • Directors roadshows • Open door policy • Walking the floor • Visit every place in the UK once a year • Try to create feedback opportunities • No duplicity, walking the talk

29. Foresight and Strategy creation • The ability to see and grasp future events • The failure of leadership, is the failure yesterday to foresee today • Failure to prepare for future scenarios constrains options , often leaving only the power to command, forcing choices between bad options. • Foresight is the central ethic of leadership

30. Foresight and stewardship • Had a 5 year plan, because people had the right to see the big picture, needed to be able to grasp the final objectives we were striving for • Understood the way change now would result in future progress • Longer term timeframes engender purpose and security in change • Failsafe built in of review at 2.5 years

32. Building mass, enabling stakeholders to work together • United all stroke care professional bodies, and patient organisations in a coalition, the UK stroke Forum.

33. Building mass by putting beneficiaries at the centre of what we’re about. • Growing service quality and reach to stroke survivors and their families, in direct face to face support. • Campaign supporters network • Media Volunteers • Users given 50% of the say on research project selection

34. Building Mass through partnerships and coalitions • Aphasia alliance 12 organisations • Stroke Club affiliation 350 organisations • NAO, and DH officials • Campaigns with other charities, Professional stroke care associations • Uniting the Stroke Care world to achieve National stroke strategies (a stroke plan in Wales) in each of the 4 UK countries • Stroke Alliance for Europe, SAFE • Stroke Survivors and families

35. Need to raise profile of stroke as a prerequisite to a leap forward. • Broad 3 stages over 15 year period PR plan • Get the public and decision makers to be aware of stroke and that something must be done • Next sequence is to show something is being done and progress is now being made • Following sequence to show that battle is being won

36. Servant Leadership as a model, further reading; • Robert Greenleaf, The Servant as Leader • Larry Spears ed, Reflections on Leadership • James A Autry, Love and Profit, the Art of Caring Leadership • Ken Blanchard, Leading at a higher level • Peter Senge et al , The fifth discipline fieldbook

37. We want a world where there are fewer strokes and all those touched by stroke get the help they need.

38. All these things that we have done The Stroke Association 2004 to 2010 With many thanks to Jo Fisher

39. 2004: Low awareness of stroke • A stroke is a brain attack • It can affect anyone of any age • Number one cause of severe long-term adult disability • Soon to become the second biggest killer in the World

40. Around 150,000 people have a stroke each year in the UK • Each year about 35,000 people will die • About 38,000 people will be severely disabled

41. But stroke is preventable and treatable…

42. 2004 • We need fundamental change to drive improvement in stroke care and research

43. Our aim is for stroke to be talked about and treated as of equal importance to cancer and heart disease

44. 2005 General Election: A chance to raise issues of poor stroke care and low awareness

45. We said: Take notice or people will die or suffer unnecessarily

46. It’s the money…National Audit Office report, November 2005 • Our networking pays off • Deemed “the most damning report on a health issue” • Makes the Government take notice

47. Christmas comes early: Winner, Medical Charity of the Year2005 Fundraising abseiler

48. 2006: Building coalitions • We work with others to grow in strength • We team up with Different Strokes to show how stroke affects people of working age

49. We create the UK Stroke Forum, a coalition of 27 organisations, to advance stroke research and care Association of Chartered Physiotherapists Interested in Neurology  ,   British Aphasiology Society  ,   British Association of Stroke Physicians  ,  British and Irish Orthoptic Society  ,  British Psychological Society  ,  British Society of Neuroradiologists  ,  Chest Heart Stroke Scotland  ,  College of Occupational Therapist Specialist Section - Neurological Practice  , College of Paramedics ,  Connect ,  Different Strokes  ,  Education for Health  ,  NHS Stroke Improvement Programme ,   National Stroke Nursing Forum  ,  Northern Ireland Chest Heart and Stroke Association ,  Northern Ireland Multidisciplinary Association of Stroke Teams ,  Older People & Ageing Research & Development Network (OPAN Cymru) ,   Royal College of Physicians ,   Royal College of Speech and Language Therapists  ,  Scottish Stroke Nurses Forum  ,  Society for Research in Rehabilitation ,  Speakability (Action for Dysphasic Adults) , The Stroke Association  ,  The Tavistock Trust for Aphasia ,   UK Stroke Research Network,UK Swallowing Research Group

50. After 4 conferences has grown to become the biggest multidisciplinary stroke event in the world