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Management books are full of advice on how to make decisions.
There's what's called a Five Step approach and another called a Four Step Approach.
Presumably that’s a bit quicker?
Not forgetting the Six ‘C’s, the Seven-Ways to decide and The Three Types, which for the record, are;
- strategic,
- tactical and
- operational.
Would you believe, there is a web-site; 29 Decision-making techniques for making effective decisions. I’ve had a look but I can’t decide what’s the best!
They’re all a variation on;
- Figure out if you have a problem in the first place; define it.
- What are the options you’re working with, think scenarios and generate alternatives.
- Stay open minded, eliminate the options one by one,
- go for it and most important of all
… explain what’s going on and be sure to include the people most affected.
The last bit is the most important bit. People have to trust decision makers. It’s not always the case that decisions can be made in broad-daylight but if a decision maker can make enough decisions transparently, they can acquire a reputation for being trusted.
Understanding how to make good decisions is often helped by a study of bad decisions.
Helpfully, NHSE has just provided an example.
Out of the blue they decided to axe the dedicated mental health support for hospital doctors, offered by the Practitioner Health Programme, which celebrated its 15th anniversary last autumn.
The service is the largest publicly-funded mental health staff treatment service in the world.
It costs £11m a year.
The decision came at a tender time.
Relationships with doctors are at an all-time low. Many NHS Trusts have been exposed as aggressive employers. Insensitive rota, poor on-call arrangements, catering, creche, parking, exam-fees, relocation and pay, all are piling up.
NHS management awaits the next round of strikes by the junior doctors. No doubt targeted at some cunning time to do the most damage.
For eleven million quid, which, in the scheme of NHS budgets is the price of a couple of beers at the local, it caused a bow-wave of aggravation across social media.
The roof came in!
No advance notice. No consultation. The decision was handled with all the deftness of a bin-man chucking the contents of your wheelie-bin into the back of his lorry…
...an announcement was dumped on social media.
Followed by a ham-fisted effort from the luckless Chris Hopson, NHSE's strategy guru, pretending PHP didn’t do much in the first place…
‘… The vast majority of this provision [he said] is, and always has been, via their employer’s health and wellbeing schemes.’
All the strategy of a fortune cookie and credibility down the drain.
It inspire other rows and commentary along the lines; if NHS mental health services are so bad that staff have to jump the queue and effectively be ‘sent private’, what about the rest of us?
The whole thing got out of hand and culminated, last evening, with the smell of burning rubber, the sound of screeching brakes, the squeal of a U-turn and another social media dump
NHSE backtracked and agreed to keep the service going for another year.
We could say; good, well done, you’ve listened.
We could say; what happens in a years time? A decision left hanging will fester.
We could say; this was a real error of judgement and timing in the first place and never should have gone live.
We could say; their decision making processes are either flawed or feral. Either way, someone was asleep at the wheel. Will they do it again?
We could say; this has undermined NHSE, because now we know, if there’s a decision we don’t like, make enough fuss and it’ll be reversed.
We could say; NHSE know they've undermined themselves and on a future occasion, will have to go to to cruel lengths to prove how tough they really are.
We could say; NHSE has no confidence in itself. They back down.
We could say; we don’t trust NHSE not to spring something else on us and we have no confidence in them.
We could say; there’s not much point in listening to NHSE’s strategy honcho… because there is no strategy.
Or...
... they could say, we got this wrong, we are sorry and we've learned a valuable lesson in understanding what's important to our people. Thank you.
As decisions go, for the record, this is a;
- strategic disaster,
- a tactical error and
- an operational shambles.
But it’s the right decision.
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