In The Spotlight
Katrina Percy, Chief Executive, Hampshire Community Health Care
Hampshire Community Health Care (HCHC), part of Hampshire Primary Care Trust, is one of the largest PCT provider arms in the country with a turnover of £135m and approximately 3500 staff. HCHC’s main business can be summarised in one sentence – ‘bringing health care home’. Many of its services help people stay independent in their own homes, help reduce unnecessary admissions to large hospitals, provide support for patients after major operations and to children and their families.
Katrina Percy is the Chief Executive of HCHC, and since joining the health service as a management trainee, she has worked across all sectors of the NHS as well as internationally. Her roles have included Chief Operating Officer and Divisional Manager in an acute trust, Strategy Lead for a Strategic Health Authority and Director of a hospital in Tanzania. Throughout her career, Katrina has delivered significant financial, performance and clinical turnaround and transformations. Since mid-2008 CentreStage has been supporting Banana Park Consulting with an ongoing development programme for over five hundred managers within HCHC by providing the roleplay and forum theatre elements of the course. Adrian McDougall spoke to Katrina about the challenges facing HCHC, her own role and the changing face of 21st Century health care.
Since mid-2008 CentreStage has been supporting Banana Park Consulting with an ongoing development programme for over five hundred managers within HCHC by providing the roleplay and forum theatre elements of the course. Adrian McDougall spoke to Katrina Percy about the challenges facing HCHC, her own role and the changing face of 21st Century health care.
As a chief executive how do you spend your time?
I spend a third of my time working outside the organisation with various stake holder groups, for example GPs, acute trusts and commissioners, a third with frontline staff within the organisation giving talks, shadowing and attending briefing sessions, and a third with my direct reports, working on moving the organisation forward.
That’s a lot of time with front line staff, isn’t it?
Yes, I think you have to with a community organisation like HCHC, where so often staff work on their own and in small groups in the community, actually in people’s homes. But regardless of that, I like to spend time with my staff and I want to know what they do.
What benefits do you get from talking to people on the front line?
It works both ways. Firstly I get a better idea of their jobs and what they think they can do to improve services and undo blocks to progress. So that informs me and enables me to move ideas forward. But they also hear me talking about my vision for the future and asking for their input. And that helps them buy in to that vision. The other big thing is around cultural change. Part of that is people hearing from me directly about the behaviours I want them to adopt. I worry otherwise about Chinese whispers and messages getting lost. I shouldn’t be perceived as a grey suit in an ivory tower. They should know they can communicate with me direct. And meeting with my staff is the most enjoyable part of my job. I find it very rewarding when I go out and get a better understanding of what they do.
You mentioned behaviours. How important are behaviours in HCHC?
As important as clinical tasks and clinical quality. I would say 95% of the complaints we receive are about behaviours and communication. And that all ties into the culture change I want to bring about. It’s about turning the decision-making triangle upside down. So while my predecessors ultimately made all the decisions, my belief is that it should be the other way round. My role is to be clear about what the outcomes and guidelines are, but my staff should know they’re in the best position to make decisions.
So what does that look like in terms of behaviours?
The biggest thing is putting the patient at the heart of everything we do, not the convenience of staff. I want to see people challenging themselves and the way they work to offer value for money, to make changes so they can offer the very best patient care and not do things just because ‘that’s how we’ve always done it’. I don’t want staff saying ‘that’s not my job’. I want them to take responsibility and oversee solutions to challenges. For example, if we’re faced with a ten week waiting list, I don’t want to hear that we can’t do anything about it. I want individuals to ask themselves how they can deliver better, how they can reduce and eliminate waiting lists, how they can improve costs and service.
Public sector organisations are increasingly being asked to become more commercial and competitive, aren’t they? What does that mean for you, and how are you ensuring that HCHC is competitive?
By commercial I mean patient focus, adaptability, flexibility, being paid for what you do, being paid for delivering and being more accountable for the money you spend. If we do those things we will be successful. If not, we won’t. We’re empowering people to do this through our leadership development programme. It’s what we call Service Line Management. We give them a budget and responsibility to deliver, and everything’s measured down to team level so teams are accountable and hence more commercial.
You brought in Banana Park to deliver your leadership development programme. Why Banana Park?
I believe they offer a more tailored solution to our environment, and they’re very good value for money. Their facilitation skills are the best I’ve ever seen and their combined backgrounds of psychology, marketing and HR are ideal for us. They engage their audience and they’re innovative in how they deliver. They come up with interesting ideas and think creatively about solutions, and everything they do is based on the principle that I share; that by deriving the best performance out of your people, you will make your organisation successful. Also, the feedback is phenomenal. People who’ve been on the programme speak incredibly highly of the experience. Crucially, too, I have 100% trust that the messages Banana Park are giving to staff through the programme are exactly those I would give, and that they’re developing people exactly as I would like. I’ve put a lot of my own energy into the programme and Banana Park knows where I’m coming from. And it’s worth noting that Banana Park run development programmes at every level in the organisation, from front line up to board level, so the input and the messages are consistent regardless of your level in the organisation. And of course that means everyone has to do roleplay!
Yes, you have firsthand experience of roleplay of course, because CentreStage is supporting Banana Park with the executive development programme. How was it?
Nerve-wracking in the same way it was for others. But it really holds a mirror up. Sometimes you know your own traits but perhaps don’t admit them to yourself, and for me roleplay allows me to try things I might not normally try. I’m aware that I don’t breathe properly when I talk, and that affects how fast I speak, so at the last executive away day I found myself lying on the floor practising controlling my breathing using my Diaphragm! Equally roleplay exposes traits we don’t know about – around the impact we have on others – and working with CentreStage has given us the opportunity to look at ourselves and get feedback about our impact on those around us.
How has the roleplay element gone down at other levels?
Feedback from other levels has been amazing. The roleplays have given individuals the confidence to address difficult situations and tackle poor performance. And when they’ve done this, they’ve realised that the real-life situation isn’t as bad as they expected.
Would you say NHS staff tend to avoid conflict then?
Yes, like any public sector organisation. And there are a number of reasons for that. Partly it’s the lack of individual accountability within the public sector and the sense that individuals aren’t empowered to tackle under-performance. Also the unions are strong and so there’s the fear of reprisal. As far as I’m concerned, if you tackle someone who’s constantly underperforming and unhappy, you’re doing them a favour.
You lead a huge organisation with a £135 million turnover. How well do you sleep at night?
I sleep very well. Sleep is never a problem for me. I only feel stressed if I think that as an organisation we’re not moving forward fast enough, or if I feel I’m not leading well enough. But no, I don’t find sleeping a problem. In fact Richard, my partner, often asks if I’m narcoleptic!
And is HCHC moving forward fast enough?
We’re getting there. We’ve built the foundations but I’m still frustrated as I’m not sure the changes around clinical services are sufficient. However the programme run by Banana Park has really improved communication throughout the organisation and that’s provided the foundations we need.
We’re in a recession. Do you spend more or less money on learning and development?
I would never cut our development budget. Development improves morale and therefore productivity, which in turn enables you to take costs out elsewhere. This is the time you should be investing in development. In fact I believe it’s the worst possible time to cut spending on L&D. If you do that, you’re expecting people to do more with less. What we’re doing is fun, which is great for morale, effective and very good value for money. We’re not paying for everyone to go to the Henley Regatta or the Windsor Races – What our development programme offers is essential to moving the organisation forward.
What would you do if you didn’t work for the NHS?
I’d like to be the Chief Executive of the British Americas Cup sailing team. It’s a totally male-dominated environment, which would present a huge challenge, and sailing is my passion. Also, the complexities of that environment suit my leadership skills – team development, developing individuals on the boat, technological development, metrology and the race tactics. I also want the British to win the Americas Cup, to be the best! Is your goal then for Hampshire to boast the best patient care in the UK? Not just the best in the UK, the best in the world! I want us to be seen as world class, so people all over the world will want to come to Hampshire for their healthcare. And that’s more likely than me ever captaining the British Americas Cup sailing team!