Managing the unmanageable and feeding the beast

Working on national NHS IT projects, it often feels like any progress is achieved in the face of the active opposition of the organisation we work for (currently NHS England). It's like the organisational bureaucracy in its wider sense (ie including the government department, DHSC, Treasury etc) has been designed with the express intention of preventing us making progress without enormous reserves of dogged persistence. We're in a war of attrition with a constantly shape-shifting bureaucracy.

This might not be a silly as it sounds. Many of the initiatives we work on may not have been formally adopted or approved by the senior leaders in the organisation, or only in the most superficial way. These projects frequently come from government documents like the current '10 Year Plan' or its predecessors. Others 'leak' into the organisation through direct contact between DHSC policy teams or individual ministers and delivery teams.

We need to acknowledge that the delivery teams themselves often have a vested interest in encouraging this model: wanting to pursue projects because they believe it to be a good idea or in patient interests, but needing a powerful backer/champion/patron to support and enable their work.

This puts management in the difficult position of not being in full control of the organisation's workload and priorities and with responsibility for satisfying a diverse group of stakeholders, many with overambitious or unrealistic expectations.

To this we can add another layer of patronage: between the organisation's senior leaders and their ministerial or civil services seniors to whom they owe the continuation of their role.

In an idealised world, senior managers would develop their own agenda and priorities, filtering all the demands, then harnessing the organisation's resources to deliver these. Simultaneously, they would manage expectations upwards. That would involve taking responsibility for prioritisation decisions, deciding who needs to be disappointed and carefully managing those difficult conversations.

Back in the real world, we have bureaucracy; an endless thicket of process. In theory, this is to ensure public money is spent wisely and to reduce 'waste'. In practice this acts as a filter, weeding out or more usually delaying those projects that don't reach a threshold of importance, support or have a sufficiently dogged and determined team trying to progress them. 

This removes the necessity of senior managers making potentially unpopular decisions because the decision-making is a multi-faceted thing defused across numerous individuals and committees.  And if the bureaucracy prevents an important project from making progress, the responsible delivery team can then be blamed for not negotiating the processes effectively, or for not being sufficiently energetic and dedicated in pushing it forward.

Everyone is a winner.....

But the costs of this are not trivial.  The amount of time and effort required, the person hours required just to gain approval for work that has already theoretically been agreed creates a massive cost and time overhead for any and every project. And of course, as in physics, any filter impedes all progress to to some degree.

This is where the real 'waste' is.

Ultimately, many of us are just engaged in this process of 'feeding the beast' rather than actually doing productive work.

Working for the other guy

The late Charlie Kirk wasn't the kind of Christian that many people in the UK - possibly many Christians across the world - would recognise. New Testament ideas and teachings - things like humility, compassion and forgiveness - didn't seem to loom very large in his personal philosophy and behaviour. These appear to have been shaped more by the Old Testament with its rigid prohibitions, denunciations, smitings and certainties.

In this way he was fairly typical of Conservative Christian views in the US. Biblically fundamentalist rather than in any real sense 'Christian', with more in common with the Israeli right than other Christians outside the US.

Kirk's great inspiration was the 'shock jock' Rush Limbaugh, and it showed. Limbaugh's stock in trade was using his position of power and influence as a prime-time radio host to be outrageously provocative. To say things that were inflammatory, insulting and deliberately designed to shock, usually at the expense of the relatively weak: women, ethnic minority groups, homosexuals. 

Punching down on steroids, it was also a way of normalising - desensitising the mainstream - to relatively niche views that many would see as abhorrent.  And this was build on a foundation of lies and dishonesty.  Many of Limbaugh's views, positions, statements and contentions were demonstrably untrue or gross enough exaggerations for there to be little difference. 

He normalised lying as performance art, rolling the turf for others like Kirk.

Limbaugh as a confident, articulate, fluent, quick thinking, experienced radio host was only too happy to use his superior position to intimidate and ridicule the far less capable people prepared to try their luck with him on the air through the sincerity of their beliefs. There was no respectful debate, it was all ridicule and belittlement in the cause of an extreme - and selective - version of hard-right religious fundamentalism.

Blessed with a similar skill-set, Kirk followed a similar path, except using face-to-face debate on college campuses instead of radio. He was quite literally 'down with the kids', influencing young minds en masse with a toxic mix of intolerance, racism, homophobia and misogyny with a sugar coating of motherhood and apple pie.

He was clearly a charismatic individual with an attractiveness which drew in young people, and a tech-savviness that enabled him to make the most of modern communications and social media.  

There was, perhaps the beginnings of a personality cult. I'm vaguely reminded of Chris Brain and his evangelical Nine O'clock Service in the 1980s. This connected with young people in a similar way albeit on a far more geographically constrained basis. I would not be surprised if issues relating to the abuse of power didn't emerge about Charlie Kirk as they have for Chris Brain.

The final analysis is whether Kirk left the world a better place than he found it, or at least has a Hippocratic legacy in having done no harm:

In fuelling division and polarisation, normalising lies and hate mongering, punching down against the vulnerable, providing support to a would-be tin-pot dictator like Trump, the balance is not in his favour. 

He was not doing Jesus' work in any way, shape or form. I think he might have been working for the other guy.

Velocity not speed

I spent a big chunk of yesterday in an internal workshop with the senior leadership team of the area I work in. The aim - ostensibly - was to work out how we could make faster progress. Failing that, how could we make it look like we were making better progress to the senior execs of the organisation? It was branded as a "Velocity Workshop".

The fact this latter point was clearly stated speaks volumes: this was as much an exercise in 'spin strategy' as it was an attempt to identify actual blockers and action that could be taken to resolve them.

In reality, most of the things making progress slow relate to the wider corporate environment, particularly extreme levels of bureaucracy which infect everything.  

For example, it can take more than 3 months to gain approval for a new Statement of Work (SOW) - essentially a time-boxed piece of work for a specific team - for an on-going project which already has a full business case, financing and approvals. 

The SOW needs multiple approvals within the organisation (from the budget holder, finance, senior management, digital assurance team etc etc) but then also needs wider government approvals from the Department of Health & Social Care, from the Government Digital Service (GDS) and now from a cross-government system called GAtS (Getting Approval to Spend).

This represents a massive overhead and a huge brake on progress. But, as well as these practical constraints that soak up time and effort in a completely unproductive way, prioritisation is also a major problem. By this I mean an almost total lack of prioritisation. 

Generally if you really want to get something done, you need a laser-like focus on the most important thing, and a gearing of as many resources as possible to move this forward.  Back in the real world of NHS England, there is almost no attempt to do this. Often this leaves individual teams competing against each other for resources and for priority in 'bottleneck' areas, in what is effectively a succession of zero-sum games.

Some of this derives from NHSE's business model, whereby new work and priorities are not always managed into the organisation from the top or in any kind of systematic way. Instead, individual ministers often develop their own projects or areas of interest working directly with the teams concerned, effectively leap-frogging NHSE's hierarchy.  

Add to that the tendency for individual teams - sometimes lobbied or led by external contractors - to push projects for their own interests, and you get layers of management who have no effective control over the organisation's portfolio of work.  The only levers they have are those that enable them to prevent work happening or at least slow it down.

Moving from the specific to the general, we can see several organisational traits emerging:

1. An organisational leadership and hierarchy that does not fully control its business or priorities, resulting in unrealistic and unachievable expectations
2. Organisational leaders who are never likely to fulfil the unrealistic expectations heaped on them, so must constantly decide who they can afford to disappoint
3. An organisational leadership whose main levers are negative ones exercised through bureaucratic constraints (often just the weight of 'process') 

To this you can add the type of leaders that have little or no agenda of their own beyond career advancement. They are the type of people whose main interest is in impressing those above them or elsewhere in the hierarchy who can help advance their career. Actual achievement - delivery of stuff - is a distant second. So actually taking responsibility for decisions on what is important (ie for the public for example), what needs to be done, or what can most realistically be achieved is generally not part of their mindset.

Back then to our "Velocity workshop".  Obviously some of its purpose was performative: ie so our director could look like she was doing something to address the perceived slowness of development, but without having to do anything difficult like making priority decisions that might draw attention or disappoint important stakeholders. 

It was also about shifting responsibility down to the lowest level possible. So instead of this being the director's responsibility to help speed up work by addressing the dysfunctional bureaucratic machinery (something only she has the seniority to attempt), responsibility was delegated to middle managers (with limited leverage and authority) to come up with ideas for increasing velocity and - more importantly - to be tasked with following these up.  Needless to say, most of these ideas will have a marginal impact at best.

Meanwhile there is no meaningful attempt to set clear priorities and certainly no reduction in the bureaucratic overhead. But our director can report a successful awayday, spent looking at how we can improve our velocity.

Job done.