In health and social care it would seem eminently sensible for everyone to be involved in decision making. Unfortunately, NHS England is essentially a passive aggressive organisation, brilliantly described in the HBR. As a result everyone has to agree to instigate change, as you can imagine this is impossible. In these conditions innovation cannot thrive. Those accountable for outcomes find they are only in the position to be blamed when delivery fails or is inevitably slow. In Gareth Morgans book, Images of Organisations, “the machine metaphor” describes the style of NHS England.
Lesson 3 – make sure your leaders are able to lead and that the organisation understands this. Enable decisions to be taken quickly, decide early and decide often.