Table Of ContentLeadership and Teambuilding in Primary Care L
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Developed alongside the NHS Leadership
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CLARE MULLINS GRAHAM CONSTABLE
learn about leadership to our g AND
situations to life, and make it easier to
teams whether we are in general i
identify with leadership and teambuilding n
medical, dental or ophthalmic
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m FOREWORD BY SIMON GREGORY
to leadership in many walks of This book is an invaluable resource for
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life. It is also readily applicable practice managers, general practitioners, r
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at various levels within teams. nurses and other healthcare professionals,
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Leadership is about much more including dentists, opticians and a
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than being in charge, and is a vital pharmacists. Allied health professionals, e
element of professional practice.’ medical students and administrative staff
Simon Gregory, in the Foreword will also fi nd much of interest.
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AND SOCIAL CARE MADE EASY Edited by Glyn Elwyn and L
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how you can really make Fourth Edition June Smail I
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a difference Ruth Chambers, S
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EFFECTIVE PEOPLE Edited by Ruth Chambers, R
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development in healthcare and David Wall M
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rraadd__mmuulllliinnss__00330077..iinndddd 11 22//55//0077 44::1122::0044 ppmm
Leadership and Teambuilding
in Primary Care
Clare Mullins
Qualified Coach and Physiotherapist
and
Graham Constable
Business Consultant
Foreword by
Simon Gregory
FRCGP
Radcliffe Publishing
Oxford • New York
CRC Press
Taylor & Francis Group
6000 Broken Sound Parkway NW, Suite 300
Boca Raton, FL 33487-2742
© 2007 by Clare Mullins and Graham Constable
CRC Press is an imprint of Taylor & Francis Group, an Informa business
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Version Date: 20160525
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Contents
Foreword
About the authors
Introduction
1 The case for leadership and strong teams
So what's the solution?
2 Finding time
Managing yourself, other people and the workpl
Prioritising and categorising
Time waster to time investor
How to say 'no'
Other tips for time investors
3 Leadership model
The action-centred leadership model
The basic leadership functions
4 Leadership styles and techniques
Defining leadership
Features of leaders
Styles
Understanding the features of leaders
What is your leadership preference?
Accountability
5 Leading by example
When to use this style
Self-awareness
Self-regulation
6 Leading by persuasion
When to use this style
Awareness of emotions, values and needs
Effective presentation and communication skills
7 Leading by compulsion
When to use this style
iv Contents
Confidence and courage 54
Interest in knowing what drives behaviour 56
Non-threatening dialogue to challenge difficult behaviour 56
Ability to keep the big picture in mind 58
Leading by enabling with coaching, training and support 60
When to use this style 60
The difference between coaching, training and support 60
Coaching skills 62
Training 65
Effective feedback 66
Patience and willingness to invest time in developing people 67
Leading by enabling with trust 69
When to use this style 69
Trust in others 69
Ability to let others work independently and let go of control 70
Belief that 'there is no failure, only learning' 72
Five steps to become a better leader 75
The five-step 'ISAGOAL' process 75
Step 1: Informing others 75
Step 2: Self-awareness 77
Step 3: Goal setting 82
Step 4: Options for action 89
Step 5: Act and learn 95
When does the process stop? 97
Fundamentals of teams 99
Groups or teams 99
Team life-cycle 100
Team dynamics 103
Management teams 106
Team size 110
Assessing and maximising team performance 112
Assessment of teams 112
Essential elements for a performing team 115
Obstacles to team performance 120
Balancing task achievement and relationships 120
Collaboration 121
Fixing dysfunctional teams 123
How to fix dysfunctional teams 123
Step 1 : Get to the root of the problem and identify what needs
are not being met 124
Contents
Step 2: Create a strategy to meet each party's needs 124
Step 3: Monitor adherence to the strategy 125
Step 4: Simultaneously develop team relationships 125
What to do if a dysfunctional team refuses to change 125
14 Essential supports for your development 128
Physical environment 128
Your relationships 130
The environment in your head 131
Your health 132
Your personal operating systems 133
Workplace culture 134
15 Situations needing extra-strength leadership 136
Handling difficult behaviour by staff 136
Handling difficult behaviour by patients towards staff 141
Times of change 143
Leading multidisciplinary teams 148
Index 151
Foreword
Leadership and learning are indispensable to each other.
(John F Kennedy, speech prepared for delivery on
the day of his assassination. )
If we are to work in effective teams and deliver effective healthcare then
leadership is vital. This book encourages us to apply what we learn about
leadership to our teams, whether we are in general medical, dental or ophthalmic
practice; yet is readily applicable to leadership in many walks of life. It is also
readily applicable at various levels within teams. Leadership is about much more
than being in charge, and is a vital element of professional practice; yet in my
experience it is barely mentioned in undergraduate studies or in postgraduate
programmes. Along with many others I have had the good fortune to participate
in the excellent leadership programmes that have sprung up over recent years.
But participating in such a programme one quickly realises that leaders are always
learning and, I hope, always aspiring to become good enough leaders. Often I find
myself reflecting on events and wishing that I had handled them better. Which of
us with any degree of insight can honestly say otherwise? Look at your own
environment and honestly evaluate the qualities of the leadership and of team
work. Each of us can learn more and this book is an excellent foundation for this
learning. Clare Mullins and Graham Constable provide a tangible and practical
resource drawing on their wealth of experience of business and the NHS, and of
general practice in particular. They demonstrate a clear understanding of our
world that is firmly grounded in insightful experience.
Leadership is about more than management and it is not necessarily the same
as being in charge. As the authors say, managers need to exhibit leadership but
leaders should not necessarily be performing management tasks.
This book is incredibly well referenced. If you have heard any management
guru spouting forth jargon or spent any time looking at the business section in
airport bookshops you will recognise the references, but the difference herein is
that they are clearly and practically explained and put to practical use. This is not
some simple self-help guide; it is a practical, thorough and useful text. It starts by
recognising that leadership, learning and team building all take time and helps to
release that time. It then perceptively explores aspects of leadership with chapters
having suggested learning outcomes and action points, practical examples and
space to encourage reflection and application. But its greatest strength is to realise
that leaders need teams to lead and teams need leaders. The later focus on team
building ensures that our learning is readily applied.
Once you have read, reflected and applied your learning about leadership and
teams I challenge you to look at quality of healthcare and quality improvement
from a leadership stand point and from a team perspective. Not only do our teams
Foreword vii
need leadership but our patients deserve it. I commend the authors and this book
to you and commend the concept of applying leadership to teambuilding.
Dr Simon Gregory ERCGP MMEd ILTM
Dean of Postgraduate General Practice Education
East Midlands Healthcare Workforce Deanery
Leicester UK
December 2006
About the authors
Clare Mullins has been a physiotherapist for 12 years working in hospitals,
general practices and her own business in Australia and England. She discovered
early in her career that she was equally fascinated with how people's minds and
bodies worked which led her to become a qualified life coach. Since then she has
formed Growing Professionals and offers coaching and training to make working
lives easier in the medical world. She does this by developing people's skills in
leadership and communication, as well as building their confidence to implement
those skills.
Graham Constable was a commissioned officer in the Royal Air Force following
which he co-founded a professional services company. He has 20 years of
business experience nationally and internationally encompassing operations,
business development, change management, organisational growth and value
management. He is a partner in Growing Professionals and the founder of The
Business Tree. He works with executives and managers bringing about change,
breakthrough development and growth of individuals, groups and teams. He
garners the innate experience, knowledge and expertise of people within organ
isations to cultivate great teams.
Introduction
'We know we have a dysfunctional nursing team but we're ignoring it because
it doesn 't affect the rest of the surgery. '
'I don't want to just tell people what to do, but the consultation approach
doesn't seem to get anything done. What else can I do?'
'There's a feeling of "us" and "them" between the doctors and the admin
team but that's the same everywhere, isn't it?'
'I want to know what my leadership style is. '
These are the kinds of phrases we frequently heard when talking to clinicians and
practice managers in primary care. There were lots of statements about dysfunc
tional relationships, problems between entire teams, the negative impact of
constant change, the challenges of handling difficult behaviour by staff and
how difficult it was to lead when they had little or no training in this area.
What was more concerning were the common approaches to such problems,
i.e. the 'if we ignore it, it might go away' approach or 'I'll figure it out as I go
along'. But, like a crack in a dam wall, these problems never went away. They
only got worse and eventually the dam wall burst. And if they were learning as
they 'went along' then it was often a long, difficult and unfulfilling path.
Ultimately there were common themes within these problems which boiled
down to a lack of leadership and teamwork. Most often this was not from lack of
trying. The people we spoke to were sometimes at their wits' end and feeling like
failures having tried so many things so many times. Sometimes they knew what
they could be doing but lacked the confidence to put it into action and other times
they just didn't have enough tools to handle the situation.
In searching for resources to address these problems we found year-long
courses, one-hour seminars and books that provided a lot of theory but left the
question 'So how do I actually do that?'. So we decided to fill the gap by writing
this book. We have aimed to produce an easy-to-use, 'how to' guide to enable
you to develop your leadership and teambuilding skills in the context of your
work in primary care. Throughout the book there are practical exercises for you
to complete and at the end of each chapter you will find suggested learning
outcomes and action points to help you focus.
The purpose of this book is to equip you with the skills, tools and attitudes
necessary to become better leaders and to develop individuals and teams around
you. You will find practical advice to help you in your day-to-day role. Because
we want you to actually do something different, there is a strong coaching and
personal development slant to this book rather than a recital of theories. As a
result there are a lot of exercises you may choose to do.
As with any new skills, how much you gain from this book will depend on how
much you actually do. Reading this, but not changing any of your thoughts,
