Posted by: ayrshirehealth | November 2, 2012

Time to Fly by @billyahpd

Time to fly.

This week I went for a jog with Laura, a Physiotherapist in Ayrshire.  I am 6 weeks into a new job following promotion from Head of Physiotherapy, to Associate Director for AHPs and she was asking me how it was going.  Last week she had seen me speak at a Physiotherapy, all staff development day, where staff get together to share good practice and hear about all the great things happening across the service.  I had been giving an overview of national and local strategic direction, and attempting to demonstrate what tangible contribution AHPs and, in particular, Physiotherapists could make to the “big picture”.

Where do you begin?

Laura told me that there was a real buzz around front line staff, and a lot of talk about what they as individuals and teams might do.  She also described how hard it is for front line staff to keep abreast of all the changes in their own specialty, never mind the bigger picture.  “Where do you even start in your job?” she said.  “There is so much out there, and so much to do, where do you begin?”

I realised that she was right; there are so many policy documents, clinical guidelines, HEAT targets, professional guidelines, local priorities, national priorities, research papers, change programmes etc that staff can feel overwhelmed.

Her comments reminded me of a poem I had used to end my presentation:

And they flew.

(Guillaume Apollinaire)

I had heard the poem a couple of weeks earlier on Radio 4 and it immediately resonated with me as a leader in the NHS.

The “edge” (or the cliff in my mind) metaphorically represents all those documents piled high to the sky, and literally represents some of the not so paper-light offices I see as I go around.

All of the “stuff” that is out there, that we need to be implementing or contributing to.  The “they” are the staff who, totally overwhelmed by the height of the cliff and the volume of stuff out there, who can react by moving further and further back from edge, resisting what can seem a constant deluge of change.

The “he” are leaders whose job is, not to know the detail of all of that “stuff” and jump heroically from the edge alone, watched in awe by onlookers, or to command and control staff, dragging them to the edge kicking and screaming before pushing them to an unpleasant end.

In order to overcome the challenges ahead we need to develop other leaders, who intimately know one layer of the cliff’s strata and are passionate about making their bit happen.  If they in turn nurture a leader or two, the strata can be dissected and distributed, eroding the cliff, encouraging more leaders and followers to step forwards.

Clinical leadership at it heart

The National Delivery Plan for the Allied Health Professions in Scotland (2012-15) puts clinical leadership at it’s heart, calling AHPs to step forwards as agents of change.

It will take distributed leadership across organisations and communities to deliver sustainable, quality and optimum health across Scotland.  “Change will not come if we wait for some other person or some other time.  We are the ones we’ve been waiting for.  We are the change that we seek.”  (Obama, 2008).

It is time for all of us to step towards the edge and fly.

@billyahpd is Associate Director for Allied Health Professions in NHS Ayrshire & Arran

Next Week: 

@aileenahpmh writes about #realisingpotential, the action plan for AHPs in mental health


Collins J (2001) Good to Great. Random House.

Hargreaves, A. and Fink, D. (2006) Sustainable Leadership, Jossey Bass, San Francisco.

Scottish Government (2012) AHPs as agents of change in health and social care.  The National Delivery Plan for the Allied Health Professions in Scotland, 2012-2015.

Spillane, J., Halverson, R. and Diamond, J. (2001) “Towards a Theory of Leadership Practice: A Distributed Perspective” Northwestern University, Institute for Policy Research Working Article.


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