Teenage Pregnancy & Evidence Based Strategies

I have just read an excellent article published on the Nursing Times website (click here for 'Exploring the evidence on strategies to reduce teenage pregnancy rates' by David Paton, PhD, Chair of Industrial Economics, Nottingham University Business School).

The overall thrust of the article is that the current strategy on teenage pregnancy reduction is just not working. As the conclusion says:

Despite more than £200m being spent on the Teenage Pregnancy Strategy, there has been little discernible impact on conception rates, at least at a national level. Although disappointing, these results should not be surprising.

The article is well worth reading in its entirety. You may not have a huge interest in the subject (although I am sure we are all concerned with reducing teenage pregnancy) - but do read it for its analysis and the incisive way in which the author uses an evidence based approach to slice through existing strategies.

I have left a comment at the end saying

This is an excellent and provocative article that I hope makes policy makers and indeed the Teenage Pregnancy Unit sit up and think about their practices and assumptions. I am sure this will not be the end of the story - but the ball is now firmly in the Government's & TPU's court to evidence their continuing strategies. I only wish more Government (at all levels) strategies could undergo such scrutiny - we need more evidence based policy and practice - in every aspect of the public services (not just in health care).

Are your strategies evidence based? How are you evaluating the impact of your strategies?

UPDATE (& EXCELLENT NEWS): 29 October: report shows that restorative justice reduces reoffending - The Prison Reform Trust today publishes Making Amends: restorative youth justice in Northern Ireland, the study reveals that reoffending rates were much lower when offenders were involved in restorative justice schemes. Figures showed four in ten 10 to 17 year-olds committed another crime within a year, compared to 71% of those who had been locked up. (Click here - pdf file)

A great story of how evaluation has shown that a policy has worked - in this case remarkably well!

Customer Journey Mapping & Attendance Allowance

On my other blog - two of the posts that have proved to be more popular than most have been the links to Stoke City Council's work on customer journey mapping. Indeed partly as a result of the interest they have received via my other blog - they are now running workshops about their model. (The links can be found here and here)

I wish them well and look forward to hearing about their workshop which is happening early in November. (I have just found out this morning that the workshop is very nearly full - so I am very happy to have played a small part in this success. Watch this space for a report of the workshop.)

I think the idea of a process to enable and encourage service providers to see their service through the eyes of the user is enormously important. So often (and this is not just with public services of course) when you seek a service you get a response that appears to not only talk a different language to you - but also live in a very different world.

From recent experience of trying to understand how the process of 'Attendance Allowance' works (on behalf of an older relative) - I have been met with what appears to be a Catch 22. The eligibility criteria for obtaining Attendance Allowance say that "your disability must be severe enough for you to need" help with washing, dressing etc. In my dictionary the word 'need' implies that you cannot do without such help. However, Attendance Allowance ostensibly exists (at least in part) to help people with disabilities live independent lives. But how can this be the case because if you needed such help - you would not be able to (albeit possibly struggling to...) live alone.

So I phoned the Department for Work and Pensions helpline yesterday. I had a confidential and non attributable chat with a very helpful adviser. She explained that some people who should receive Attendance Allowance often do not apply because of this issue. She gave the example of a person crawling up their stairs on their hands and knees to get to bed. That person may feel they don't need assistance but they could do with some help. Their lives could be immeasurably better with some help. A person in such circumstances would get Attendance Allowance. However... would that person apply?

This seems to be a clear example of where some 'customer journey mapping' might help to sort out this service / benefits arrangement. Have the DWP ever spoken to people in these circumstances to understand their perspective on all of this?

I do not want to have a cynical view that the DWP has an interest in people not applying for Attendance Allowance - but unless they look again at the language of the legislation and guidance - as given on the relevant page of the Direct.gov.uk website then I may have to revise my view.

So I hope the DWP will show leadership here (and maybe even attend the workshop being run by Stoke City Council) and think about Attendance Allowance from the perspective of the claimant.

Means and ends

Do the ends always justify the means?

If the end is a valued and valuable social and/or financial result – are the means always justifiable?

• If not – why not?

How have your boundaries on what is and is not justifiable changed over the years?

• How come?

Change alchemy: Posters

I am really very unsure of the glossy posters that sometime spring up around a change programme. They seem to invariably create an air of cynicism. I am thinking here of posters which say things like ‘there is no ‘I’ in team’ etc. Others seem to offer mindless advice such as ‘mind how you go’.

A while ago, I learnt that the best poster campaigns:

• Are targeted
• Are positioned shrewdly
• Give clear information – that is informative!
• Avoid stating the ‘blindingly obvious’

How are you using – or planning to use – posters to get messages across?

Change Alchemy: Symbolise

Outside of one HQ was a set of flag poles – it made the car park look like a parade ground. This would be fine if it was military establishment – but it was not – it was the HQ of an ambulance service. The new Chief Executive wanted to impress upon all his staff that the organisation was about healthcare not about parading in uniforms. One night he and friend cut down the flag poles with a chain saw.

A radical act perhaps – but it certainly provoked much debate and was a visible symbol of the changes that the new Chief Exec was seeking to put in place.

How have you symbolised the changes you are putting in?

What other ways might there be?

Change alchemy: Tools

If things have to change – do people have the tools, the frameworks, the guidance, the power, the authority to make the changes?

What can you do to facilitate these changes – to give people the tools to make the change happen?

MPs Expenses: an OD perspective

I would like take an Organisation Development slant on the issue of MPs expenses which has resurfaced in recent days. Obviously it is an crucial matter that that all party leaders and the vast majority of MPs are still actively seeking to resolve. Whilst I have some thoughts about the issue itself – more importantly I would like to describe a process for resolving this – that might be a way out of this morass that is damaging politics on all sides.

As regular readers of this blog will know, I am a long time advocate (and practitioner) of using an approach to conferences and meetings called ‘Open Space’. It was invented by Harrison Owen and has been used worldwide over 200,000 times to help (often very large and often conflicting) groups of people find and agree ways forward. There is much information available on the net about the process (www.openspaceworld.org). There are also you-tube links that explain it too (e.g. interview with Harrison 1.57 minutes http://www.youtube.com/watch?v=TDi0GLTO9ao&NR=1 I have more links if you want them - please email me - or you can search on open space on the you-tube site.)

My suggestion towards finally kicking this expenses issue into touch would be get all the main protagonists in a room together – for a day – to sort the issue. By protagonists, I include front bench and back bench MPs (all parties of course), external observers including lobby correspondents and other journalists, key civil servants, others by dint of their expertise, gravitas, experience and wisdom (whoever those might be – but probably a few members of the House of Lords), some ‘ordinary’ members of the public, a few notable bloggers such as Iain Dale... and anyone else who might have some worthwhile things to contribute. The task would be sort out the issue of the expenses, for once and for all. The process would be Open Space – which would mean that all that people who wish (and have a passion for) to talk about – could be talked about. The agenda would emerge - with no order papers, whipping or catching the eye of the Speaker.

Why am I proposing this? It seems to be that this issue has become so corrosive to public confidence that action needs to be taken quickly to arrive at a broad consensus. I know of no better way to achieve consensus than through Open Space – as it is a totally transparent, creative and sublimely simple and elegant process. Whilst Sir Thomas Legg has made an good start - his actions clearly has left a good deal of rumblings behind and there is some way to go. An Open Space process could slice through all of this and be emblematic of the kind of new politics of which I believe many in the Houses of Parliament and in the country wish to see more.

I do know about politics and how decisions are often made, the deals are usually done, positions taken and resolutions driven through by majorities. Whilst politics is, always has been, and probably will continue to be about interests clashing and change often being bullied through – I know I (and maybe many other members of the public too) want something different this time about this issue in particular. Perhaps a new type of politics could rise from the ashes of this issue - but only if it is handled well - with a good process.

OD 3.0

(This is a blog post in progress!) Please watch this space - over the next few days - I plan to record some thoughts about the origins of organisation development, where I think it went off the rails, and where I hope the discipline (although I am not sure if that is the right word...) is now going. I think the time has come (although it has been coming a long time...) to reclaim OD as something that is done intensively and interactively with people, organisations & systems rather than to them.

Authentic leadership: who are you today?

Authentic: "authoritative," from O.Fr. autentique (13c.), from M.L. authenticus, from Gk. authentikos "original, genuine, principal," from authentes "one acting on one's own authority," from autos "self" + hentes "doer, being." Sense of "entitled to acceptance as factual" is first recorded 1369. Authentic implies that the contents of the thing in question correspond to the facts and are not fictitious; genuine implies that the reputed author is the real one. Authentication is recorded from 1788. Authenticity dates to 1657 (in form authentity). (Thanks to the Online Etymology Dictionary for this)

On this basis - authentic leadership means being the author of one's own life and being true to oneself.

Many years ago I read a book by Warren Bennis "On Becoming a Leader" and one of his key themes was authenticity. To lift a quote (and thanks to the Amazon site for making this easy!): First and foremost, find out what it is you're about, and be that. Be what you are and don't lose it...It's very hard to be who we are because it doesn't seem to be what anyone wants.

I sometimes wonder in this age of competency models and evidential assessment whether sometimes people end up believing that leadership is some kind of puzzle to solve - a bit like one of those spot the difference competitions. If I can just tick enough of the boxes on the leadership framework, I too can become a senior manager, a director, a chief...

Warren Bennis and I (& no doubt many other people) say something different: first and foremost, being leader is about being yourself and being true to yourself. It is about knowing who you are and relaxing into being you.

How are you today?

Who are you today?

Change alchemy: Broadcast wins

In any change process, some aspects will go well and some aspects will not. It is in the nature of human communication (aka gossip) that the negatives will be discussed far more.

An effective change leader understands this and seeks to counter balance by ensuring the good news is broadcast as well. This will also help people see a connection between their efforts and the results being achieved.

How well do you broadcast the good news?

Change alchemy: change leadership?

Can change be managed or should it, indeed, be led?

Readers of this blog will know that I have titled several posts as 'Change Alchemy' with the first one explaining why I used this term. Making change stick still seems to me to be a 'daunting mixture of alchemy, tenacity and luck'. On this blog I have sought to outline what are some of the critical ingredients that need to be added to the crucible.

Certainly there are many elements of change leadership that might be reasonably called change management. There are various tasks that need to be manipulated and sequenced, and critical decisions need to be made. But all this seems to be to be more like the project management of change. So change management is a subset of change leadership. The question is, what are the extra ingredients?

I am reminded of an apocryphal comment on someone's professional development review 'not a born leader, yet'. I am pondering whether the ingredients that make change leadership different to change management can be learnt? I hope and believe so - since I am about to craft a workshop entitled 'change leadership'! Here is my starter for ten (and the beginnings of the workshop agenda) of the three most critical ingredients:

Number one for me is passion. Change leaders have and express a passion for where they want to go. This passion is sufficiently infectious and sincere to inspire others to take the journey as well. Change leaders are comfortable with creating visions of the future that are compelling both logically and emotionally. However this passion is not rigid or brittle like cast iron. This passion is strong like an old tree, able to bend in the wind and adapt whilst standing firm.

This heralds a second critical ingredient which must be resilience. Change leadership is rarely easy. I recommend reading 'The Prince' by Niccolò Machaivelli. This quote come comes from the Penguin 1961 edition translated by George Bull:

‘It should be borne in mind that there is nothing more difficult to handle, more doubtful of success, and more dangerous to carry through than initiating changes in a state’s constitution. The innovator makes enemies of all those who prospered under the old order, and only lukewarm support is forthcoming from those who would prosper under the new. Their support is lukewarm partly from fear of their adversaries, who have the existing laws on their side, and partly because men are generally incredulous, never really trusting new things unless they have tested them by experience.’

The Change leader needs to know how to handle resistance and finesse the power of the resistors so that the goal is still achieved.

Thirdly comes being able to make change thrilling but safe. Change is a scary and threatening thing for both leader and those who are on the same journey. Change is always a process of letting go, not just of the past, but also the future. We can allow our past and present to hold us back from trying something new. We can have a fixed idea of the future we think we are going to have. However, ultimately change is about casting off and setting sail to another country. We may look back and think of the years we spent doing 'x' and feel driven to justify it. We may have hunkered down in a cosy image of our future...

But then a change leader comes along with something very different that challenges what we have done (in all good faith) and what we thought we were intent on doing in the future. The change leader will only be successful in these circumstances if they make it safe to change. Recriminations, blame and threats (whether intended or not) have no place in good change leadership. Instead the process of leading change is to create just enough discomfort with the status quo to make people want to change but not so much that fear of the future or justifications of the present way of doing things are provoked to emerge. Not only must the leader make it OK to change, they need to find the balance between comfort and risk.

Perhaps the job of being a change leader is about designing and then operating a rollercoaster!

Citizens not customers

There is much discussion and indeed mission statements in the public sector about the need to focus on customers. However, I don't think the public services have customers in the same way that say Pizza Hut has customers. I think the public services are there to serve & engage citizens whilst being accountable - through politicians - to taxpayers/citizens. This makes the whole relationship a far more complex one.

I think saying that the public services have customers simplifies and indeed commodifies the relationship. For example if I want a pizza, I buy a pizza: the transaction has ended. However, if I, as a police officer (say), wish to serve and help my community become a safer place to live and work, I have to work with the local citizenry to achieve that. I cannot do it alone. There is no simple one way transaction there.

Yes, all public service workers should give good customer service to the citizens / service users / public that they are there to support and help. That almost goes without saying in my view. But that is but one small part of a much richer relationship.

The role of public service workers is to be transformational not merely transactional. The job of the public services is to generate sustainable social outcomes, not merely perform a series of one way transactions.

Sadly, the use of the word customer has become all to common in the public services. People may defend its use as reasonable shorthand. I take a very different view. If there is a shorthand to use, it should be 'citizen' not customer.

For me the biggest danger in this use of the word 'customer' is that it shapes (consciously or unconsciously) the business of providing care, education, community safety (etc.) into being a commercial enterprise. It is not. It is more subtle, more complex, indeed more important than that!

X Factor: 3 Leadership lessons

For those who don't know, X Factor is a UK based (but syndicated in many other countries including the USA) reality TV show where members of the public audition to take part in a live pop singing show. It is a very compelling programme which dominates the weekend schedules for several weeks each year. I will come clean and admit that I am fan - mostly because I am captivated by the journeys that the various contestants go through. See http://xfactor.itv.com/2009/

But watching the programmes over the weekend - I got to thinking - what does this show say about leadership? (OK - it is mostly about entertainment - and leadership is probably not high on its agenda but...)

Firstly I recall a video by Tom Peters from many years ago - where he was talking to a large group of managers in the Albert Hall (I think). To paraphrase - he said "if you don't like people - don't become a manager! You have to really delight in seeing people grow and develop to be a good leader".

I think this is partly what makes Simon Cowell a good leader. Yes, of course, the cynic in me says that all is ever in his mind is a stream of pound notes and dollar bills. However, looking carefully at him when people perform (or don't perform) - I see a gleeful twinkle when anyone excels. Moreover, he smiles even more, when people appear to have been on a journey of development and discovery. I think this is what marks him out as a good leader. (For the record I would put Cheryl in the same category - but I am not sure about Louis and Danii...)

So leadership lesson one is: delight in reflection, growth and development and show it - your followers will aim for even higher things as a result

What Simon is also excellent at - is giving feedback. Yes, he plays to the crowd sometimes and can be quite cutting. If he is ever harsh (and some might say cruel) - he does it with a clear purpose designed to either get the person to give up on hoping to become a celebrated singer or to get the person to improve. His criticisms are never just extraneous. He is also honest and direct.

Leadership lesson two: give feedback purposefully and helpfully - say what you believe and believe what you say. Of course in a work context, giving developmental feedback needs to be more than the one liner from a reality TV show - but the principles are not that dissimilar.

One of the themes that Simon and other judges often return to is self belief. Comments such as 'she is really beginning to believe in herself now' pepper the show. I think one of the most important attributes of a good leader is the ability that they have to inspire true and deep self confidence in the people that they lead. I suspect that singing coaches, also know this - and whilst there are undoubtedly techniques and tricks to learn - I am guessing that the most important aspect of a good singer is confidence. Leaders and coaches need to act on this.

Leadership lesson three: Do all that you can to build confidence among the people you lead - indeed, look to create the leaders of the future.

Saying sorry - an act of leadership

Everyone gets things wrong sometimes. Some people seem less inclined to own up to when thing go wrong.

A good sorry almost certainly involves

• Being clear about what you are sorry for
• Being aware of and recognising the hurt caused by your action
• Taking responsibility for what you did and not blaming someone or something else
• Saying the word ‘sorry’ and asking for some kind of forgiveness
• Saying and meaning that you intend never to do what you did again
• Offering to help or recompense to the person in some way

When was the last time you said sorry at work?

How did it feel?

Did you mean it?

Acknowledgement: http://www.perfectapology.com/how-to-say-im-sorry.html - thanks!

UPDATE: Great article in Nursing Times about this too:

A sincere apology that expresses regret and acknowledges shortcomings can help patients come to terms with something that has gone wrong - and can also help nurses

 Click here for the full article

Change alchemy: well poisoners

There are some people who know that by being explicitly against a change that this will neutralise their position. These are the ‘seasoned’ change resistors who sneak out at night and put poison into the well. No one quite knows who they are.

Continuing the metaphor – what is a leader to do? Post sentries on the well.? Give antidotes to everyone else.? Find out who they are?

What should you do?

Change alchemy: resistance

If the change you are putting in is not creating some resistance – you are probably doing something wrong. Debate and dissent are essential to finding the best ways forward.

How much resistance are you meeting?

Trust & leadership

Just stumbled across a great article about the manufacturing company of W.L. Gore & Associates. Do read the whole article - it is well worth it. Click here: Small Groups, Big Ideas for the link.

I really liked the quote "The way you become a manager is by finding people who want to work for you. In a certain sense, you’re elected rather than appointed. It’s a democratic structure inside a business organization." cited in the piece (by Thomas Malone, a professor at Massachusetts Institute of Technology’s Sloan School of Management and the author of The Future of Work)

This (together with the heralded special on 'Trust' to be broadcast on 'You & Yours' on BBC Radio 4 tomorrow) got me thinking about trust - and what leaders must do to earn it and indeed keep it.

Googling 'trust meaning' comes up with an array of definitions. However, I would define trust in the context of leadership as 'your confidence that the person has the future interests of the organisation, the world and you & your colleagues in mind when making decisions based upon past integrity, transparency, honesty, evidence, empathy and passion'.

With recent events including a range of financial crises, stories about shabby greed amongst our leaders & elections which have far more to do with corruption than fairness, it is very easy to become cynical, frightened & despairing. Where are the leaders whom we can trust? Where are the people taking epic, heroic and inspirational actions? My hunch is that there are still many of those leaders around, quietly getting on with business and getting some hard jobs done.

Clearly there are some of these people in W.L. Gore & Associates. There are probably some in the organisation where you work. And you will have some neighbours too who continue to make a huge difference to families and communities. Maybe there are fewer to be found in the media spotlight, or on the stages of the political conferences over the next few weeks than there used to be. But if you look carefully - perhaps out of the corners of your eyes - you will see many, many people who are earning trust and being good leaders - up, down & sideways in organisations and our communities. I see such people all the time, taking the lead with honesty, tenacity, integrity & verve - resolutely refusing to be 'cynicised' into inaction. These are the people who will:

• Look for the positives
• Take a wide variety of views into account
• Say what they mean and mean what they say
• Think about the balance of benefits from a course of action
• Think of the future & the long term and avoid being ground down by just reacting all the time
• Listen to people - really listen
• Use humour, energy and passion
• Evaluate what they have done and seek feedback
• Have fun (and at no expense to anyone)
• Work from the common ground rather than self interest

How many people do you know who are like that?

Are you one of them?

Milestones: yey!

In any piece of work – good leaders find reasons to celebrate. A milestone is reached and it is an excuse for a pizza, or a box of chocolates, or handwritten thank-you note to all the team...

In this way, everyone’s efforts are applauded.

When is your next opportunity for a celebration?

Why do we have old style conferences anyway?

Browsing through an old copy of The Psychologist journal (December 2008) which I get as a member of the British Psychological Society, I came across an interview with Emeritus Professor John Sloboda (from Keele University).

He was asked for 'one moment that changed the course of your career'. This is what he said:

Meeting the late Michael J. Howe (of Exeter University) quite by chance at a conference we both found boring. We sloped off to the pub, and by the end of the conference had made decisions that led to the most productive and long-standing research collaboration of my academic life.

I find this thrilling as it shows, yet again, how people given the space can make profound connections and decisions without the need for too much structure - or even any structure at all.

Why do people persist in arranging conferences and events which are dominated by 'expert' speakers whilst the experts in the audience are left to sit passively wondering about what conversations they could be having otherwise? Instead people hope that the busy networking in the coffee breaks and lunchtimes will suffice.

Clearly in Prof. John Sloboda's case it did - fortuitously. But I am left wondering how many conversations have never happened for want of some more (open) space in which they could have occurred. How many opportunities for collaboration, understanding, rapprochement and exploration have been missed over the years by the starchy, constrained and over controlled (but looking very worthy) conferences?

Why not use Open Space instead? Not only is everyone empowered, supported and enabled to have whatever conversations they wish to have - but everyone else gets to know what everyone else is talking about too.

So much more efficient and effective!

Change alchemy: cynicism

In any change there are the people who will say “we have done this before – it didn’t work then – it won’t work now” or variations on that theme. In my experience, cynics are often enthusiasts who have been put on the sideline.

How will you channel both the enthusiasts and the cynics in pursuit of your goals? Is there some way to include them all in shaping the future?