Leadership Lessons
Feature in "Children Now", 27th September-3rd October 2006
Demands on CAMHS Managers are increasing, so Asha Goveas looks at how boosting their leadership know-how can help.
Introducing change means winning hearts and minds. But when Lisa Williams took over as joint commissioner in child and adolescent mental health services (CAMHS) in East Sussex she faced a double challenge – it was her first job in CAMHS.
In line with Government policy, Williams wanted to broaden the strategic direction of the service to ensure that children’s services, not just CAMHS, took greater responsibility for children with mental health problems.
But to make this shift work, she was acutely aware she needed a firm understanding and commitment from the people it would affect – particularly front-line clinicians and managers. So to ensure her strategy ‘hit the mark’, she enrolled in a 10-month programme of management development specifically for CAMHS professionals. The six full-day sessions started last March.
‘The beauty of the sessions was to have clinicians, managers and a commissioner from other areas. It meant I could ask them about their experience of how and how not to go about things,’ says Williams.
Real solutions to real problems
During the sessions Williams attended, each participant spelled out a real-life issue. The rest of the group then asked questions to ensure they fully grasped the problem, before posing questions that offered a different way of looking at the issue, such as suggestions from their own experience. This helped each participant look at the subject afresh and decide what action they would take or experiment with’. They pointed out some of the risk in what I was trying to do and suggested ways I could minimise this,’ says Williams.
One group member found clinicians refused to use a new method of assessment he had introduced because he had failed to consult them, for example. ‘Having the sessions with managers and clinicians helped me realise the importance of having a systematic way of maintaining contact with these professionals,’ explains Williams.
One way Williams has put this into practice is by attending monthly meetings for CAMHS managers and professional leads. She says this is a great way of understanding the services she’s commissioning.
Demands on CAMHS managers are increasing as teams strive to meet targets to provide a comprehensive service by the end of this year. Yet whereas time out to develop personal and leadership skills is perceived as a necessity for top-level NHS staff, for CAMHS managers it barely exists.
Liz Hill-Smith, Williams’ group facilitator, and associate of CAMHS Consultants, which runs the training, says: ‘A lot of people don’t feel they have the right to management development. But people are working hard in very challenging circumstances, often with very needy children, and they need somewhere to work it out and spend time on their own development.’
The sessions, held every other month, aimed to create a ‘supportive and nurturing network’, explains Hill-Smith. This helped to support participants as they started making changes, evaluated their progress and honed their management styles, she says. One group found the support so useful they decided to meet as a network after initial sessions.
Groups made presentations on innovative local projects, and would raise issues from how to integrate health and social care staff, to negotiating trust mergers so that CAMHS teams are based with children’ services rather than adult mental health trusts.
A nurturing network
Each group had a facilitator to help them on logistical issues, such as working out the day’s structure, The facilitator also provided management expertise, for instance by helping participants challenge professional stereotypes and learn how to phrase advice constructively. ‘We get them better at framing experience to ask questions so that people can work it out for themselves,’ says Stella Charman, CAMHS Consultants’ Director.
Charman worked in NHS management in acute and children’s services before setting up a consultancy programme in child mental health at the Centre for Mental Health Development at King’s College, London, which eventually became CAMHS Consultants. Her experiences have strengthened her belief in the importance of an alliance between clinicians and managers. ‘Management should create an environment in which clinicians can deliver’, she says.
By contrast, Hill-Smith has 15 years’ experience of helping organisations undergo strategic change and believes CAMHS professionals benefit from an external perspective. ‘People doing very challenging roles need to be supported, valued, allowed to be curious and to ask questions,’ she says.
Williams agrees: ‘It’s important to have the time to reflect and plan, and to learn about other areas so you don’t need to reinvent the wheel.’
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