A paper about the charactersiticis of a good manager

1. What makes a good manager?
Managers in Partnership Master Class 24th November, 2009
Professor Derek Mowbray.
©Derek Mowbray
derek.mowbray@orghealth.co.uk
derek.mowbray@psychologistsdirect.org
www.orghealth.co.uk
www.derekmowbray.co.uk
‘If you feel well you will work better than if you feel ill’
•78% with poor mental health find it difficult to concentrate at work
•57% say it takes longer to do work
•46% say they are less patient with customers or clients
•41% say poor mental health interferes with their decision making
•26% say their mental health is moderate to very poor
•56% of these state the reasons are both home and work related
•CIPD Employee Outlook Survey 2009
Wellbeing and Performance
The definitions of wellbeing and performance follow two models shown below.
Wellbeing is a personal sense of wellness. You can feel well and energised whilst being diagnoses
with illness; equally you can feel unwell without any illness for example a hangover. If you feel
well you will be able to concentrate better on your work that when you are thinking of

2. something else, like your illness or the sensations of feeling unwell. The feeling of feeling unwell
includes psychological distress where your concentration is diverted by the cause of your distress
– often the behaviour of other people towards you, in particular your manager.
The ‘Just a Minute Performance Model’ illustrates the need for concentration. In addition to
being able to conduct your work without deviation, hesitation of repetition, the performance
model includes clarity of purpose and ensuring your work achieves its aims.
Wellbeing and Performance
Just a Minute Performance Model
Wellbeing Performance
feeling well clear aims
being well and feeling well appropriate aims
being ill but feeling well clear timetable
being alert efficacious action
concentrating no deviation
motivated effective action
engaged no repetition
having energy efficient actions
no hesitation
Quality of Care
The essential feature of high standards and quality of care is the point of delivery which is
essentially chaotic. This means the ability to respond to events that unfold in front of you and
being sharp enough to react appropriately to the situation. Events may be entirely random, which
suggests that with the appropriate skills, knowledge and experience, combined with the correct
intervention for the task, based on appropriateness, efficacy, effectiveness and efficiency, you
should be a position to respond the chaotic events successfully. Much depends on your ability to
concentrate at the time the chaotic event occurs.

3. Quality of health care
Appropriate
K
N S
O Efficacy
K
W
I
L Effective L
E
L
D
Efficient
G
E
chaos/dynamic/change/action
experience
What is stress?

4. Stress is at the wrong end of a continuum that starts with pressure, moves to strain and ends
with stress.
Pressure is energising, and heightens one’s concentration and produces higher levels of
performance. However, we can only tolerate pressure for periods of time dependent on our
levels of resilience. If we cannot see an end to the pressure we can move into a state of strain
where our concentration becomes diverted because of a sense of feeling unwell, which may be
similar to a sense of anxiety and slight panic. If this continues and we feel out of control of the
sensations we move to a state of stress, which can be very serious.
Pressure – Strain - Stress
Stimulant (pressure)
Diversion (strain)
Impairment (stress)

5. What are the characteristics of stress
in individuals?
Irritation
Glucose intolerance
Anxiety
Hypertension
Insomnia
Coronary heart disease
Fatigue
Diabetes
Smoking
stroke
Over eating
Heart attack
Headaches
Cancer
Physical inactivity
Excessive drinking
The are are many signs of the impact of stress. Overtly, levels of stress cause about half the
reasons for people going off sick, and more than half the reasons why people leave their jobs for
another somewhere else. Leaving jobs is a method of coping with stress. In the following slide,
taken from the survey of the Top 100 Companies to Work For the turnover of staff in ‘successful’
organisations is higher than truly successful organisations that are in the range of 1-6% staff
turnover annually. In this slide it is seen that about 46% of the apparently good organisations
have staff turnover of greater than 16% the costs of this to the organisations and individuals is
massive.

6. 40 Turnover of staff 2006, 2007
and 2008
31 30 ‘Top 100 Companies to Work For’
30
Source: Sunday Times March 2007, 2008 and 2009
25
23
22
2006
Number 20
of 17
2007
companies 15
15 14 14
13 2008
11 11
10
9 8 7
7
56
5 4 4
1 22
0-5 6-10 11-15 16-20 21-25 26-30 31-35 Over 35
Percentage of all staff turnover pa
The impact is, also, on compliance with HSE Management Standards, the costs of insurance
premiums for staff medical insurance, the costs of manager time and costs of tribunals and
litigation, as well as the haemorrhaging costs to the organisation.
The impact of stress at work
The Law
Individual and
misery Tribunals
HSE
Management Insurance
Standards premiums
Sickness
absence
staff turnover
money.
Complexities of the NHS
The NHS is a complex organisation largely because of the multi-professionals delivering its prime
product, but, also, because of the extensive background services that are largely in support of
the foreground activities, and in a recent observation, the same size as the foreground

7. operations. There are different cultural foundations relating to foreground and background
activities – the foreground is highly influenced by professional cultures based on individual
responsibility towards the patient or client. The background cultural foundations are based on
bureaucratic principles of targets, procedures, processes and political accountability.
These cultures can clash at the delivery level of the NHS where there is an existing conflict
between the professional and the bureaucracy – where the professional focuses on the needs of
the individual whilst the bureaucracy focuses on the needs of all individuals. This tension needs to
be managed effectively for both aims to be satisfied together.
Healthcare organisation
Threats to quality
foreground background

8. Professionals and bureaucracy
Threats to quality
professionals bureaucracy
Typologies of organisations that reflect wellbeing and performance, and,
therefore, quality.
The following slide shows some generalised examples of organisational characteristics that link
wellbeing, performance and output/outcome.
Look at your own organisation to see if parts of it relate in any way to any of the typologies.

9. High personal wellbeing Average personal wellbeing
Good business performance Poor business performance
Characteristics: Characteristics:
Clear purpose Ambiguous purpose
Commitment, Trust, Engagement Poor recruitment practices
Effective recruitment practices Average terms and conditions
Good terms and conditions Mismatched skills to jobs
Team working; staff involvement Laissez-faire management practices
Adaptive leadership and management Few company wellbeing programmes
Customer and staff focus Average company benefits
Low sickness absence Average sickness absence
Low staff turnover High staff turnover
Low costs/high profits High costs/ low profits
Poor personal wellbeing Poor personal wellbeing
Average business performance Poor business performance
Characteristics: Characteristics:
Clear purpose Ambiguous purpose
Average terms and conditions Poor terms and conditions
Limited alternative employment Lack of Commitment, Trust, Engagement
Transactional management Coercive, competitive and bullying culture
Incentive and bonus schemes High level of presenteeism
High levels of sickness absence High numbers of tribunals
High number of tribunals High levels of sickness absence
Limited wellbeing programmes High staff turnover
Average staff turnover High costs/Low profits
Very high costs/Minimal profits
The iceberg effect or presenteeism
Many people remain in work whilst feeling unwell and lacking in focus and concentration. They
feel lethargic and unenthusiastic about their work, and essentially go through the motions
without being identified as unfit for work. Such people may under-perform and may be counter-
productive. The overall cost of the iceberg effect and presenteeism is far greater than the costs
of sickness absence and staff turnover.

10. Costs of the ‘Iceberg Effect’ as a percentage of
total costs of psychological distress at work
32%
58% sickness absence
staff turnover
‘Iceberg effect’ reduced productivity at work
10%
Tackling these problems
The first step is to listen to your staff. There are many ways of achieving this – open space
discussions, learning sets, workshops and staff surveys. The best approach is for managers to
listen to their staff, and to help with this there are a number of tools that can be used. The one I

11. would like you to complete now is below. It will take you less than a minute and provide you with
a good idea of how people are feeling at work.
Health and wellbeing at work
questionnaire
We want to find out if you are feeling good about your work, and about your working situation. To help us
find out we would like you to complete this questionnaire. It focuses on how you feel now and over the
recent past (say a couple of weeks). Please try and complete all the questions.
Thank you very much for your co-operation.
Have you recently:
Been unclear about what you are supposed to do at work? Not at all No more Rather more Much more
than usual than usual than usual
Found that others have been taking decisions that prevent you Not at all No more Rather more Much more
from performing at your peak? than usual than usual than usual
Not at all No more Rather more Much more
Become irritated by the behaviour of your manager? than usual than usual than usual
Not at all No more Rather more Much more
Found yourself idling the time away?
than usual than usual than usual
Been spoken to by someone you thought Not at all No more Rather more Much more
than usual than usual than usual
was being rude, unhelpful and thoughtless?
Found it difficult to get involved in your work? Not at all No more Rather more Much more
than usual than usual than usual
Felt under pressure at work? Not at all No more Rather more Much more
than usual than usual than usual
Spent longer than your normal time at work? Not at all No more Rather more Much more
than usual than usual than usual
Experienced sexual innuendo or verbal abuse at work? Not at all No more Rather more Much more
than usual than usual than usual
Felt you have been unfairly treated? Not at all No more Rather more Much more
than usual than usual than usual
Been feeling energized at work? Not at all No more Rather more Much more
than usual than usual than usual
Taken a decision that has been acknowledged
as a major step forward at work? Not at all No more Rather more Much more
than usual than usual than usual

12. If you circle either of the two right hand answers for the first ten questions or the left two
column for the last two questions you are experiencing something that may amount to strain,
and you need to tackle the causes.
Next, you need to establish a framework as a strategic outline for your overall approach to
reducing and eliminating psychological distress at work. The following includes five strategic
purposes:
Prevention – to prevent psychological distress from happening in the first place.
Prevent deterioration – once someone is identified as under strain the purpose here is to stop
that situation from deteriorating further. This requires interventions of various kinds, the most
effective of which is good man management. However, often managers abdicate their
responsibilities and expect HR, Employee Assistance Programmes or Occupational Health to
solve this problem for them.
Restoration – once someone is off work due to psychological distress the purpose here is to
restore the person back to their normal level of independent life and beyond. This requires
sophisticated arrangements for rehabilitating people back into the environment that causes the
problems in the first place.
Palliation – once someone is off sick for 6 weeks or longer it is more difficult to restore them
back to their normal level of independent life. The purpose here is to use sophisticated skills to
bring people into any form of work, voluntary or paid, as this is known to improve their
wellbeing.
The next generation – once you have developed a culture that prevents psychological distress
from occurring the purpose here is to maintain that culture whilst staff change and managers
move elsewhere.

13. Strategic purposes
Prevent
Prevention
deterioration
Next
generation
Palliation Restoration
Next: take a look at the influences on wellbeing and implement programmes that address these.
This talk cannot go into these in any detail other than the headlines.
Components of wellbeing
Spiritual
Mental
Emotional Physical
Social Environmental

14. Next: is taking the strategic framework above and identifying the kinds of programmes that help
to populate the framework. The following slide provides some ideas, but again, time prevents
any exploration of these in any detail.
Wellbeing and Performance
strategy
Positive
Working Culture
Derek Mowbray 2009
Getting down to the nitty gritty
We are all actors
We all act. We act according to our understanding of the situation we are in, and respond with
the behaviours we believe to be correct under the circumstances. We are not very good at this in
a culture that is hostile, and where the cultural foundations are not based on virtuous intent
towards wellbeing and performance of staff.

15. We behave according to the meaning we place on specific situations
Threats to wellbeing and performance
There are three levels of threat. The most significant is our behaviour and the behaviour of
people towards each other.
Organisations are controlled communities, and the people who control the communities are
normally called managers. A prime threat to wellbeing and performance is often the behaviour of
controllers.
The second level threat are life events that each of us can expect to experience at least once.
These can be, therefore, predicted and managed. They are foreseeable and common. Much
depends on our personalities and levels of personal resilience as to how we cope with these
events. For example, the difference between J’s and P’s on MBTI proves insight into why some
people find change difficult compared to others. J’s like events to be well planned and any
alterations causes anxiety, whilst P’s are more flexible and can adapt to change very quickly.
Other personality influences include ‘conscientiousness’ and ‘extraversion’ which help in
resilience.
The third level threat are most familiar as they are the describable effect of failed interaction at
level 1 threat with events from level 2 and are packaged in HR policy terms and can be presented
for arguments in court or tribunal.

16. Threats to wellbeing and performance
Coping, resilience and prevention
I want to briefly touch on three types of activities that help to tackle the problems of
psychological distress.
Coping strategies:
Coping with your own stress
laugh

17. The most effective coping strategy is laughing.
Other strategies include self cognitive behaviour therapy, shouting at yourself in the mirror with
positive thoughts and determination to overcome the misery you are experiencing. You’ll feel
great after doing this each morning! It’s more complicated than this sometimes, but doing this
will raise your adrenalin and get you going in the morning.
Others include:
Imagery with deep breathing
Self hypnosis
Meditation
All of which will calm you down and provide th thinking space you need to regain personal
control in stressful situations.
Resilience strategies:
There are eight resilience strategies to adopt. Time prevents me from any detail but there are
exercises to be undertaken within each of these headlines that will strengthen your personal
resilience.

18. Building resilience Controlling oneself
Self-
assurance
Personal
Active
vision
Wellbeing Flexible
Socially
connected and and
adaptable
Performance
Interaction
Organised
effect
Problem
solving
Prevention
The third activity I wish to introduce is prevention. As part of my efforts to introduce prevention
programmes to the NHS I have been involved, and initiated, the new Code of Conduct for
Healthcare Management that is receiving support from MiP, IHM, HSE, BPS, RCN, BMA, DoH,
Health Foundation. RCGPs, and Welsh Assembly Government.
Code of Conduct for Healthcare Management
Wellbeing and performance
The context within which managers are expected to behave
The behaviours they are expected to exhibit
The actions they are expected to take
Download draft copy from MiP web site

19. This is about creating a Positive Work Culture based on wellbeing and performance. The overall
aim is to build organisations with the following characteristics:
Our benchmark for organisations
Psychologically healthy organisations have:
•a clear, unambiguous purpose, expressed as a simple ‘big idea’, an idea which all the staff relate to
closely, and are proud to discuss with friends and colleagues.
•an atmosphere of confidence, where all the staff are interested in each other, support each
other, and project this confidence towards clients and customers.
•staff who behave respectfully towards each other, value each other’s views and
opinions, work in teams which are places of mutual support, where anything is debated
without a hint of humiliation, where the critique of individual and team work is
welcomed, discussed and where lessons are learnt and implemented.
•staff who ‘go the extra mile’ by providing unsolicited ideas, thoughts, stimulus to
each other, and where their interest in their customers offers something more than
is expected, beyond courtesy, and beyond service, offering attentiveness and
personal interest.
•challenges for their staff, that provide opportunities for personal
development through new experiences, and which treat everyone with
fairness and understanding.
•staff who are personally driven towards organisation and personal
success - intellectually, financially, socially and emotionally.
Contact: E: info@orghealth.co.uk T: 0845 833 1597 W: www.orghealth.co.uk
I refer you back to the typographies of organisations and these characteristics are found in the
top right hand typography.
We start by having an Organisation Development framework:
This includes organisation purpose, architecture, rules and how to play the game (behaviour).
Remember that organisations are two or more people acting together to achieve a common
purpose, so this framework applies to each department, team as well as the larger organisation
or envelope for everyone else.

20. Organisation Development
Organisation purpose
Organisation Organisation Organisation
architecture ‘rules’ ‘how to play the game’
Organisation
development
Derek Mowbray 1994
In order to make progress we have to have an overall cultural aim, which is virtuous intent based
on wellbeing and performance. To achieve this, the organisation, its design , rules and behaviours
need to aim to build commitment, trust and engagement. There are specific activities that
achieve this and they are headlined below:
Factors that influence trust and commitment
Purpose
The ‘Big idea’
Manager – employee Architecture
relationship
Employee attitude Structure
Manager discretion
Employee discretion
Attentiveness
Rules of the game
Management encouragement Job
Leadership ability Recruitment
Performance appraisal Pay
Teamwork Challenge
Involvement Secure
Openness
Communication
Work life balance Career opportunity
Responsiveness
Citizenship
How to play Training and Behaviour
Procedures
the game development Policies

21. Under the new Code we move on to the behaviours managers are expected to show. For the
purposes of this presentation I am focusing on ethical leadership that headlines the behaviours.
The 4S model of ethical leadership
Status– the profile of an ethical person that shines
through into leadership and convinces followers of his or
her common sense, wisdom and effectiveness as a leader.
Staff – the behaviours and decisions of leaders that lead
to the engagement, trust and commitment of the
workforce in their work and their organisation.
Service – the behaviours and decisions of leaders that
produce the highest quality and standard of service.
Society – the behaviours and decisions of leaders that
demonstrate a concern to prevent harm to, and promote
wellbeing in, society at large.
The attributes and behaviours needed to conduct ethical leadership are shown in the following
slide. I can train everyone in both the attributes and behaviours – remember, everyone acts,
therefore we have to train everyone in acting out a different script, and the script is one that aims
to achieve wellbeing and performance by building commitment, trust and engagement.
Personal attributes and Behaviours
behaviours
Attentiveness
Politeness
Personal attributes Courtesy
Personal communication
Attentiveness Body language
Trustworthiness Addressing needs
Empathetic Engagement
People Demonstrate wisdom
Intellectual flexibility Commitment
Leaders Assertive
Emotional intelligence Trust
Managers Intelligence with humour
Negotiation Resilience
Passion
Sharing Tolerance
Direction with committed
ambition Reliability
Address individual needs Honesty
Nurture Clarity
Fairness
Humility
Conflict resolution
Encourage contribution

22. Under the new Code the behaviours are grouped under headlines as follows:
Attentiveness
Intellectual
Encouragement
flexibility
Behaviours that inspire
commitment, trust
and engagement in others
Resolve
Reliability
conflicts
If you take nothing else away from this session take away the behaviour of attentiveness. If I am
attentive to you, you will be attentive back. This is the starting point of a successful interaction. If
you are not genuinely attentive to others they will break off any sense of commitment to you.
What we don’t want is:

23. What we do want is:
Followers of Strictly Come Dancing will know that as the weeks go by the remaining contestants
grow in confidence, and strengthen their trust and commitment in each other so much that their
quality of dancing improves, but, also, they try more complex and difficult dance steps. This is a

24. useful metaphor for managerial behaviour. The ‘rules’ include the basic dance steps, but the
interpretation relies on discretion – managerial discretion that allows freedom of choice within
limits of the rules is what we are after.
If we can achieve this we have a map that is different to the iceberg effect:
Management actions
The final aspect of the new Code is management actions. The slide below sets out the categories:

25. Actions managers are expected to take
Appropriate Co-
Efficacy ordination
Effective Direction
Efficient Control
Strategy
Administrative
Executive
Return on investment
Building a Positive Work Culture produces real success on a number of dimensions. For a
relatively modest investment the following benefits can be achieved:
Return on Investment
Costs
Performance
Engagement
Inspiration and Innovation
Trust
Commitment
Quality
Thank you