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Writer's pictureGary Hughes

Leadership decides

That’s always the case. I’ve seen this year working with practices, PCNs and federations, and more than 16 years working in primary care. I’ve seen it in other organisations outside of primary care too.



There are many good practices, PCNs and federations but there are many that are the opposite; dysfunctional, challenged, underperforming. 


There are always positive characteristics that are common and stand out in those that are good.


Equally there are common and negative characteristics seen in those that are less than good. 


In the good you’ll find;

👍 A large amount of trust

👍 A strong work ethic

👍 A willingness to take risks and try new things

👍 Engagement with others to shape the future

👍 Strong leadership

👍 Skilled management  


The above doesn’t just happen.

Its importance is recognised.

They have the right people with the right skills.

They devote the required time, energy and money to do it.

They keep doing it, and know if they stop then their success will start to diminish. 


In the not so good you’ll find;

👎 Conflict and disagreement, because trust is poor.

👎 Little or no progression or growth.

👎 No real Interest in, or engagement with others.

👎 Blame is apportioned, and responsibility and accountability lacking.

👎 Leadership is weak, and lacks self awareness.

👎 Management is undermined and unsupported. 


This doesn’t just happen either.

Denial, arrogance or ignorance is often a cause.

The need to change isn’t recognised, with no desire to do so.

The skills to work differently either don’t exist or aren’t encouraged.

Sadly, it’s easy to slip from being good, into not so good and a downward spiral. 


Ultimately, this isn’t about circumstances you have no control over, fortunately it is a choice. The leadership in the practices, PCNs and federations decide this. 


What will you decide?





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