System leadership viewpoints: Joanna Killian

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At the time of this interview Joanna Killian had been Chief Executive of Essex County Council since 2006. In May 2015 she left Essex County Council to join KPMG.

At Essex County Council Joanna delivered major programmes of change, reducing operating costs by £550 million and delivering improved outcomes to the 1.4 million residents, service users and businesses in the county.

This interview is taken from our report on the practice of system leadership.

Do you see yourself as a system leader?

I do regard myself as a system leader. And we’ve been thinking more and more about the need to develop a very coherent leadership model across Essex. From all my experience, you can build technical programmes and you can develop incredibly coherent business cases. But what makes these things go is strong personal relationships across organisations, and the governance that drives better leadership.

What skills does it take, and what are some of the challenges?

So how do we get a much stronger sense of mission and purpose, and feel a trust bond between leaders to get these things done? And then how do we create the conditions for success in our own organisation so that people feel that in the middle of the organisation and at the front line? It requires the application of emotional as well as business intelligence.

Health – in terms of the issue of the moment – achieving the benefits of some sort of health integration is critical.

I think over the last few weeks, with colleagues in the health service coming under real, real pressure, we’ve been able to achieve more because we have had a shared mission with much of health.

It meant that in the current crisis we have been mobilising people and going beyond our statutory responsibilities to respond. So in Essex we have had very low numbers of delayed discharge from hospital from a social care perspective. We’ve put in extra resources, and extra people on to wards in a couple of the hospitals. I have felt as responsible for sorting out this A&E crisis as my colleagues have in the CCGs. I don’t feel the pain of being a hospital chief exec. But I have felt compelled to try and help them. I think that’s what starts to happen if you believe you are jointly accountable for the outcomes in a system. It is built on strong and developing relationships with health in some parts of the country.

It doesn’t work uniformly well across it. And that is partly because, on the health side, people come and go so frequently. The stability of leadership there is an issue. So in places where people have hung around, those relationships are stronger, inevitably.

For a number of the big organisations operating in Essex, whether it is health or criminal justice, I think there is a realism that the next few years require a different order of collaboration to deal with the resource situation. Some of the policy drivers – the need to get more integrated services – are also equally clear.

The things that continue to make it difficult are the different performance regimes and cultures.

So we receive a lot of grant from central government, but we don’t have to account for much of it to central government – which is great. It’s a very different world for colleagues who work in the NHS. They look upwards all the time, and it is difficult for them to operate with a system where they are held to account by others who may not share the same system view, and that is true for the police and some other parts of the criminal justice system.

We, as a county, have only limited control over our overall finances at the moment. But we get to set priorities locally and determine how we exercise our functions. I don’t personally feel that I am forever looking over my shoulder, or looking up to government, in the way that my NHS colleagues are.

What are some of your successes and failures?

There have been some fantastic pieces of work driven by some of our Community Budgets and Whole Place programmes. We’ve had a programme called Family Solutions, which predated the Troubled Families initiative, which brings together agencies to really tackle families that are in crisis. It uses deep demographic research tools to really understand how people feel, what they want from their lives, and therefore how we should be designing public services to respond. The benefits have been significant numbers of families that are less troubled, more families in work, evidence of improving educational outcomes. Some of those children in families who were on the edge of some sort of child protection programme are now being supported, and that’s involved the council and colleagues from health, probation, Jobcentre Plus and schools. And you just can’t do that as one agency. It is impossible.

If you really put the customer in the middle of your thinking, it requires a system leader approach, you get better outcomes and, in most instances, it saves money too.

But we still have failures. Essex is a two-tier system so we have district councils that are responsible for the collection of bins from individual households, and it’s not unusual for each of those districts to have their own provision, either in-house or out to market. So there are 12 different collection systems, 12 different types of disposal arrangement. But as the county council we have to process all of that waste to find a strategy for dealing with it. We’ve tried to get a single programme or some more creative partnership to drive out cost, but it’s been a no go. If you are district council it is central to what you do. Not doing it is a challenge to your purpose and your very existence, in a way.

The biggest challenge in system leadership is not the getting going, because we can often find programmes or projects for which people have appetite. It is the next couple of stages that are difficult. How do you jointly invest to deliver the outcome? How do you put the mechanics in place to get activity working effectively across organisations? How do you share the benefits?

How do you develop system leaders who see beyond the boundaries of their organisations?

I think you have to do it in many ways. My senior leaders and my colleagues in other organisations have to develop a critical mass of people who believe in it, and behave it. Not all of them feel the same because they have so much going on in their own organisations that they cannot see beyond that. But when we do, we need to give people the tools and have a performance management system that requires collaborative working. So we have just put in a big learning and development programme, at the heart of which is building confidence and competency about outward-facing collaboration in our staff. So you have to do it on lots of dimensions.

I don’t know what the answer is for health. Where we are working really well with them, it is because we have two or three really innovative, outward-looking, very strategic people who will be powerful in their own sort of organisations, articulating need for change, and getting their boards to go with them. So you know there are individuals that can do it. But it does feel like a very command-and-control environment for them. Most of the colleagues that I know in the NHS do want collaboration and meaningful integration, because they know it would really make a difference, but they struggle to have consistent structures and leadership. It is the sustainability and continuity of it all. Local government changes less than the NHS, in terms of both people and structures.

Read the next interview: Dame Julie Moore >