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Succession planning: a case for revisiting the process in critical care

2017; Wiley; Volume: 22; Issue: 4 Linguagem: Inglês

10.1111/nicc.12308

1478-5153

Julie Scholes, Josef Trapani,

Interprofessional Education and Collaboration

Succession planning is an organizational approach to vacancy replacement and is often associated with or directed toward senior leadership positions. Latterly, it has received less attention in health care research but as we approach a new era in which services provided by the National Health Service (NHS) and social care are transformed and how the impact of these 44 new services are evaluated as both successful and sustainable (Ham et al., 2017) succession planning is likely to return as a hot topic. As funding is reallocated and services are redistributed to favour more community-focussed care, there will need to be strategic leadership in critical care services to ensure these remain sustainable and of high quality. The health care professions have always focussed upon skill acquisition and performance through a quasi-apprenticeship, coaching and mentorship scheme from student to consultant (Hampel et al., 2010) to ensure the next generation of practitioners are fit for purpose and practice. So, succession planning in its broadest sense is not the sole preserve of management, human resources and executive team leaders. Succession planning targets training and development opportunities to ensure key positions are filled internally should a vacancy arise through attrition, retirement or ill health. Thus an organization is not left vulnerable in any key area. Risk is reduced and by proxy, the organization is considered to be sustainable because it exercises succession planning. Planning for the future when struggling to deliver a service under increasing work load demands and time pressures may not be a priority. Even less of a priority if that future is being planned around the potential of your absence. Unless viewed through a legacy lens, sharing experiences to facilitate others to acquire a range of new skills to potentially replace you, can seem burdensome. Uncertainty about the future might compound a willingness to provide programmes to upskill. However, succession planning is becoming an increasingly essential component of NHS delivery and is notable within the sustainable transformation plans (STPs). Advancing transformation through effective leadership is the mantra of the STP (Ham et al., 2017). However, in the NHS everyone is considered key to delivering a high-quality service and leadership can be exercised by every employee, not just those in an executive position (Storey and Holti, 2013). Ergo, succession planning should be inherent throughout the system and be a consideration of all and not just senior managers or executives. Succession planning provides opportunity to establish what is core to any key role and what skills and competencies are required to fulfill it. This helps the persons responsible to reflect upon the inherent values that underscore the service or role and what elements, activities and strengths are required of the potential successor. That is if there is a degree of stability within the system and certainty about what the role might entail in the future. Horizon scanning is a notoriously complex and inexact science. Thus forward planning has to include the capabilities to cope with enduring challenges, ‘wicked problems’ (Rittel and Webber, 1973) and uncertainty and find people who are motivated to work in these conditions. Under these circumstances, succession planning can be viewed with suspicion when compounded by change fatigue and risk aversion. To ensure success, open competition to find the most suitable (determined by essential existing capabilities), motivated and enthusiastic incumbent with transparent processes surrounding the selection procedure can help to eradicate suspicion around the motives of the succession planners (Community Foundations of Canada, 2017). Transparency around what is to be expected of the person who undergoes a succession programme and what he or she can expect from the people who facilitate them is essential. This includes what they would be expected to do, the time it would take, what they have to achieve and in what time scale. Whether there is financial remuneration, whether they have to forego any other roles that might represent a conflict of interest and what extra work will be required of them. The provider has to be clear about what will be delivered by whom and when. Finally, it has to be evident what the outcome of the programme will be and whether there are guarantees from either party or an option to appoint or to leave. Therefore, for an organization there is a risk that they can invest in all the training to lose that person to another business and for the person in the succession programme no guarantee he or she might assume the post to which they aspire. However, this does provide both parties with options albeit an opportunity to impress. Thus a non-contractual succession programme can potentiate commitment and excellence on both sides. Finding the right persons to facilitate the programme and appoint into the programme is therefore essential for success and should be independently audited to ensure fairness and equity. Feedback on how the succession programme is working is critical with opportunity to experience facilitation from different mentors holding complementary skills. A commitment to change the programme based on evaluative feedback is also critical to ensure a dynamic and responsive approach to succession planning. Long-term follow-up to capture data on the impact of the programme for career trajectories and not just immediate destination is key to understanding how well the programme has worked. Succession planning can therefore be an activity that can be established at an organizational or unit level. It is different to continuing professional development (CPD) because it is expressly targeted around upskilling for a more senior role and a performance inherent within that role (Richards, 2017). What goes into the plan and how the plan is made operational makes a declaration of the values and priorities of the organization or unit that writes the plan. Succession plans can be as diverse as the organization and services they provide. Embedded in succession planning is success. Nursing in Critical Care proudly addressed its own explicit succession planning programme last year. In October we advertised for two editorial internships that included opportunity to explore all the aspects of the role of editor across the spectrum of responsibilities. The programme was intended to last 1 year and each internee was allocated an editor as mentor with an option to swap at the 6-month point of the internship. They were also afforded access to participate in the journal management group, the journal advisory group and with BACCN Executive Team. We are delighted to announce that Dr Wendy Walker and Dr Josef Trapani were appointed to the internship positions last December and have been actively engaged in all aspects of the editorial role. The last issue was collated and prepared by Dr John Albarran and Dr Wendy Walker. This issue has been the responsibility of Dr Trapani and myself. Setting up the internships has been a really exciting opportunity to revisit the values of the journal and explore these with the BACCN and the Advisory Board before they were made explicit in our set of development opportunities and in our welcome to Josef and Wendy. The feedback we receive from Josef and Wendy is exceptionally insightful and both have a great eye for detail that helps us to see what might otherwise have been obscured by familiarity. On their part Josef and Wendy tell us they have gained an insight into the challenges and complexity of an editorial role that has only become apparent through the experience of working with the editors to prepare and deliver each issue. That requires a lot of focus and commitment but they feel the benefit is the excitement of broadening their skills in the field of journal management and publication. Succession planning is not only about moving up but also about moving sideways. In the current economic climate and drive to reconfigure services we need to keep the ‘talent pipeline’ (Lawrence, 2013) flowing. One way of ensuring retention of staff is to provide CPD. However, explicit succession planning programmes can also serve to develop staff to achieve their potential and develop skills to fulfill a new and challenging role. This can have an impact on staff retention (Goldsworthy, 2014). Fundamental to success is recognizing which of the roles in any critical care unit are key to continuity and strong leadership in uncertain times. Framing a succession plan to upskill colleagues who demonstrate the potential for those roles is a cost neutral approach to ensuring the talent pipeline keeps flowing.