Abdication of Responsibility

1. Abdication of Responsibility By Anna Wilson and Caroline Wrobel

2. Overview • What is Abdication of Responsibility (AoR)? • Case to contextualise AoR • Formulation causing AoR and suggested Intervention • Structure • Teams/ Groups • Intervention Evaluation • Summary • After-thoughts!

3. Introducing the concept of AoR • Concept of responsibility is defined as “a thing which one is required to do as part of a job, role or legal obligation” (Oxford English Dictionary) • Distinction between Responsibility (which everyone has and can be delegated) and Ultimate Responsibility (which cannot be delegated) • Definition of AoR is “failure to fulfil the requirements or take ownership of your responsibility” (Oxford English Dictionary)

4. Difficulty of defining concept… • Variations in AoR: • Financial/ Environmental/ Moral/ Professional/ Personal • Deliberate versus Accidental AoR • Conscious versus Unconscious AoR • Who decides who is responsible? Who decides who is abdicating? • Hard to identify • Does all AoR lead to negative outcomes?

5. Case: Victoria Climbié

6. Organisations who had the opportunity to intervene: • Housing Authorities; • Social Services; • Child Protection teams of the Metropolitan Police; • Hospitals; • Specialist centre managed by the NSPCC • (Church)

7. Formulation and InterventionGeneral Points to consider: • All factors are equally important • When considering each factor we need to consider • assumptions • context • history • Each factor will affect • the individual • the team • the manager • the organisation

8. Who was responsible?

9. Simplified Model… Victoria Victoria’s family Front line workers Between levels/ organizations Management Within levels/ Organizations Organisation

10. Structure • Top-heavy structure (i.e. power/control) • Lord Laming said “the inquiry saw too many examples of those in senior positions attempting to justify their work in terms of bureaucratic activity, rather than outcomes for people”

11. How do we know there were issues of ‘structure’? 1. Senior officers claimed: “no-one ever told me” 2. A Medical Director was advised by partners to: “get an external inquiry because it will protect your position…” but replied… “as time went on it was not going to be worth pursuing”

12. Re-cap:Structural Issues • Poor communication • A ‘them and us’ situation • Senior level remoteness from cases • Lack of involvement from those at the ‘top’

13. Intervention: Structure • Front line leaders (Prof. Aidan Halligan, NHS) - “clinicians need to lead from the front” - e.g. Modern Matron - ‘Leader-exchange’ theory - dissolve top-heavy structure - not seen as a ‘safety net’ though! • Regular case conferences

14. Team/ Group Influences “Evidence to this enquiry demonstrated very clearly the dangers to children if staff from different agencies do not fulfil their separate and distinctive responsibilities. No set of responsibilities is subordinate to another; each must be carried out efficiently and effectively. Gathering together staff in a dedicated team might well run the risk of blurring their responsibilities”

15. Teams/ Group influences of the AoR • 2 clear areas within teams that are influential: • Identity- in terms of the situation, organisation, the team and the individual • Inadequate transition to self- managed teams- within the teams/ groups and between teams and groups

16. Identity • Perceptions of team and organisational identity by the team • Perceptions of team and organisational identity by external parties • Identity establishes responsibilities, goals, and the importance of the situation

17. Identity (cont.) • Teams had unclear concepts of their own and others identity- therefore no clear understanding of who was responsible • There was a lack of inter- professional collaboration and within and between organisations at all levels

18. Inadequate Transition to Self Managed Teams • To some extent teams were self- managed • However during the inquiry people commented, “No one ever told me”- suggesting they were expecting to be managed from above- a contradiction!

19. What makes a successful Self managed team? • Support from the organisation • Structured but Flexible goals and objectives agreed by the team • Clear and distinct team identity

20. Inadequate Transition to Self Managed Teams (cont.) • Teams lacked all 3 areas • Team members were still expecting to be managed from above.

21. Intervention for Teams/Group Issues • Development of clear and distinct yet flexible roles. • The creation of clear communication lines between and within teams and organizations. • Encouragement of inter- professional collaboration between groups and self regulatory behaviour.

22. Intervention Summary • Front Line Leaders; • Regular case conferences; • Improved communication; • Clear team identity; • Effective self-managed teams. But…these only address two of the case issues

23. Criteria for Evaluation • Staff attitudes/opinions; • Staff turnover; • Case outcome; • Self regulatory Behaviour; • External Auditing;

24. Some thoughts to take away with you……. • To what extent do we stop classifying things/events as AoR? • Can we ever remove AoR entirely? (i.e from individuals, groups, organisations & society)

25. Are there any questions?

27. References • Lewin, K. (1948). Field Theory in Social Science. Harper & Brothers Publishers, New York. • Millward, L.J., (2005- in press) Understanding Occupational and Organizational Psychology. London: Sage Publications Ltd. • Millward, L.J., (2003) Leadership in Health Care – a position statement from a social psychological perspective, Paper presented at the HWRG Seminar on The Impact of Organizational Structure on Health Care 26th November 2003 • Millward, L.J. & Bailey, S. (2001). Perceived Organizational Support in Nurses: What difference does the Quality of leadership make? RSCH report, University of Surrey. • Millward, L.J. & Cropley, M. (2003). The Psychological Contract of NHS Nurses. Journal of Nursing Management, 11, 107-120. • Mullins, L.J.,(1999) Management and Organisational Behaviour (5th Edition) Pearson Education Limited, Essex • Wayne, S.J., Shore, L.M., and Liden, R.C. (1997). Perceived organizational support and leader-member exchange: a social exchange perspective. Academy of Management Journal, 40, 82-111. • http://www.victoria-climbie-inquiry.org.uk/