Holby City and project governance

I am an avid fan of the BBC medical soap Holby City. Recently Holby City has been running a story about a ‘project’ which set me thinking about some project governance issues.

The scenario in the soap, which some of you might recognise from watching, is about a ‘project’ to find a way to repair broken and damaged back nerves and thereby cure paralysis. In the soap, the ‘project manager’ is a senior medical consultant, with mighty ambitions to make himself famous, who is showing many of the signs associated with psychopaths. These include intense self-interest, maniacal work rate, intense secrecy – with a lovely script reference to password changes based on a Fibonacci Series – and particularly aggressive defence of the project against any criticism of any sort, not listening to anybody whilst saying he is listening.

Recent episodes have focused on the bending of ethical constraints, dismissal of a doubting junior doctor, falsifying data to get new guinea-pigs for the surgery and has now included disabling a potential and senior whistle blower during surgery for a road accident head injury! Nothing too mundane then – and of course nothing that you would have come across in your real professional lives!

After the last episode I watched I muttered, “where’s the project management governance then? &%$£*!” I know it’s only a soap but…!!

Let’s consider some of the scenes from the soap against the good practice guidance now available in the recently published APM guide Directing Change 3rd edition.

In earlier episodes several recognisable project management controls were evident: business cases were prioritised by the board, financial budgets and resources allocated – all good stuff. But there was little about the ‘boring’ stuff (for a TV programme), like appointment of a sponsor independent of the project manager, reporting and oversight, gate reviews, risk assessment, etc. The stuff of project management governance.

The overriding purpose of good governance is to achieve successful change/project outcomes with certainty and confidence. Directing Change states:
Section 3 There are two key roles accountable for effective governance:

• The board
• The sponsor

The sponsor appears to be missing from the project in this case – even though research tells us this is the crucial role for project success. Therefore the chances of good governance being applied are slim.

The chances of the project being delivered ethically are equally as slim. According to Section 4.5 of the APM guide: ‘The appropriate cultural and ethical environments must exist for teams to work effectively and deliver successfully’. Other statements include:

• The board to ‘set the right tone’ and be role models for appropriate behaviour.
• A culture of open and honest disclosure is a key requirement.
• Business ethics are moral principles that guide the way.
• They assist in making the right choices.

Further evidence of the value a sponsor can bring is listed the key principles from Directing Change.

• Principle E7 ‘Each change initiative, programme or project has a named, competent and engaged sponsor. The designated sponsor is accountable to the board for the success of the outcomes and good governance. Success criteria are agreed by the board and the sponsors.’
• Again, a sponsor is needed to be responsible to the board, ensure accountability of the project manager and gauge progress and coherence to good practices.
• Principle E14 ‘there are clearly defined processes and criteria for reporting status and for the rapid escalation of risks and issues to the appropriate levels…’.
• Principle P8 ‘Risks, issues and limits are specified for fast escalation to the appropriate governance level for action’.
• Principle P10 ‘Projects are subject to (independent) review at key points in their life cycle’.
• Principle E13 ‘All programmes and projects have an approved plan containing authorisation points at which the business case, risks, viability and strategic alignment is reviewed.
• Decisions made at authorisation points are recorded and communicated’.

So how would you tackle the scenario? Would you stop the project, or replace the project manager? First you need transparency and an open culture in order to find out about the ethical issues before the catastrophic reputational damage occurs. A classic case of missing a sponsor who can apply checks and balances to a psychopathic project manager.

A sponsor seems essential, capable of understanding ‘world class’ research, gate reviews, audit or psychological interviews with participants past and present.

No dramas then, but hey, it is actually a drama! And, of course, so far from real life!