Thursday, May 25, 2017

Why, in whole systems, is it so hard to move from papers to action?

This is a shorter version – full version of the above is available here:  full version.

One of the strangest experiences in whole systems change in the public sector is observing how much energy is spent writing papers that are not acted upon, attending meetings that don’t make decisions, and holding workshops that lead to elaborate diagrams but no agreement to proceed.

Ron Heifetz [1]coined the phrase ‘work avoidance’ to describe the way leaders are distracted from the difficult conversations that need to take place if we’re to achieve ambitious outcomes in tough times. Work avoidance is quite the opposite of laziness, indeed to avoid the real leadership work we often exhaust ourselves with back-to-back meetings, and slave over hundreds of pages of data and vast action plans.

Work avoidance, says Heifetz, can take a number of different forms:

It can feel discomfiting to talk about deep feelings and intentions when we are used to an impassive managerial style in our meetings. It can seem like ‘not proper work’ to discuss fears and worries. A flurry of meetings gives a reassuring sense of activity, while difficult conversations can get stuck, or go backwards for a while. But real leadership takes time and self-conscious effort – it involves telephone calls, and meetings in coffee shops, reflection and self-examination, looking into our own hearts to find our values and priorities. It can seem destructive to challenge work avoidance activity, since people are clearly working very hard. Finding ways to do so without blaming individuals is an important part of leadership. But, just as an experiment, if you suspect your ‘system’ is locked into work avoidance, try some of the following:

This is an extract from a longer article that can be found on our website. For more information about OPM’s work on system leadership – contact Sue Goss, Principal in whole-system change and integration – sgoss@opm.co.uk, 020 7239 7800

[1] See, for example, Ron Heifetz: Leadership Without Easy Answers, Harvard University Press, 1994

 

Monday, September 19, 2016

Health and social care integration in Kirklees

Background

We have worked to develop collaborative leadership across health and social care systems in a number of localities. In Kirklees we were asked to support the creation of a integrated mental health commissioning system as an exemplar from which the whole system could learn.

What did we do

A very senior group of leaders worked together over a number of sessions to develop a shared set of principles and goal – and a series of practitioner workshops began to flesh out what this would mean for front line services. Recognising that success would depend on the strength of relationships between staff in different organisations, we designed and delivered a ‘Skills for Systems Leadership Programme’ for the public health, social care and CCG senior teams – agreeing key health outcomes and providing the skills and techniques that enabled cross-organisational teams to develop shared approaches to changing behaviour and tackling long-standing problems.

Outcome

The programme built a strong network of organisations and individual leaders, a shared understanding of systems pressures and agreement about the way forward. The work included providing individual coaching and support to key leaders, facilitation and team coaching sessions for top managers and partnerships. The final stage of the programme was to create a dramatic ‘future scenario’ event for fifty or so participants including the voluntary and community sector, from which partner organisations developed a set of principles to guide future shared direction.

Monday, September 19, 2016

Repairing a dysfunctional partnership (client confidential)

Background

We were asked to step in when relationships between a County Council and Clinical Commissioning Groups broke down. Trust was low, meetings were fractious and unproductive and progress in health and social care integration had halted.

What did we do

Sue Goss began a painstaking process of meeting each of the leaders individually, listening carefully to their feelings as well as their account of what was going wrong. After hearing from everyone, she brought a leadership group together and shared a ‘problem tree’ – a visual representation of all the emotions, concerns, problems and issues that had been aired – and gained agreement from everyone to try and change things. A carefully structured awayday followed, in which leaders worked in pairs to listen to each other and build an understanding of the different perceptions and assumptions that had grown up. These were then shared in small groups and finally in the whole leadership group.

Outcome

Participants discovered that although they were often in rooms together, the pace and format of meetings and the size of agendas left little time to think and less time for meaningful conversations. The formal technical language of strategy and plans made it hard to express worries, and no-one felt their concerns were heard or responded to. What was striking was that this was a dysfunctional system with no “villains” – everyone was trying to do their best.

By creating space for the right conversations to take place, and the difficult work that had so far been avoided to be faced – it was possible to slowly build trust. Relationships slowly improved over a number of months – and while tensions didn’t go away, it was easier for them to be named, and dealt with. Leaders began to pick up the phone or go for coffee together, rather than sending prickly emails. This is work in progress.

Monday, June 16, 2014

OPM helps Lincolnshire County Council to lead the way to becoming a commissioning council

A team from OPM have been working with Lincolnshire County Council on commissioning skills and lead consultant Judith Smyth has written this joint blog with LCC colleagues.

Over 200 people at Lincolnshire County Council have completed the first round of 30 development days delivered by OPM, this included managers, elected members and commissioning support officers which supports the establishment of Lincolnshire as a leading commissioning council. Lincolnshire’s commissioning policy is at heart to ‘right source’. That means making decisions about the right delivery channel based on evidence of what will work best to improve outcomes for citizens and service users and on a robust analysis of the market.

Lincolnshire County Council (LCC) produced a very impressive toolkit in four sections to describe the standard phases of commissioning – Analyse, Plan, Do, Review. OPM worked with LCC to co-design a bespoke development programme around the toolkit. Both are frontloaded with an emphasis on Analyse so that participants in the programme understand the critical importance of the agreement at the end of the Analysis phase of a robust and credible commissioning strategy. This lays solid foundations for the agreement of detailed requirements specification and plans for any chosen delivery channels (which may include insourcing, influence and partnership, outsourcing or in-house local authority provision). The third  phase ‘Do’ is about effective ‘contracting/service redesign’ and, when needed, sound procurement. The Review phase aims to establish a consistent, effective approach to outcome focused performance review at both population/systems and service/service user levels.

During the programme we built on existing local expertise and Lincolnshire examples of effective commissioning including Lincolnshire’s Energy from Waste plant, the Highways Alliance and recent procurement of a new support services contract. We also used examples from Children’s and Adult services, Public Health and Community Safety.

In the last year Tony McArdle, Lincolnshire’s chief executive, has worked with the leader of the council, elected members in the executive and the senior manager cohort to make the commissioning approach a reality. This is set to be the operating model for all council business, governance and decision making. This means that scrutiny, financial review and budget setting, council structure, HR policy and the development of more integrated working with the NHS are all being aligned. The next step in the journey is to start a phased programme of work to develop the 17 agreed commissioning strategies that cover all Lincolnshire County Council’s activities.

Judith Smyth, who worked closely with Hilary Thompson, OPM’s chief executive to design, lead and deliver the development programme, says that “it has been a privilege to be working with the Lincolnshire team and using such a good toolkit. OPM likes nothing better than to work with a well-led and exacting client who shares our ambition to embed effective commissioning to drive efficiency and improve outcomes for citizens and service users. This is a challenging change programme. We are proud to have been part of the team at the outset”.

Thursday, February 6, 2014

Shropshire Council change programme

Background

Shropshire has merged a county and five district councils. OPM supported this major, strategic, complex change programme, with the potential to achieve large efficiency savings, improved customer service and more effective arrangements for local citizen engagement. The two pre-existing tiers of government had different functions, ways of working and organisational cultures. At least three of the district councils were opposed to the proposal to create a unitary authority and had developed rival plans for change, but were nevertheless obliged to be involved. It was clear to the client that skilled external support, which would be perceived as “neutral”, was needed in this exceptionally difficult stakeholder environment. OPM contributed to the overall strategy and led several critical interventions to support the implementation of change, including: the generation of priorities and values for the new council, support for the interim managerial and political arrangements, the development of new locality-based political structures and the creation of a new managerial team. Support for the new political leadership team is planned.

The major challenges were:

What we did

The approach we took and the benefits and value added as a result included:

Impact

Leading-edge consultant capabilities that enabled success were:

Building a close client-provider partnership, modelling effective behaviour and continuing to learn together throughout the project was central to our success. Skills and knowledge were transferred to the internal OD team and to programme participants. For example, councillors learned alternatives to committee-style approaches to local meetings; senior managers improved their ability to work as a “whole system” and to reflect on their leadership styles and access a range of styles as required.