Tuesday, March 31, 2015
Systems leadership – now we need to bank the learning…
As the election campaigns kick off I’ve been looking back over the past five years and wondering what will happen over the next five.
Since 2010, most of my work has been supporting systems leadership – working with leaders who are collaborating across organisations to achieve difficult outcomes with shrinking resources. And despite (or because of?) the financial challenges, something very exciting has begun to happen. Health and social care are beginning to integrate. Sub-regional and regional partnerships are driving economic growth and creating jobs. Organisations are sharing services and sharing assets. We are learning very practical things about how to change complex systems and leaders are emerging with the confidence, generosity and foresight to work collaboratively. Organisational boundaries are becoming more open, and more porous. We are even developing a robust evidence base about how systems work, and effective practice in how to develop system leadership skills; through interactive and creative programmes.
But we have yet, in most areas, to see results. We are perhaps on the cusp (my experience teaches me that it will take another five years for the learning to spread), for new ways of working to become mainstream, for obstacles to be overcome, and confidence to grow. In the few places like Manchester, where real change is now visible – they’ve been collaborating for decades.
What usually happens when government’s change, is that all the previous projects are pulled up by the roots – initiatives are abandoned (old thinking), training and support agencies are shut down (‘bonfire of the quangos’), leadership programmes are abandoned (waste), and the civil servants who have learnt the most move on (‘need for fresh blood’). Old concepts have to be renamed – ‘total place’ becomes ‘community budgets’ – LSPs become health and wellbeing boards and Local Economic Partnerships. After about two years, something very similar to what went before is painfully restarted, often minus the learning, and new initiatives spring up that resemble the old ones, although couched in new language.
Between 2015 and 2020, for whoever wins the election, there will be no realistic alternative to collaborative working across systems, no viable way to deliver health and social care without integration, and no sensible approach to jobs that doesn’t work across the whole local and regional economy. New communities cannot be created unless transport, housing, leisure and the environment are linked. Mental health problems or obesity, for example, can’t be tackled unless local government, health and communities work together. This time, with money tight and crises looming, we can’t afford to lose two years.
Which is why it’s so important not to lose the learning from systems leadership, and why across public services we need to bank, and share, the experience of the past five years – both good and bad. We need to involve chief executives, senior managers, politicians, community leaders, clinicians and professionals as well as HR and OD specialists, so that we can mainstream innovative approaches, learn from mistakes, and don’t have to return to ‘year zero’.
There have been excellent publications produced by the Leadership Centre for Local Government and by the Virtual Staff College. My contribution is a short paper, Systems Leadership: A View from the Bridge, which is a very personal account of what I have been learning and how to make systems leadership work in practical terms. The paper has been shared widely with OD and HR colleagues and I hope it can form the basis of a wider conversation, so that the next five years can build on the discoveries of the last five.
Tuesday, March 31, 2015
Systems Leadership: A view from the bridge
Across the public and third sectors, we are beginning to accept a new way of thinking about the leadership required, applying the theory of ‘systems thinking’ to the practical reality of trying to achieve complex change. For both practitioners in OD, leadership development and for leaders themselves, there is an important opportunity now to exchange learning about how to lead well in these difficult times.
This paper is a personal account from OPM’s Sue Goss on how to make systems leadership work in practical terms. It is not simply about toolkits and ‘hot tips’ – there is a need for new theory to help explain what is happening, as well as carefully observed learning from practice. The paper has been shared widely with OD and HR colleagues and we hope it can form the basis of a wider conversation, so that the next five years can build on the discoveries of the last five.
Thursday, March 5, 2015
Learning from Systems Leadership – what role for OD and HR leaders? Reflections on OPM-PPMA joint summit
Last month, OPM hosted a summit, along with the Public Sector People Managers’ Association (PPMA), to explore the latest learning about ‘systems leadership’ and its implications for the role and practice of OD/HR leaders and practitioners.
It was a great opportunity to exchange the emerging learning about this challenging but exciting approach to leadership thinking and practice and explore the OD and HR questions it raises. With over 60 participants from across local government and health, it is clear that many in the OD and HR community see the need for this too.
Sue Goss shares her thoughts alongside panellists (from left to right)
Kerry Furness, Debbie Sorkin and Liz Goold
Why this event?
Systems Leadership – an approach to leading across organisational, sector, professional boundaries at different levels and places – offers the kind of collaborative and collective leadership that will be increasingly needed to handle many of the complex ‘wicked’ issues facing public services, like integrating services or preventing ill-health that cannot be resolved by acting alone. This approach, by its nature, can also challenge existing models of leadership, cultural norms, working methods and workforce skills. OD and HR professionals can bring a lot to these challenges. They also need to be at the centre of this wider conversation and emerging practice at different levels – from supporting leadership at community level through to equipping senior leaders to effect whole systems change – as well as modelling systems leadership themselves.
With a growing body of research and practice in systems leadership and as we approach an election, OPM and PPMA saw this summit as a timely opportunity to take stock and ask – how might OD and HR professionals apply this emerging learning to equip our organisations, localities and communities for an even more challenging future? And what might this mean for their role and practice?
The day itself
Debbie Sorkin, the National Director of Systems Leadership at the Leadership Centre joined the panel with Liz Goold and Sue Goss from OPM and Kerry Furness, the OD lead for PPMA – all bringing a rich mix of experience and expertise in systems leadership thinking, development and practice in public services, as well as OD. The summit involved stories and input, small group and plenary conversations and an Open Space session.
What are we learning about systems leadership?
We explored lessons from research and practice ‘in the field’, along with participants’ own experience. Debbie spoke of many incidences of real progress being made in Local Vision places and NHS Pioneers, as part of the national Systems Leadership programme, for example, Wakefield, Wiltshire, and North West London. She shared factors that have helped systems change and leadership to flourish, for example:
- Being willing to cede organisational goals in service of a collective ambition;
- Going wider than you originally thought – involving people in communities – as that’s often where the energy and creativity lies;
- Not being bound up with formal roles – willingness to experiment and take risks;
- The crucial importance of shared purpose and strong/honest relationships to weather the storms; and
- Having a coaching and support network.
Further learning about the difference that systems leadership can make will also be made available through an evaluation of the Local Vision pilots that is currently underway, commissioned by the Leadership Centre – so watch this space.
Sue Goss shared stories from her experience as a ‘system enabler’, including a vivid account of her work with one integrated health and social care board where there was much ‘dancing around’ the partnership table, avoiding the difficult conversations which then escalated into conflicts. For Sue, the systems leadership perspective here means, “informal meetings, having honest, difficult conversations, careful design of formal meetings, making sure the right people are in the room – talking to those who are not – getting the right work done in advance, and understanding each other’s perspectives. Some of the most important meetings happen in Costa Coffee”.
This approach may mean re-focusing attention on where the differences are, not just where there is consensus. It sees conflict as useful – if it is creative – rather than being used to avoid the difficult issues. At the same time, this disturbance can cause much anxiety which needs to be acknowledged and held to enable creative, courageous thinking and wise action without minimising the scale of the challenge.
Many OD practitioners (including myself) will see this as familiar territory but what systems leadership offers, is the opportunity to move OD thinking and practice out onto a much wider, cross- organisational, cross-cultural, cross-sector and cross-systems canvas. Several commented on the day that this challenged their own mind-sets and models of OD. As one participant commented, “what shift do I need to make in my own model of OD? How do I practise and model systems leadership as an OD practitioner?”.
Mindsets and behaviours needed
This led into a conversation about the mind-sets, behaviours and skills needed by systems leaders. Drawing on international research and practice, the model below illustrates different inter-related dimensions of systems leadership – with improving social outcomes at its heart. Above all, it emphasises that systems leadership is a mind-set or approach, rather than a set of technical skills or competencies. The Virtual Staff College has commissioned a helpful synthesis paper outlining this model further.
Sue Goss also shared a draft paper from her practitioner experience that develops these dimensions further, which will be circulated more widely shortly. Reference was also made to related research on the ‘21st Public Servant’ carried out by INLOGOV and the University of Birmingham.
Systems Leadership: Exceptional leadership for exceptional times,
Virtual Staff College 2013
Many recognised that OD and HR leaders/practitioners also needed to model, integrate and feel confident with these different dimensions, if they are to be (and be seen as) systems leaders themselves. As one participant commented, “we need to up our game”. Others recognised this approach also surfaced dilemmas and tensions between contradictory paradigms and competing demands that needed to be navigated “what happens when system leadership thinking – emergent, distributed, complex – hits up against more structured/conventional expectations of OD? How do we deal with the tension between complexity, collaborative working & accountability?”.
So, how might these mind-sets and behaviours be nurtured and developed?
Different examples were shared by colleagues of developing, promoting and influencing systems leadership including national place-based programmes, local joint commissioning leadership programmes (see Kerry Furness’s article in the Municipal Journal for more info), in-house workshops for senior leaders and action learning sets, engaging politicians with public health professionals and supporting community-level action with parish councils. Creating the conditions for these to happen often involved exercising systems leadership, as well as using the key principles in their design. For example, the national ‘Leadership for Change’ programme, where I am co-Residential Facilitator, is run by Virtual Staff College as part of a systems leadership alliance, including Public Health England, The Leadership Centre, NHS Leadership Academy. Design principles involve:
- Senior leaders (e.g. local government, public health, CCGs, Third Sector) learning together from the same locality – through ‘place teams’ rather than just as individuals;
- Effecting change, as well as deepening learning by experimenting and working on live systems leadership challenges in-between sessions, in their locality, supported by a place team coach; and
- Creating synergies and connections with leaders from across different sectors. A Third Sector programme participant commented on the value and power of developing fresh perspectives, challenging assumptions (her own and others) and developing new relationships that were unlikely to happen otherwise – and how different this was to other leadership programmes that often just involved individual leaders from the same sector.
Key questions for exploration – Open Space
The conversations generated a number of themes and questions, some of which we explored further in an Open Space session. These included:
- The big Why? Who or what is this ultimately in service of? – How do citizens, communities, patients remain at the centre? Is this about re-distribution of power, social good, behaviour change? To what extent does it point to larger social questions e.g. democracy? How might we see systems leadership as part of creating a social movement for change?
- Creating a narrative for systems leadership and our role in it – How might we find innovative ways of telling a story of the impact of this kind of approach and the added value we can bring, often in unseen ways? How might these stories speak to/engage others, e.g. politicians? How might ‘the business case’ be framed in a different way? (i.e. can we afford not to, given where we are heading?). The evaluation of Local Vision pilots may be helpful here.
- How to build capacity/take systems leadership forward from an OD/HR perspective? – Are current leadership programmes enough/fit for purpose? What other approaches might we take informed by systems leadership principles? How do we develop our own understanding and practice as systems leaders? What can good OD thinking and practice also bring to the table?
- Engaging with senior leadership – How do we help them create the right conditions for promoting/modelling systems leadership – and what if they’re not? What crucial conversations do we need to have?
- The role of politicians in systems leadership – How do we engage with them meaningfully?
- Do we know what is already happening in our own organisations/what else is going on out there? This led to one group mapping out what was already happening in relation to systems leadership nationally – as a basis for building on existing or making new connections rather than duplicating and building a LinkedIn group for participants – all part of systems leadership!
The next cohort of the Leadership for Change programme will be running in June/July 2015.
Do we know what is already happening in our own organisations?
What else is going on out there?
Taking systems leadership forward
Some useful pointers for taking systems leadership forward from an OD/HR perspective from the Open Space session included:
- Don’t try and do it top down or organisation wide all at once – go where someone has a problem where it might help to move things forward – go where the energy is;
- Help identify values and behaviours and ‘simple rules’ with a more systems focus;
- Find some energy or friendly faces and just have a go – start small and use what you have;
- Break away from the ‘usual suspects’ – use cross slice working bringing the right skills together – knitting together different perspectives-use informal networks;
- Upskill OD/HR business partners in key skills to facilitate systems leadership activity and offer those services more;
- Develop your own narrative from this experience that speaks to those you are seeking to connect with/mobilise;
- Engage senior leaders – be prepared to have the difficult conversation;
- Involve politicians from the start and all the way through, not just ‘reporting back to’ at the end. Engage in creating a shared story with them; and
- Probably best not to give it a label – just approach the work/problem using the principles.
The last point is a helpful one, as it may be more important to integrate and apply the underlying principles in everyday practice rather than get too hung up on a label. Developing a shared narrative of these principles and finding practical ways of applying them, would help with that. As Debbie remarked, “OD and HR people in local government and health need to develop their own narrative of systems leadership and see themselves as central to it”.
We also see many synergies with principles underpinning more contemporary approaches in OD and change, which could enrich and deepen systems leadership work. Likewise, with community capacity-building work. OPM has been exploring these synergies with PPMA members recently, as part of some action research, which you can read out about in this article from the Municipal Journal. We see a real benefit in OD practitioners, systems leaders and those involved in community engagement bringing these principles together – as part of a shared narrative and practice.
As indicated before, systems leadership is more of a mindset and approach than a list of tools and techniques. By its very nature, it helps to widen your lens – or indeed, apply different lenses, wherever you are in the system. It means connecting with the disconnected, going beyond the ‘usual suspects’ or traditional networks, getting multiple perspectives into the room, having the right conversations, thinking beyond the individual ‘hero leader’ and organisational boundaries and paying attention to the relationships and patterns between. It will constantly ask, ‘who or what is this service of?’ – keeping citizens, communities and patients at the centre. It is not by any means the ‘silver bullet’ and does not intend to discount or replace other forms of leadership or management – but it may well challenge them. If basic management processes are not in place, then arguably, a systems leadership approach will struggle to add value – but on their own, they are not enough.
This approach to thinking and leading across multiple systems can be challenging all round, including for the OD/HR system(s) itself but given the difficult times we face, this approach does seem very relevant and in need of attention and support. OD and HR leaders and practitioners have a key role to play here and need the appropriate support and development themselves.
Action and feedback
“Very thought provoking and energising event, met some useful contacts for follow up sessions that I now want to do locally and also useful to promote our regional plans for an OD Systems network”.
“I thought the panel part of the session with the practical examples was really valuable – and hearing the different experiences on the ground”.
“This event supported the bringing together skills at comparable levels across numerous organisations which allowed for productive debate and sharing”.
From the conversations and feedback at the event and since, it’s clear it has stimulated thinking and connections and supported a clearer sense (belief even?) of the central role that OD/HR has to play in systems leadership – as well as the courage and confidence to give it a go. From the individual commitments made on the ‘commitment tree’ at the end (see flip-chart notes) and feedback received, it’s clear there is a lot of energy and momentum to do just that in different localities, as well as in individuals’ own practice.
The Commitment Tree
Follow-up – support and next steps
- PPMA want to build on the energy and interest in the room for developing communities of practice and connections with other OD/HR networks across sectors. Based on feedback after the event, Kerry Furness will be contacting PPMA regional chairs about the possibility of repeating similar events in regions. Please get in touch with Kerry or your regional chairs if you are interested and with any further ideas you have;
- OPM and the Leadership Centre are available as a resource for those who want any further support in taking systems leadership forward (see contacts below);
- Following feedback, there is a desire to explore themes and practical examples/methods in greater depth. For example, a joint event is now currently being explored for OD/HR practitioners with NHS Employers around health and social care integration and what OD and systems leadership can offer, in particular the cultural implications;
- Connect with each other – a contact list from the event will be made available and use the LinkedIn group being set up!;
- The Leadership Centre is currently developing a workbook, The art of Change Making, that will offer an important resource and will be available shortly;
- Sue Goss’s draft paper, Systems leadership – A view from the bridge, is also a resource from a practitioner perspective. She will be writing a blog on this shortly – so watch this space;
- Share this write-up and the resources attached with your networks to share learning, stimulate interest and build connections; and
- Ultimately this means us all taking responsibility for creating spaces for individual and collective reflection on practice- and giving systems leadership a go, wherever you are in the system.
This event was a collaborative endeavour between PPMA, OPM and the Leadership Centre and we sought to exercise systems leadership ourselves by drawing on our respective networks and creating the conditions for conversation and connections to support learning and change – and we hope this will continue and spread. We are all keen to hear your own stories of how you are influencing, developing and modelling systems leadership wherever you are, the steps you are taking, however small, what you are learning, what changes are happening – and let’s see where the energy takes us!
If you would like to connect with us and build on this momentum, please contact:
The Leadership Centre: email@example.com
 ‘Leadership across organisational and geopolitical boundaries, beyond individual professional disciplines within a range of organisational and stakeholder cultures often without managerial control (or formal /professional authority). The intention is to effect change for positive social benefit across multiple interacting and intersecting systems’ Systems Leadership: Exceptional Leadership in Exceptional times, Virtual Staff College (2013)
Thursday, January 22, 2015
Learning from Systems Leadership: What role for OD and HR leaders?
How is systems leadership enabling innovation and transformational change across public services, localities and communities? How can systems leadership be best developed and what does this mean for the role of OD and HR leaders?
The public sector faces major challenges that need strong collective leadership operating across local systems, rather than within single organisations. We’ve seen several good examples of this over the last decade, particularly through a number of ‘whole systems’ experiments and pilots – from Local Strategic Partnerships (LSPs), to Total Place, to the more recent Local Vision Systems Leadership pilots sponsored by a powerful coalition of health and local government leadership bodies.
As we learn from these experiments, new leadership theory and practice is emerging around ‘Systems Leadership’ development to support public service organisations working in complex and multi-agency settings. Organisation development (OD) and HR professionals are naturally well placed to support this and need to be at the centre of this wider conversation and emerging practice – from supporting leadership at community level through to equipping senior leaders to effect whole systems change.
With this in mind and as we approach an election, it is important to take stock and apply the emerging learning in systems leadership to equip our organisations, localities and communities for an even more challenging future.
At this special joint summit, PPMA and OPM will bring together learning from the most recent experiments to do just that and to give the chance for you to connect with other senior OD and HR professionals. We’ll be exploring what this learning might mean for your role and how you might be at the forefront of this challenging but exciting shift in leadership development and practice.
Spaces are limited, so don’t miss out.
What we’ll cover
- Lessons in supporting systems change and systems leadership – including emerging systems leadership research.
- Practical learning about the skills and qualities needed for systems leadership – and how they are best developed, drawing on evidence from experiential national leadership programmes and ‘learning-in-action’ within and across organisations and localities.
- An exploration of the role of HR and OD professionals in supporting senior leaders to acquire these skills and the cultural and workforce implications this raises, alongside the evidence from experiential national leadership programmes about how to develop ‘learning-in-action’ within and across organisations and localities.
- An opportunity to explore what this means for the OD and HR community in going forward.
- Debbie Sorkin, National Director for Systems Leadership, Leadership Centre
- Sue Goss, Principal, OPM and system enabler for current Local Vision experiments
- Liz Goold, Senior OD Fellow, OPM and facilitator on a number of national systems leadership development programmes
- Kerry Furness, OD lead, PPMA and OD Manager, Norfolk County Council
This is a free event and the limited spaces will be offered on a first come, first served basis. If you’re interested in attending, please email Rosie Keefe at firstname.lastname@example.org.
Refreshments and lunch will be provided and if you have any special access or dietary requirements, please let us know and we will do our best to accommodate them.
If you have any questions, please get get in touch with Rosie Keefe at email@example.com or on 020 7239 7816.
For more information about PPMA go to www.ppma.org.uk
For more information about OPM go to www.opm.co.uk
Tuesday, January 6, 2015
Evaluation of the Leading Integrated System Level Change Programme
The Advancing Quality Alliance (AQuA) is a membership organisation supporting NHS commissioners, providers and their partners. In April 2014, AQuA began delivery of a new support programme ‘Leading Integrated System Level Change 2014/15’.
The programme involves a series of master classes on large-scale change and complex adaptive system theory and distributed leadership. It also includes the Integrated Care Fellowship Programme and International Exchange Programme. Paul Plsek and The King’s Fund are working in partnership with AQuA to deliver the programme. Bespoke coaching support is also available as a draw-down offer.
The programme is aimed at senior leaders from health and social care organisations, who have authority to take decisions and influence change within their organisations and across the local health and social care system. The participating economies are: Central Manchester, Bolton, Wigan, East Cheshire, Trafford, Oldham and Pennine / East Lancashire. Wirral initially joined the programme, but have currently withdrawn from engagement.
In May 2014 OPM was commissioned to undertake an independent evaluation of the Leading Integrated System Level Change programme. The aims of the evaluation are to provide an understanding of how the programme supports large scale system change, and to explore the transferability of the model to other system level reforms. The evaluation also aims to explore the value added by the International Exchange Programme and the AQuA Fellowship. AQuA will use the external feedback to shape the programme and demonstrate its impact.
This report presents the emerging findings at an interim stage of the evaluation.
Tuesday, February 25, 2014
Organisational development of North East Lincolnshire Clinical Commissioning Group
The initial phase of work with North East Lincolnshire CCG (NEL) was one of early governing body development, with a particular focus on distributed leadership and operating as a membership organisation, in line with authorisation requirements. OPM offered learning from elsewhere on these key topics as well as encouragement for new ways of working. NEL were successful in the first wave of authorisation. They now have clear clinical leadership in place and have worked over the past year to balance this with community input and challenge alongside managerial support.
Following a shared diagnostic process with top team members, OPM was invited to further work with NEL to deliver a series of development interventions which were designed to:
- Clarify how the triangles connect with other parts of NEL’s governance structure
- Create a common understanding of the role and remit of the triangles and of each participant’s role within them, with an emphasis on developing mutual respect and an appreciation of the value-adding potential of different contributions.
- Connect the triangles to the wider CCG membership, building skills to create engagement and deliver change.
- Ensure that the managerial and support functions of the CCG are aligned with the work of the triangles.
What we did
To address these aspirations OPM facilitators worked first with the three groups of clinical leads, lay members and managers separately to explore how each group saw the contribution of each of the three roles and what helped and what hindered from their perspective. These group discussions surfaced a great deal of previously unspoken confusion, a lack of clarity about the extent of their discretion to make decisions, some uncertainty about what those in other positions could contribute, and a real acknowledgement of how little conversation had so far taken place about this fundamentally important aspect of the CCG’s operation.
We then arranged and facilitated meetings with the three members in each of the eight service area triangles, invited them to reflect on a share their thoughts about the earlier group meetings, and then worked through a typical cycle of commissioning tasks and their roles and likely contributions at each stage with them. Through this process of more informed, open and focused discussion, differences were discussed and greater clarity about roles, responsibilities and areas for development emerged. Feedback to and discussion with the top team about their role in modelling ‘triangle’ thinking , behaviour and culture set the scene for a whole system workshop which brought all the triangle members together with the senior team to agree the key elements of future work in NEL and the means to their achievement.
From the perspective of early 2014, we feel confident that the challenge and support we contributed to NEL’s organisational development has led to some longer term changes, in line with the CCG’s strategic intentions. The clinical chief officer has recently commented that: ‘The way care is delivered has shifted to be responsive to community wishes and priorities – it’s no longer only about clinical priorities’.
Thursday, February 20, 2014
Breakfast Seminar: Systems Leadership – what is it, do we need it, how do we do it?
Join us for this free seminar where we will discuss how systems leadership could be the key to successful service integration.
As public sector leaders develop radical plans for service integration, ‘systems leadership’ is increasingly at the heart of success. And while it’s hard enough to lead a single organisation well, many of the new experiments involve several organisations pooling resources, people and strategy. At this seminar, we are bringing together leading systems thinkers and practitioners to explore systems leadership challenges.
We will look at the leadership needed to change a whole system, how to do it well and the pitfalls and obstacles to look out for. We will explore:
- System redesign – how do we create the leadership to redesign a system both vertically and horizontally, for example working with troubled families or the work programme?
- Changing thinking and practice across several organisations at many levels and in many places at once. What does this mean for leadership, for organisational development and for culture?
- Health and social care integration – how do we create powerful shared leadership in a fragmented delivery system?
- Relations with communities – public services working collaboratively to support communities in helping themselves.
Learning is gradually accumulating from Total Place, Community Budgets, and now the LGA/NHS system leadership experiments, and the NHS pioneers – so we are building up both a theory and practice of good systems leadership. At OPM we’ve been working with a number of whole systems and are keen to share the learning and to explore the emerging dilemmas. How do you balance experimentation with project management to get change at pace and scale? How do you control potentially escalating transaction costs? How do you cope with system pressures that drive change off course? How do people stay open and courageous when change involves cutbacks? What support is needed?
John Atkinson, leadership advisor to private and public organisations, advising on the requirements of fundamental change. Previously John was a director at KPMG and before that, managing director of the Leadership Centre for Local Government.
Deborah Mckenzie, Director of Organisational Development, Public Health England
Sue Goss, Principal in Local Services, OPM. Author of Making Local Government Work-Networks, Relationships and the Management of Change
Who should attend?
This workshop is for chief executives, executive directors, senior clinicians and managers, politicians and third sector managers interested in improving their own, and their organisation’s capacity for system leadership.
The seminar will be held at Lumen URC, with breakfast served from 8.30am (for a 9am start). The panel discussion and Q&As will be finished by 10.30am, leaving half an hour for networking. If you have any special access or dietary requirements, please let us know and we will do our best to accommodate them.
Wednesday, February 19, 2014
Bath and North East Somerset CCG simulation of the urgent care system
Bath and North East Somerset (BANES) CCG asked OPM to design and deliver a simulation of the urgent care system as part of their planning for winter 2013/14. Senior leaders in the area were aware of the need to establish fundamental change across the whole health and social care system that would help to meet the challenge of rising demand for emergency care in a climate of limited or reducing resources.
A process for thinking creatively, holistically and collectively was needed – where current services and delivery practices would be challenged and ways of improving patient experiences and flows could be explored. To meet these requirements OPM designed a behavioural simulation exercise of the whole urgent care system from primary care, ‘blue lights’ and A&E, to discharge and social and community care services.
What we did
Following desk research, scoping work with CCG and RUH colleagues, a simulation was developed. The event held on 23 July in the centre of Bath, brought together local stakeholders from across the health and social care economy, collectively fast forwarding the local health and social care system. Simulation constructs a plausible but simplified version of reality, sufficiently developed so as to create a clear sense of what a place is like and how different events will impact, but simplified enough to be manageable in a compressed timeframe.
Fifty-one people participated in the event, drawn from across the health and social care system in BANES and Wiltshire.The simulation was designed to provide participants with the opportunity to shape and influence plans for the management of urgent care, and to ensure that the system can respond quickly and effectively to urgent care challenges when they arise.
The simulation succeeded in galvanising the entire system to take more concerted action to improve urgent care planning in Bath. It also confirmed in the minds of all parties that it is the CCG that, as system leader, has the responsibility for making this happen.
Overall there was clear evidence of a wish to move beyond any version of ‘awful is normal’. Escalation processes are of course essential to manage immediate pressures but they do not in themselves establish action plan to manage pressures in the whole system more effectively in future. However, the strong sense that all members of the health and social care community need to work together, with clear leadership, to deliver sustainable hospital occupancy levels, was increasingly evident as the simulation progressed. As a direct result of the exercises a number of tangible improvements to plans have been made.
Working with the whole health and social care system in a local area together for a day, participants are able to explore and shape their plans for the management of urgent care in a way which effectively speeds up the usual processes of arranging meetings, building better working relationships based on an understanding of each agency’s contribution and limitations, and using that time together to challenge the usual ways in which seemingly ‘stuck’ problems may be addressed. While the central focus is on urgent care provision, it is no coincidence that other aspects of integration and improved patient experience also receive valuable attention. We wrote about we learned from the simulation in the Health Service Journal: How simulations can help develop new thinking to tackle winter admissions crises.
Thursday, February 13, 2014
Coaching: A guide to helping people to succeed at work
This guide is for anyone wanting to use coaching skills to help colleagues succeed. In particular, it is intended for managers and those with responsibility for enabling staff. Coaching is a rapidly growing method for helping people to improve, develop, learn new skills, find personal success, achieve aims, manage change and overcome personal challenges. It can be used both in our professional and in our personal lives. This guide will concentrate on the former, providing an overview of what coaching is, how it can be used, by whom, when and where, and how to access it.
Tuesday, February 11, 2014
Coaching skills to help NHS Trust managers meet the challenges of Foundation Trust status
Pennine Care NHS Trust is a mental health trust in the north west of England which in recent years became a foundation trust. As part of the transition the Trust was keen to ensure that managers at the third tier level were able to meet the challenges of foundation trust status. In particular, the Trust wished to enhance the capability of managers to work together effectively – this level being the crucial interface between strategic and operational functions.
One of the Trust’s senior managers had participated in one of OPM’s ILM Diploma in Executive Coaching and Leadership Mentoring programmes and was keen to draw on the benefits of coaching for helping managers, individually and collectively, to achieve this goal. Working closely with the senior manager we designed a bespoke one-to-one coaching programme that was implemented over an 8-month period during 2009 and created space for third tier managers to:
- Work through their own views about their roles and the contribution they make to the achievement of the Trust’s goals;
- Review the progress of the Trust and the third tier management team;
- Identify and enhance individual and collective strengths;
- Build their capabilities to meet the challenges facing the Trust; and
- Establish the most effective ways the Trust can support them in your role, now and in the future.
What we did
The coaching programme comprised three elements:
- A ‘scene-setting’ team workshop facilitated by OPM to open the programme;
- A series of four one-to-one coaching sessions for each manager with an independent executive coach provided by OPM – these sessions focused on building each manager’s capabilities in areas of relevance to them; and
- A ‘forward planning’ team workshop facilitated by OPM to close the programme and determine how to follow-up emerging themes.
At the scene-setting workshop an OPM coach used a team coaching approach to enable managers to identify the major challenges facing the third tier team as a starting point for individuals to establish an appropriate agenda for the coaching conversations. Following the series of confidential coaching sessions the team came back together for the forward planning workshop to share their learning, agree practical strategies for moving the team (and the Trust) forward.
In subsequent years the Trust commissioned OPM to run ILM Level 5 and 7 coaching qualification programmes as part of its strategy to establish a cadre of in-house coaches and develop a coaching culture. Over the years we have continued to provide support to Pennine Care coaches in the form of supervision and advanced skills workshops. Now that the Trust has trained its own internal coach supervisor our role has focused on CPD activities.
We have continued to provide executive coaching to individual managers on a call-off basis, including:
- Transition support for 4 managers over the first 12 month period of their involvement with the Trust following the merger of their community-based health organisations into Pennine Care;
- Support for managers moving into new roles; and
- Helping managers to deal with specific and complex challenges.
Our coaching work with Pennine Care has been highly successful. Feedback from the senior manager who commissioned the coaching indicates that both he and his top team colleagues have noticed significant improvements in individual effectiveness, notably in relation to influencing, giving and receiving feedback, and in the cohesion of the management team, including the incorporation of new members.
The Trust sees coaching – alongside other organisational development initiatives – as a key way of equipping individual managers and teams to deal with the challenges of foundation status. OPM is now working with the Trust to create a team of qualified, in-house executive coaches at senior level to sustain and expand the benefits of coaching throughout