a high performance and values based culture, in which autonomy is earned by Divisions, in pursuit of the highest standards of reliable, person centred care
Remember: who holds onto the string?
Avoiding a disconnected hierarchy
Leadership
Mobilising the attention, resources and practices of others towards particular goals, values or outcomes. It requires: • presence and visibility • first hand knowledge of reality of front line • learning from and remaining connected with those for whom you are responsible.
The Leadership Role
Culture change and continual improvement comes from what leaders do: - through their commitment, encouragement, compassion and modeling of appropriate behaviors. NB - The currency of leadership ……….
The Leadership Framework If leadership is not rooted in Values Mindset Behaviours then you will never deliver the goals you have set.
Effective Modern Leadership
Leaders at all levels are crucial in creating the culture of care and compassion in the NHS. Today’s effective leaders in the NHS demonstrate their leadership by:
Clarity of Purpose • • •
Aims & Values What, how much, when Assess & Measure
Behaviours • Hear Patient voice & listen to Staff • Authenticity – Signal Generator • Defer to expertise • Adopt a coaching approach
Leadership in Pictures
1. Leadership Visibility
4. Accountability - Reward - Address bad behaviours
2. Reluctance to Simplify + measurement
5. Deep Staff Engagement Share the Learning
3. Deference to Expertise
6. Teamwork
Award winning leaders – Learning from the best
@nhsc_conference #confed2014
Event supported by
Award winning leaders – Ladybirds, Lego and Leadership… Dr Nick Harding Chair MB ChB BSc FRCGP MFLM DRCOG DOccMed PGDip
Belief spells RISK
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Our health challenges •Areas of health inequalities •Inner city population - 530,000 •Health conditions – Long term conditions: stroke, heart disease, respiratory disease (COPD), diabetes; frailty •Wellbeing – mental health •Lifestyle related conditions obesity, smoking, alcohol •Cancer •Infant deaths
Our priorities: 1. 2. 3. 4.
Smaller new specialist hospital Prevention and early intervention Care closer to home – for people with chronic conditions e.g. diabetes Wider range of services available locally including specialist clinics
Evolution versus Revolution
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Our journey 2014
Our RCRH health economy a feature by Sir David Nicholson for BBC TV Newsnight for big scale transformation.
2013
Health Service Journal CCG Of the Year 2013 SWBCCG – first wave authorisation no conditions
2012
SWBCCG Clinical Commissioning Group shadow form Oct 2012
2011
New NHS reforms – GP consortia…
2010
5 GP Consortia form; 22 RCRH Care Pathway Reviews
2009
Partnerships form: Vitality Partnership, ICOF 10 Strategic Models of Care and clinical strategies agreed
2008
Primary Care Collaborative development
2007
Practice Based Commissioning
2003
Right Care Right Here Transformation Partnership forms
2002
PCTs arrive 16
Local engagement – a new perspective
Black Country LCG
Sandwell Health Alliance LCG
HealthWorks LCG
Pioneers For Health LCG
ICOF LCG
Sandwell and West Birmingham CCG
Population 530,000
Practices 111
5 Local Commissioning Groups each formed democratically by members and responsible for involving their GP practices 17
Big and small Local Commissioning Group Local ownership Ideas into action quickly Relevance
Clinical Commissioning Group Robustness at scale Resilience Strong voice in the health economy and contracts
Patient representation and Ability to deliver through major involvement partnerships Ability to deliver Overview of system improvements and efficiencies
18
Our governance Sandwell and West Birmingham CCG Governing Body
Finance & Performance
Organisational Development
Quality & Safety
Strategic Commissioning & Redesign
Audit
Partnerships
Renumeration
19
The Commissioning “Tension-o-meter” Clinicians Not being aware of harm
Poor quality of care
No services
Money
Patients What is needed
Unwise spending
Everyone’s preference
20
Three way relationship – essential Patients Clinicians Managers and support
Improving patient care •
• •
•
Better prescribing – more effective cholesterol medication
•
Redesigned and delivered new model of mental health services
•
Improved estate in primary care
•
Gateway portal - voluntary sector services available in primary care
Prevention - AF screening Coordinated information enquiries management time2talk Quality – clinically led improvements
v
Clinical Commissioning Group •
Working in health economy – decreased beds, new smaller hospital
•
Medicines management – QIPP savings £2.5 million
•
Staff culture - values based appointments
•
Primary care development – patient experience
•
Organisational development – driving new models of working
Local Commissioning Group •
•
•
Commissioning – informing specifications Service redesign Community nursing Innovation - End of life pilot – first in the country (SEIF with Marie Curie)
•
Integration health and social care
•
Leadership – Over 30 Clinical leads
•
Local Resilience – LCG structure
•
Consistency – map of medicine
Wider health economy • • • • •
Stroke – regional reconfiguration Two Health and Well Being Boards Clinical Commissioning Network – CCGs Urgent care NHS111
Introducing “push sites” • • • • • • • • • •
CCG teams have been refocused in 2014/15 12 enthusiastic groups of practices “pilot push sites” Building on community multi-disciplinary teams Locally driven change- what’s best for the community Maximising self care Prevention Develop commissioning intentions Ultimately 35 push sites Over two years 111 Better Care Fund plans
