‘Being a senior or emerging leader intent on enabling better systems working across the health and social care sectors can be a lonely business,’ says Nicholas Bradbury, senior associate at the NHS Leadership Academy, as he leads the design and delivery of their Director and Intersect programmes.
Many of us have become used to 'silo working', which creates large gaps, not only between health and social care delivery, but within our own organisations.
Effective systems leadership pans out to see inter-dependencies. It looks at the ‘whole’ from all perspectives, overcomes rivalries and, in some cases, the fear of relinquishing power by sharing.
It works on the assumption that systems can only move at the speed of the trust held between all those involved. Whether improving pathways between local government and social care, or improving communications in hospitals, where trust is absent, so is system collaboration.
So if put simply, systems leadership shows how ineffective it is to stay in silos, what’s stopping us?
- Small-picture thinking: We’re still prioritising our own organisations rather than the system as a whole
- Red tape: Regulators are often considered a barrier, as research from The King’s Fund recently revealed. Rather than encouraging each organisation to just act independently and compete on its own terms, we need to encourage a whole-system approach with all parties working towards the same end-goal
- Lack of trust: You can’t have system collaboration without everyone coming together and believing, trusting in a shared objective
The NHS Leadership Academy’s Intersect programme is creating a community of like-minded people right across the public and third sectors. It aims to develop and nurture systems leadership capability across services for the benefit of patients and citizens.
The programme approaches this by challenging its participants to do profound and challenging personal work while promoting and sharing a deep understanding of cross sector dynamics and cultures - empowering leaders to tackle inequality, social exclusion and conflict.
It gives participants:
Access to leading edge thinking
- The increased confidence to establish meaningful and productive relationships
- The opportunity to network with senior cross-sector leaders from across England
- Increased emotional intelligence and self-awareness
- The personal authority and relationships skills needed to co-create effective systems leadership networks
So if you want to adopt an open, enquiring mind set and refuse to be constrained by current horizons, this may be the programme for you.
As one participant summarises:
I can now move more easily beyond the remits of my control, take risks, build relationships that are meaningful and influence the wider system within which I live and work. I have found a power that is humble, just and innovative, and it seems to work!
Comment by Pearl Baker posted on
I gave evidence to the Leadership Academy on the NEGLECT identified in my Photographs, nothing has changed for (some) I was contacted by a Senior Social Worker in Birmingham who identified 20 Safeguarding issues with one owner/provider but 'powerless' to act? three Carers with relatives in the same 'supported unregulated accommodation' contacted me?
I have just returned from a CCGs and LA meeting, no LA representative turned up?
The meeting was about 'Care Plans' and LTC, when questioned 'how could they 'evaluate' Mental Health patients who have NO 'Care Plans' there was a silence.
It is well overdue that the CCGs had some form of 'feedback' procedure from the General Public, until this occurs Mental Health will remain the 'Cinderella' for ever.
I have identified the 'gap' in Mental Health? they often become 'invisible' > Hospital discharge to GPs is where the problem lie. The CQC have viewed the evidence and agreed to my 'agenda' meeting with the Trust Clinical Director, and the CQC Lead in Hospital Inspections. The CCGs have not replied to my invite to attend?
Comment by Craig Anderson posted on
A few reflections
Crime & Disorder Partnerships, with a 'Duty to Co-operate across LA/Police/Probation/Health/Social Care were good at co-ordinating resources to hit firm targets. We need the same 'duty to co-operate' across public service.
Until a' duty to co-operate' is championed at senior management level silo working will remain the cultural norm, with occasional evidence of bold managers challenging the status quo.
Gap identification' needs to be embedded in corporate culture and reflected in Personal Objectives for Directors to cascade.
Comment by Joseph Hannigan posted on
Comment by Paul Lamont posted on
Often the best kind of integration and cross-system working is simple. A couple of days ago I read of a really neat integration project being run in the Sutton area of London. It is as simple as a bag containing patient data, belongings and medication that is accessible to care homes, hospitals and ambulance personnel. It looks to be improving hospital transfer in the region significantly. I will be interested to see if the idea spreads to other areas.
By the way, the article can be viewed at https://alpinehc.co.uk/engage/positively-caring/the-red-bag-a-brilliantly-simple-initiative-making-a-big-difference/