Resources bank

We met to discuss the American approach to clinical and professional system leadership with Robert Saunders, Margolis Centre of Health Policy, and what this means for our work in south east London.

What came out in our discussion?

There is huge commonality between approaches to developing clinical and care professional leadership in south east London and the US. Key themes of our discussion included:

Barriers. There are similar barriers to effective system-wide clinical and care professional leadership in the US and south east London, including investment in skills and protected time for leaders. As we develop our approach in SEL, surveys are key to baselining, identifying ideas and tracking progress

Culture. We discussed how competing cultures can lead to dysfunctionality within a wider system. In the design of the south east London ICS we must start developing our understanding of all partners working across the system, particularly social care. In the US, many systems are seeking to establish better partnerships between health and social care but face similar issues of misaligned funding, poor referral systems and processes.

Training. Many clinical and care professional leaders face a lack of training in how to be effective system leaders. We need to provide a bridge between existing healthcare professional education and learning on the job.

What is one thing we should take forward in developing our approach in south east London?

• Ensure this is multidisciplinary and not just focused on physicians.
• Investment for colleagues to develop their leadership skills. We need a safe space to try out new ideas and concepts.
• Need to enable leadership roles across the whole system, in a stronger way. We are working on this but we need to do more.
• Protected time as a team.
• Establishing support and training for those willing to step into leadership position.
• Training for multiprofessional teams going into leadership roles and distributed leadership.
• Broaden our church of clinical leaders. Allow them to do this by supporting their time.
• Frontline staff involvement.

Watch Robert’s presentation below.

A discussion of Dorset’s approach to clinical and care professional leadership with Karen Kirkam, and what this means for our work in south east London.

What came out in our discussion?

There is huge commonality between approaches to developing clinical and care professional leadership in Dorset and south east London. Key themes of our discussion included:

Shared understanding. We recognised there is there is a need for much better mutual understanding between health and care partners. It is vital to learn what it is like to be one of the other players in the system. In Dorset they were originally astonished at how little people knew each other. This understanding can be facilitated by joint workshops and learning opportunities, and perhaps by job-shadowing.

Long term vision. We understood that we often expect to see impact in such a short time and don’t give change enough time. Globally successful integrated care systems have taken up to 15 years to be a success. Post Covid, each system needs to identify its own burning platform. Taking a population health approach can be a powerful lever.

What is one thing we should take forward in developing our approach in south east London?

• Look to make plans for 3+ years when looking at relationships and patient outcomes.
• Hold it close to heart, have a long term view up to 15 years, constantly re-evaluate and keep at it!
• Building relationships.
• Agree a long term vision.
• Opportunities to shadow leaders in other parts of the system.
• Creating some shared learning / development opportunities.
• Please bring pharmacy to the table.

Watch Karen’s presentation below.

We met to discuss Greater Manchester’s approach to clinical and care professional leadership with Tom Tasker and Warren Heppolette, and what this means for our work in south east London.

What came out in our discussion?

There is huge commonality in the challenges and approach to enabling effective clinical and care professional leadership between Greater Manchester and south east London. Key themes of our discussion included:

Principles. We recognised that emerging ICS’s are currently navigating a matrix of tensions as they establish their role. Both GM and SEL must consider how we can reframe these tensions so partners can be considered together rather than in competition (e.g. place vs/and system and primary vs/and acute. Clinical and care professional leadership will be vital in acting as the conscience and the glue to bridge these tensions, with patients at their heart.

Structures. We agreed that enabling and flexible structures are necessary to support effective leadership. ICSs need to be able to describe clinical and care professional leadership at place level as well as system level. Resourcing is essential and people need to have protected and remunerated time to lead.

Diversity. We discussed how it is necessary to drive diversity and inclusion in leadership in all forms, ensuring that our leaders represent the diversity of our workforce and population. Additionally, we must ensure intra and inter professional representation of all clinical and care leaders.

What is one thing we should take forward in developing our approach in south east London?

• While I agree that a distributed clinical leadership is right, how do we make sure there is enough overlap and make sure these shared spaces provide a level playing field for all the participants.
• I think the “who speaks for me” dynamic is something we are going to have to think about.

Watch Tom and Warren’s presentation below.

A discussion of Accountable Care Learning Collaborative’s approach to great clinical and care professional system leadership and what this means for our work in south east London.

Watch Eric Weaver’s presentation below.

John Lotherington of the Salzburg Global Leadership Academy started our discussion on how we can bring leaders together to develop a shared purpose and work together effectively.

What came out in our discussion?

There is much to be considered in South East London when it comes to convening leaders, as Salzburg Global Leadership Academy do. Key themes of our discussion included:

Relationships. We discussed the importance of building relationships before embarking on problem solving. To bring everyone together, it’s important to have genuine curiosity in others, and proactively encourage creative disagreement, to establish trust.

Inclusion. We agreed that in order to create change, diversity of perspective needs to be proactively encouraged. Practically, this might mean having smaller group discussions and openly discussing the barriers to inclusion and diversity, such as hierarchies.

Sustaining change. We recognised that there is a challenge in ensuring people are bought in to long-term change, particularly when focussed also on the immediate-term. We noted how having a statement of intent, a flexible road-map and a key individual to maintain momentum could help with this.

What is one thing we should take forward in developing our approach in south east London?

• Win the argument as to why diversity is to be welcomed and should be deliberately pursued.
• ‘Your ignorance is your greatest strength’ – encouraging curiosity and the bravery to truly have a different approach.

Watch John’s presentation below.

Peter Bibawy of the Frimley Academy discussed the Academy’s approach to system leadership.

What came out in our discussion?

There are many similarities in the challenges of system working between Frimley and South East London.

Authenticity. We recognised the benefits of bringing some of the inspiration and skills that professionals have in other roles into the leadership space. Empowering emerging leaders to develop is an important part of this.

Perspectives. We acknowledged that there is a wealth of knowledge to gain from broadening our perspectives to our wider community. This might include welcoming input from beyond health and the public sector, for true system-wide collaboration. Inspiring early career professionals to be part of leadership can also be a way to contribute towards diversity of perspective.

Ambition. We discussed the importance of normalising resistance while being ambitious. This includes being sensitive to and complementing the current system. Talking about and having champions for our vision helps with navigating obstacles.

What is one thing we should take forward in developing our approach in south east London?

• Doing the right thing! Using this as a driver for harnessing a passion for change.
• Being prepared to start small and build momentum.
• Inclusion by default.
• We should be the change that we want to see in the SEL health landscape.

Watch Peter’s presentation below.

On 10th May, over fifty members of the Connect community heard from the social explorer, author and much sought-after speaker, Cormac Russell.

Cormac discussed the importance of communities of place for societal change, arguing that it takes a village to achieve integrated care.

On 25th May, Don Berwick, founding CEO and President Emeritus of the Institute for Healthcare Improvement, shared his insights from supporting health systems around the world with the Connect community.

On 20th June, over fifty members of the Connect community came together to explore the need to act and connect differently as leaders to tackle lasting health inequalities in south east London.

We heard from a panel of inspiring system leaders, composed of Ify Okocha (Chief Executive, Oxleas NHS Foundation Trust), Lea Misan (Executive Director and founder, Act for Change), and Tafadzwa Marapara (Lead for PCREF and Service User Health Inequalities, Oxleas NHS Foundation Trust) who shared their insights from applying the latest innovative approaches to tackling health inequalities.

You can see a write up from a session here, or if you missed the event you can watch the recording below.

On 18th September members of the Connect System Leadership Community came together to explore how we need to act and connect differently as leaders if we are to truly unlock the potential within our system and integrate VCSE as an equitable and integral partner.

We heard from an inspiring panel of system leaders including Tal Rosenzweig (Director of Voluntary Sector Engagement and Partnership, SEL ICS), Barbara Gray (Development Lead, KINARAA), and Christopher D’Souza, Lead Commissioner ((Building Healthier Communities), Public Health, Lambeth Council).

Read the write up here and watch the recording below:

On 26th September Connect community members joined the launch of our second Collaborate System Leadership Programme in on 26th September to hear from two international experts in leadership and system change:

• Dr Don Berwick – The former Administrator of the Centers for Medicare and Medicaid Services, President Emeritus of the Institute for Healthcare Improvement, and Senior Fellow at the Center for American Progress, Dr Berwick is a global leader in health care quality improvement, patient safety, and health policy.
• Professor Hahrie Han – The inaugural director of the SNF Agora Institute and professor of political science at Johns Hopkins University , Professor Han is a renowned scholar of civic and political participation, collective action, organizing, and social change.

Watch the recording below: