Health Service Focus

30.10.19

Building a leadership culture fit for the future – NHS England

Source: NHE Sept/Oct 2019

 

Dom Hardy, director of primary care and system transformation at NHS England, is leading the implementation of the NHS Long Term Plan’s commitment to create integrated care systems across the country. As he explains, change starts at the top.

The NHS Long Term Plan set out bold ambitions for the people we serve, such as improving care outside hospitals and developing more joined-up, preventative and personalised services. To make these a reality, we need to sustain a new style of behaviour, making the most of all the skills offered by different members of local health and care teams.

This begins at the top. The best leaders have always understood that their organisations need to be less institutional and hierarchical, focusing more on what they can do for patients by working together. Now, the development of integrated care systems, with their emphasis on collaboration and shared goals, offers a watershed moment in how the NHS and its partners practise truly system-wide leadership.

We have already seen thoughtful and energetic leadership development across local systems, based on what people want to contribute rather than their job title. Areas such as Frimley, Surrey Heartlands and Lancashire and Cumbria South are building strong networks to support future leaders, training staff from different organisations and disciplines to work beyond historical boundaries.

We want others to be able to draw on their learning to do the same. So, we recently established a national programme to help 23 areas initiate new leadership schemes, and bolster such work already planned. Aimed at local clinical and non-clinical leaders at all levels of seniority, its priority was those directly responsible for improving and joining up services. These will be people who work across local systems, not just for NHS providers and commissioners but in partner sectors such as social care or community organisations.

This follows the experience of systems such as North Cumbria and Greater Manchester, whose leadership work has long included colleagues from, for example, the voluntary sector and care homes. It recognises that the challenges the NHS faces cannot be solved in a vacuum but will only be addressed by tapping into the expertise, energy and common goals of our partners.

The programme will benefit around 2,500 people – from GPs, consultants and therapists to nurses, social workers and managers – enabling them to lead their teams in a collaborative way. For example:

  • Spending more time looking outside their organisations to lead across systems, regardless of institutional divisions
  • Placing greater emphasis on trust, strong relationships and common purpose
  • Developing a collective, distributed leadership culture in which all wider team members are empowered and confident to problem-solve.

Schemes vary from area to area. For example, the West Yorkshire and Harrogate system plans for more junior leaders to broaden their understanding and knowledge of system leadership through a ‘shadow system leadership executive’. They will share funding across its large geography so that different local places have their own distinctive offers.

Other areas have identified their own local needs and priorities. Dorset’s proposals include developing leadership through primary care networks, and areas including Devon, Lancashire and Cumbria South will more widely share learning from work already undertaken.

Over the next year, we are extending this programme so that other systems benefit from this support too – a total investment of around £3m. I have met many local leaders at every level during the past few months, and I have been struck by their great appetite to deliver the Long Term Plan, and their willingness to rethink the definition of leadership to do this.

Our ambitions are bold, and changing culture necessarily takes patient, sustained effort. But by investing to support leaders from every part of local systems and spreading what has worked well in other areas, the NHS is building a leadership culture ready to embrace the challenges of the next five and 10 years.

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E: opinion@nationalhealthexecutive.com

Tw: @nhenews

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