In times of economic and structural upheaval, there's a natural instinct to hunker down and wait for the storm to blow over. But Macmillan Cancer Support is responding to the flux in health and social care by taking a brave step forward: investing in a large-scale programme from The King's Fund to make the organisation more effective, resilient and better equipped for the new health and social care economy.
Why take action now?
'The external environment across the UK has become extremely complex,' explains Juliet Bouverie, Director of Services at Macmillan Cancer Support. 'We want to play an increasingly influential role – both nationally, by influencing bodies such as the Department of Health, and locally – for example, by working with clinical commissioning groups or hospitals that need to save money.
'Macmillan also increasingly sees its role as that of a change agent, transforming services so that they meet the needs of an evolving cancer population. So we needed a leadership programme that would help our regional service managers to understand the changing external environment across the UK, develop skills to influence and negotiate with multiple partners, and understand the methodologies to redesign care pathways so that they are better co-ordinated and more person centred.'
What does The King's Fund programme deliver for Macmillan?
The King's Fund responded with a complex intervention that is being delivered to 65 staff from across the UK. 'The programme has multiple aims,' explains Judy Taylor, programme director. 'The design includes mechanisms that engage Macmillan senior leaders in the process, to ensure that the result aligns with the organisation's strategic agenda. These mechanisms also create a feedback loop into the senior leadership team, to help senior managers understand the regional service manager's experiences of working differently, so that they can change organisational processes and systems to support new practices. Participants are also undertaking projects with staff with whom they usually have little contact, building new relationships and ways of working across the whole organisation.'
What are the benefits of this programme
'The spread of the impact goes way beyond the participants: it's actually reshaping Macmillan's role nationally, so that the organisation is better able to respond to the changing needs of people with cancer and the fast-moving NHS and social care environment,' says Judy.
For participants, the nine-month programme is an intensive learning experience. 'At the beginning there was some apprehension about the programme,' admits Juliet. 'Staff weren't sure if it would be used as a performance management tool. Choosing The King's Fund helped to increase its credibility, and it's considered a flagship provider among our managers, and many had been on its programmes before.'
Just a few months in, the programme is already starting to pay off. 'This is by far the biggest investment we've ever made in a development programme, so we didn't take the decision lightly,' says Juliet. 'But it's been transformational. We're investing in people at the front line where the change is going to happen.'
What do delegates think of the programme?
'It's not easy making time for the development days, but I really look forward to them. The activities are useful, dynamic, intereresting and relevant. It's so valuable to reflect in such a fast-moving world.
'A big part of the work involves looking at relationships in the organisation. There's also a recognition that the organisation is working to adapt to a world that's changed so dramatically. The leadership and co-creation skills are helping us to go out more confidently and help partners to design services that are truly patient centred – building on Macmillan's strengths and taking them to new levels.'
Ingrid Goodman, Senior Macmillan Development Manager, England
'My job involves working with senior civil servants and government ministers, so I was already quite a confident communicator, but this programme has given me a theoretical framework and context for the way I work. I thought I was a total maverick, and it was useful to discover that my way of working was a valid approach!
'The programme is helping us come to see change – both internal and external – as 'business as usual'. Health and social care is in flux across the UK. The challenge for Macmillan is to keep the focus on cancer throughout all this change and to spot the opportunities. The programme is hleping to equip us with skills for the new world, while helping us to develop relationships across the organisation too.'
Heather Monteverde, General Manager, Northern Ireland
This article first appeared in Insight, a magazine produced by The King's Fund for the NHS Confederation Conference 2012.