Leading across the health and care system

Lessons from experience
As the NHS seeks to move away from competition towards integration and to develop new models of care, individuals and organisations across the health and care system need to learn to work together to make the best use of collective skills and knowledge.

This paper offers those who are leading new systems of care some guidance on how to address the challenges they face. It draws on the Fund’s work on the development of new care models, sustainability and transformation plans, and accountable care organisations. It is also informed by the experience of people who have occupied system leadership roles and draws on case studies from our research and organisational development work.

Leading across the health and care system - publication cover

No. of pages: 24

Key messages

The paper details five factors that facilitate system leadership:

  • develop a shared vision and purpose: this requires a shift from a reactive problem-solving mindset to creating a positive vision of the future built around the needs of local populations
  • have frequent personal contact: face-to-face meetings enable leaders to build rapport and understanding and to appreciate and acknowledge each other’s problems and challenges
  • surface and resolve conflicts: this depends on leaders’ ability to recognise conflicts, work them through and create the conditions in which it is safe to challenge
  • behave altruistically towards each other: to work together in a collaborative way, leaders need to move away from a traditionally competitive style and to focus on the bigger picture
  • commit to working together for the longer term: leaders need to invest time and energy in forming effective long-term relationships and to resist the pressure to focus on the immediate, transactional issues.

Our work shows the importance of working on all five factors together and of focusing on the need to transform the relationships among people in the system. NHS leaders could benefit from the experience local authority leaders have in achieving results through consultation, engagement, persuasion and influence.

How can we help?

Organisational development practitioners respond to the specific needs of each area and each group of leaders, and can use their skills to enable leaders to find solutions through reflection and dialogue.

Our Leadership and Organisational Development team has experience of working with a range of partners in new care models and other joint bodies, supporting them in creating the leadership and culture they need to work across the system.

We also offer a range of leadership development programmes that aim to support collaborative working, including our Building collaborative leadership programme and the Advanced OD practitioner programme.

Related content

  • Nick Timmins talks to Ruth Carnall, managing partner at Carnall Farrar, about her experience as a chief executive in NHS London, the barriers facing system leaders, and whether system leadership can be taught. Watch the video >

  • David Meates, chief executive of the Canterbury District Health Board in South Island, New Zealand, describes how transformation was delivered. Watch the video >

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#549651 Pearl Baker
Independent Mental Health Advocate & Advisor/Carer/DWP Appointee/Deputy to COP

As a CARER we come across those who take 'CONFIDENTIALITY' too far: GPS are the worse, will the latest Guidelines introduced by the GMC on the 25th April 2017, make a difference?

Take into account:

'The significant role that those close to the patient can play providing support and care and the importance of recognising that role'. I doubt it will make any difference, yet this is 'entwined' with 'safeguarding'.

New standards coming into force for Pharmacy Professionals 12th May 2017 nine standards: in my opinion does not go far enough.

Those Professional Agencies responsible for delivering an 'Integrated' service should at least 'SPEAK & Communicate' to each other before making significant changes to their current practice.

If you want to make a difference you need to be Proactive. It is about knowledge and expertise.

A GP may decide not to speak to you? but it does not stop you setting up systems with other agencies that can help you and those you care for to be protected from a system not 'fit for purpose'.

Pharmacist in general are keen to help, provide them with your Carers name contact Number, any Medical Information, including allergies, arrange for them to CONTACT you when drugs are ready for collection.

If you are concerned for your relative, who has no Psychiatrist, find your own. (they are out there) and willing to help.

Ruth Carnall was the most interesting of your Panel of Speakers she expressed her own TRUTHFUL view on the current system . Similar to my own, HONESTY has been thrown out of the window.

'Sustainability and Transformation' Fund is about 'robbing Peter to pay Paul' because the POT is EMPTY

#549653 tERRY

Reading the above from Pearl Baker identifies how wobbly the wheel is in such simple matters. You can produce as many 'papers' on the subject and have as many development programmes as you like but if managers and leaders cant/ wont/don't communicate and importantly are allowed to get away with it, all is lost.
I think the most worrying is that the system knows of such weaknesses but hasn't the b---s or seemingly ability to put it right. Managers and leaders must manage - full stop. If they have been promoted beyond their ability or have become stuck in a rut, do something positive about it and that does not mean having a group hug.
I feel so embarrassed that the good people in the service have to suffer, as do the public, for such continuing arrogance and incompetency in the most basics.

#549664 Greg Fell

In a relatively short number of sides, in simple clear language, this sets out the key elements of "partnership" that a thousand pages of governance guff and legalese contracts will never get close to
Amazing resource
Should be compulsory reading
Nothing new however, we all know that it always boils down to people and not structures, common sense of mission, shared principles and wider than individual organisational self interest. This doc reinforces that really well
Well done

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