Strengthening leadership

and building new teams Dr Jen Allinson and Chris Ash

Better Local Care (South Hampshire)

Our MCP in South Hampshire • Around 30 GP practices working in partnership with Southern Health

NHS Foundation Trust.

• Supporting population of 220,000 in three initial localities (Gosport, East

Hants and South West New Forest)

• Supported by 16 local health providers, commissioners, local authority and

third sector partners.

• Significant growth across Hampshire anticipated…

Our MCP in South Hampshire East Hampshire

10 practices / 70k patients

Semi-rural “new town”

Gosport

11 practices / 80k patients Urban deprived

New Forest 7 practices / 70k patients

Rural – older demographic

Three levels of transformation A new model

of care

A new care model with better access to care, extended primary care team proactively managing need, and specialist advice and support in the community.

Provider reform

Primary Care and Southern Health coming together to deliver the new model of care that has been co-designed with local people, is seamless across health and social care services and is cost effective

Commissioner

reform

Pooling the combined resources for the local population and commissioning services using long term outcome and capitation based contracts

A new model, based around natural

communities of care

Wider primary care at scale

Improved access to care

An extended primary care team

Fewer steps to access specialist support

Enabling workstreams

Design and implementation of

extended primary care team

Putting in place the leadership

team and development support

Creating a single health record

and shared information

Getting the right estate for

the MCP

Developing governance

arrangements for the MCP

Ensuring the MCP represents

good value for money

Building a social movement for change via

effective communications and engagement

Evaluating the impact of

the MCP

Your health, in your hands, with our help.

Strengthening leadership

and building new teams

Appointing to values

Building leadership capability

Accelerating team capability

Building team and leadership potential

Working in new ways across traditional

barriers requires a new, shared culture

Appointing to values –

Assessing leadership capability

Understanding of role suitability and fit

Evaluation of values, attitude and leadership style

Measurement of potential as well as capability

The foundations for a tailored development plan

Team leaders

Natural community leaders

Executive leaders

Front line leaders

Different ways of assessing different leaders Assessment outcomes

Day 1 - assessment Day 2 – integration & feedback

Psychometric evaluation

Role play simulations

Written exercises

Behaviourally based

interview

Integration

Feedback 1

Feedback 2

Feedback 3

Feedback 4

Feedback 5

… Natural Community Leads assessment format

Appointing to values –

Assessing leadership capability

Building leadership capability – leadership diagnostic

Aspirations and values

Areas of competence and strength

Risk factors and derailers

Unique talents and capabilities

Specific development requirements

Leadership diagnostic Combined individual and team development

Measures or preference, values and derailers

&

360

Pas

t P

rese

nt

Futu

re

Review of past performance, learning

and experience

Current capability

Potential capability

Likely strengths

Likely derailers

Pre-work Diagnostic Feedback

Goal clarification

Development planning

Review of current effectiveness and

potential

Review of future aspirations, needs

and plans

Format and outputs

Building leadership capability –

leadership diagnostic

Team development overarching aims

• accelerate team formation, capacity and capability

• build sustainable structures, processes and cultures across teams

• embed models of care and ways of working that are ‘scale-able’

• empower teams and patients to shape services around local needs

• share / contribute to the latest ideas both locally and nationally

• give teams the confidence to leave behind old ways of working

Innovation ‘pushed’ by leaders New services ‘pulled’ by communities

Unclear leadership and accountability Right leaders accountable for right things

Closely guarded resources Resources shared and benefits utilised

Conflicting incentives for delivery Mutually beneficial incentives for all

Duplicated, inefficient models of care Joined up and efficient service delivery

Integration perceived as complex Simple delayered models of care

Historical provider/commissioner boundaries An integrated ‘team’ with 1 real customer

Multiple organisations trying to work together A team within its own right

The past Desired future

Team development – shifting our culture

Team Development - Enabling elements

Vision, clarity of direction and clear

roadmap for all at MCP and team level

An ‘Ikea’ manual + the latest research / case studies to stimulate

local solutions

Enabling people to let go of the past and build optimism and a sense of

hope for the future

Accelerating the pace of team development and

enhancing team effectiveness

Understanding and co-designing services

around the needs of the local population

Bringing the right mix of people together, in the right

environment and empowering them to find local solutions

Team development - format Day 1

D

D

D

D

D

PDSA

D

D

D

D

D

PDSA

D

D

D

D

D

PDSA

D

D

D

D

D

PDSA

Day 2

Day 3

Day 4

D

D

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PDSA

Days 5 & 6

Redesigned access to primary care

Extended primary care teams

Engagement, prevention and self management

De-layered specialist support

A cultural shift

Empowered and engaged community

Access to local and national data

Local and national expertise, stories and

case studies

A safe space and ‘permission’

Team diagnostics and development tools

Co-production with users and volunteers

Support tailored to the needs of each team

West Cheshire Way: Developing the

future primary care team

Dr Jonathan Gregson, Primary Care Cheshire

Journey so far…. • Pre-new models of care ‘local vanguard’

• Collaboration with NHS IQ – Bringing disciplines together to learn together

– Improvement methodology – what can I do differently, how will I know I have made an impact

• Bridging the divide – programme of joint training between practice and community nurses

• Primary Care CQUIN – Outcomes based – Incentivises working in clusters

– Time to think/develop/learn together

Plans going forward…. • Value Proposition enables

Education and Training

– Roll out of improvement methodology skills to all front line workforce

– Roll out ‘behavioural change’ skills to all front line workforce

– Develop shared primary-community-secondary care education programmes for: • Paediatrics

• Long Term conditions

• Geriatrics

Leadership – Primary care leadership skills: cluster lead GPs, Practice Manager Lead GPs

Key Challenges • Supporting ‘innovators’ whilst motivating ‘laggards’

• Developing new roles: GP cluster lead, Practice Manager cluster lead

• Different working day for GPs

• Getting multidisciplinary teams to work well

• Developing right skill mix and new roles