Leading for Systems Change
What is it?
Leading for System Change is a new national offer providing place-based support for Integrated Care Systems (ICS), to build collaborative system-wide leadership. It supports pan-sector teams working across organisational boundaries on complex issues relating to ICS strategic priorities. The offer is to provide practical, place-based support to help build collaborative leadership thinking across all areas, building understanding and expertise regarding what it means to work at a system level – and to encourage new ways of working that will lead to better outcomes for patients. It is recognised that to meet current and future challenges, we will need to embed system leadership working in true collaboration, irrespective of organisation:
“Systems will have a central role in helping design new models of care and major service changes, to deliver better population health outcomes.”
The offer consists of a set of flexible components, tailored to the needs of a particular ICS and delivered within that locality. Its primary focus is to help fulfil the aims set out in the NHS Long Term Plan, to “bring together local organisations to redesign care and improve population health, creating shared leadership and action”, with an approach based on ‘learning by doing’.
The development support available brings together system leadership knowledge and principles with their practical application, to enable colleagues to work together on deep-seated, complex issues that form part of the ICSs priorities.
Who is eligible?
We are looking for up to 15 teams (some flexibility about team size and therefore final number) from across the South East Region to join the programme. These will include a range of leaders from across the system (e.g., ICP Directors, Clinical Directors, lead clinicians in PCNs, clinical and care MDTs, Local Authority, Voluntary sector and Public Health leads) looking at the redesign of clinical and care pathways, and prevention from a systems perspective. Equally, some teams may work on the development of provider collaboratives for specific conditions or services, health and well-being or public health priorities.
The teams may be new or drawn from existing groups and teams within an ICS footprint and would ideally have between 6-8 participants. Eligible teams, or sets, will be:
- Pan-sector – drawn from across different parts and levels of the NHS, local government, public health, the voluntary and community sectors, education, housing, sport and leisure etc
- Working on a ‘wicked’ or complex issue, that is relevant to the ICS and requires cross-sector collaborative working. This would be inked to a specific priority area for the system (this could be part of a local recovery plan for example).
- Willing to work in new ways to achieve measurable improvements in health and wellbeing with potential to deliver clear benefits to patients and citizens
- Able to demonstrate and ensure patient /citizen / community involvement from the outset
- Able to show explicit support from senior stakeholders across the system (i.e. not just from the NHS), and have commitment from sufficiently senior participants to undertake the work.
- Committed to the work during and beyond the programme and willing to share learning, both across the ICS and more broadly.
What kinds of projects could we work on?
Projects can be new or existing. Examples of appropriate projects could include:
- Focusing on health inequalities; identifying ways to ‘flip the system’ from treatment to prevention, using resources more effectively.
- Establishing what better ‘joined-up’ support looks like in different places across our ICS offer (i.e. not just NHS and social care but wider determinants of health).
- Developing better understanding of what works, in terms of early help/prevention?
- Identifying how we can change commissioning of care/commissioning models – moving towards placed-based or community-based models that address population health needs.
- Identifying ways to improve working within place-based models, based on better understanding of workforce/resources available.
- Establishing how voluntary, community and social enterprise (VCSE) partners can play more of a part in system-wide working.
- Creating better understanding of patient flow pathways from a patient rather than an organisational standpoint.
- Establishing how we can better support people from different cultures/geographies – especially during reorganisations (e.g. hospital mergers, unitary authorities and ICS development)?
- Identifying how can we commission more effectively to better-support homeless people and reduce rough sleeping.
How does it work?
The support offer combines theory and ideas with practical application, based on two elements: Orientation and Discovery over 6 months.
The Orientation phase is the gateway into the process and will equip participants with an understanding of the fundamentals of what a system is, approaches to system thinking, characteristics of systems, the implications for managing and leading within them. The Discovery phase presents the opportunity for participants to apply their learning to the real challenges they are grappling with day-to-day in their system. Participants will identify plans or tests of change, implement actions, observe and reflect on impact and new learning, identifying where new knowledge and understanding has been acquired.
Participants will be able to apply their learning immediately as well as over time, enabling them to learn and adapt as necessary. They will be working with others across their system, with a focus on collaboration, collective leadership and shared learning.
What are the outcomes?
For patients, service users and citizens the aim is for benefits to be seen in more joined-up services and reduction of healthcare inequalities.
For the system the aim is to help encourage greater levels of integration, collaboration and effectiveness, through increased willingness to share resources, expertise and learning.
For participants benefits will include:
- Becoming more confident and aware of the behaviours that encourage and enable system leadership
- Demonstrating system sightedness in their behaviour, mind-sets and attitudes, based on appreciating and engaging with multiple perspectives
- Developing a range of skills and tools to apply and further their learning about systems and leadership in systems
- Recognising and choosing leadership approaches which build trust, empower others, share risk and foster collective accountability
- Gaining opportunities to connect across boundaries and, build empowering relationships and networks to deliver a shared vision for change
What happens next?
Initial programme places are now full for 2021/22.
Please contact us if you would be interested in this programme in the future.