We've worked really hard at maintaining the right senior behaviours within those negotiations and I think, broadly speaking, we have managed that - a credit to the values of people on both sides of the table, but it is immensely hard when you are in mediation, leading towards arbitration and trying to make your points, which both sides believe in.
We need to focus together on delivering the scale of transformation that will bring our local system back in to balance, a place it hasn't been for many years. We have edged towards that over the last year, but we do need to find a way to get through contract negotiations in tact in order to reset our ambition.
Nancy Kline's "Thinking Environment" is a key part of how we work in our Locality (the Western Locality of NEW Devon covers the city of Plymouth - Britain's 14th largest city and the 4th largest natural harbour in the world! - and the surrounding rural area of South Hams and West Devon) and increasingly across the CCG. Her ten components provide the space to improve thinking on the basis of "the quality of anything we do relies on the quality of thinking we do first". We practice hard at keeping to the components and running meetings in that style. It creates a calm, reflective and purposeful atmosphere which is helpful in a week like this.
One element is to start and finish meetings on a positive (and the blog isn't living up to that!). Another is to practice the 5:1 ratio of praise and affirmation to criticism - and so after a start that notes the challenging week, on to the 5 positive reflections....
Highlights of the Week (@jeclo)
Highlights of the Week 1: first CCG annual members' meeting. More GPs and practices than we expected and great engagement, plenty to discuss
You plan a members' annual meeting and then wait to see if there is any level of engagement of practices with that kind of event when we are describing a bit about our first year and more about our work ahead. The sight of extra tables being set up is either a sign of success or a low level of expectation; in reality a bit of both I suspect.
The world doesn't change as a result of the event, but it does give some reassurance about the general direction we have set with our Clinical Leads and Board members; it also provides some challenge and new perspective which we can use to refine our ideas.
Our Members seemed happy with the five pillars of our 5-year strategy and were interested in what the support as a Challenged local Health Economy will bring. We had a really interesting discussion about what co-commissioning primary care would mean for the CCG and Member practices - up for change was a strong view.
Highlights of the Week 2: staff brief-talking about the huge potential for improving care through integration & honestly about staff impact
The CCG is working hard on two streams of integration work, one with Devon County Council and one with Plymouth City Council. They are both progressing well and this week we were briefing staff in the Western Locality on the work in Plymouth as papers were published for a Council Cabinet.
The impact of the programme with stated goals of full integration of commissioning (and full integration of provision of community health and social care services) will be profound and completely changes the notion of what a CCG is and it's governance. The prize is worth the level of change and those who came to the staff briefing heard the honest description of the benefits and the potential uncertainty for staff. The response was reflective and positive - I think most staff share the sense of importance of the task, above what it may mean individually.
Highlights of the Week 3: Individuals at the Centre mentors' catch-up. Seeing where the teams are for 9th May. Sounds fantastic, but scary!
We are just over a month away from the final module of our Individuals at the Centre learning set. This means in about 5 weeks we will know whether the enthusiasm, tools, techniques and guidance we have offered to five teams in the CCG has resulted in 5 changed and remodelled processes or systems in the organisations together with 28 new change agents.
The temptation is to forget all the intent we have shown throughout the programme and provide a firmer steer or greater opinion, rather than support for the teams' ideas and work.
But the call gave us all the reminder about the greater purpose and we are excited about all the great snippets we shared about what the teams are planning. I feel a bit like a worried parent, but I'm sure that the 9th May will be a huge celebration of success.
Highlights of the Week 4:booked leave to write book in May. Announcing to increase personal commitment! A break to spend every hour working?
I have toyed with writing this book for over a year. If I hadn't rejoined the NHS it was the natural next step in my coaching and development work, based on a process I had been working on with groups and individuals over an 18 month refinement.
It is a 10 part model for thinking about career, job match, CV and interview preparation in a way that allows people to powerfully focus on themselves at their best. It has had great results and featured heavily in the work I was doing around the transition from PCTs to CCGs.
Having worked with a few people recently using the model again and realising that I need to keep working on the things that bring inspiration to me and those I work with, I have told a few key people that I'm going to take some leave in May to break the back of the writing - doing so will mean I will do it as I can't stand owning up to not achieving a goal I've set for myself!
It will fall in the middle of really intense work on the Challenged Local Health Economy, so I'll be exhausted beforehand and busy afterwards. It still feels like the break - though full of long days locked on to a keyboard - will re-energise, so am just agreeing with the family that I can hideaway for a short period.
Highlights of the Week 5: Friday! (never said it before) but tough week (for all) at work means very much looking forward to York weekend
I am definitely not someone who only works for the weekend - work being the way we earn the money to do the things we really enjoy. I am clear that I want to enjoy every aspect of my life, each day and the work I choose allows me to enjoy my contribution to the society I work in.
But I can't claim to get that balance every day or every week. Some days at work are incredibly stimulating and enjoyable, better than the weekends laying paving slabs or erecting sheds; others are tough and sometimes even I have to admit that the weekend with the family is the thing that seems to make sense of the week.
This weekend was spent travelling the 6 hours back up to see old friends in Elvington, near York. The whole family has loved the move to Devon, but it is lovely to see them reunited with old friends and for me to have some relaxation that can't involve any DIY or running a taxi service.
A 6 hour journey home (hopefully!) will see me ready for the new week ahead....
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