Highlights of the Week - 11th April 2014

I would avoid next week's blog if I were you, unless you want to read about the joys of skiing in the sunshine with the family.  This week was therefore about ensuring that progress continues with all the major work within the CCG and left in a neat state before heading off.

We are still concluding contracts (negotiating on some, agreeing heads of terms on others and moving towards signing final contracts on others, though less of these); working hard on the financial plan that doesn't yet square up in terms of the risk we will be carrying as an organisation to meet our agreed control total; completing a programme structure for how we will deliver all the schemes that add together to form the basis of the financial plan; and are in week 2 of the 11 week intensive support around the Challenged Health Economy work.

We struggle to meet all those demands when they arrive together at this time of year and, of course, underspending on running costs is one element of our financial recovery plan, so additional resources to address the issues impacts directly on the chances of success; but I know this story will be familiar to many.

One of the elements of a governance review of the CCG a couple of months ago was a commentary about the wisdom of entering last financial year without any reserves or contingencies.  The report noted that this wasn't robust or good governance.  As we look to make sense of this year's plan, it is hard to see how we won't be in that position again - is that bad governance, bad leadership or an artefact of the position we find ourselves in?

Anyway, nearly time to ski, so....

Highlights of the Week - 11th April 2014 (@jeclo)

Highlights of the Week 1: Strengths based leadership day with the Western Locality Senior Leadership Team

As trailed last week, our strengths based leadership day, facilitated by Mike Roarty from Clearly Inspired, was a hugely enjoyable and positive experience.  The photo shows how the 7 strengths from each of the 16 members of the team (half clinical) are distributed across the different quadrants and facets.

So our team has more strengths in the relational quadrant (4 of my 7 are in the execution section), but the really interesting perspective was to compare this to our previous version of the diagnostic in December 2012.  We had clearer areas of similarity then - the picture was more "spiky" (about a third of the team has changed in that time and individual's profiles may also have altered) and overall the picture now looks more balanced.

We spent the afternoon looking at how this applied to the critical work plan delivery we have ahead of us (workstreams such as integration, elective care, urgent care, primary care and system configuration) and how we would best work to deliver that using this new information.  

The team felt in good order and ready for the challenge ahead!

Highlights of the Week 2: Meeting with Kelichi Nnoaham, new Director of Public Health in Plymouth.  Discussing how we move forward in partnership

We haven't had a substantive Director of Public Health in Plymouth for a while and it was great to meet up with Kelichi as he came to the end of his second week in post.  We have spoken a few times and each time it felt like we had good alignment on our views of the joint purpose, but this was a time to test that out.

There are many challenges.  Public Health outcomes in Plymouth are poor; in comparison to other areas of the CCG in Devon, they are really poor.  Public Health funding in Plymouth is way below other comparable authorities and the City Council is working hard with Public Health England to try and address the anomaly.  And the Public Health team (based in the same building as we are) have seen a number of people leave to join Public Health England as that infrastructure is established.

It was a good first discussion with a commitment to further action and to ensure that Kelichi gets a prominent role in some of the local architecture to make sure that the issues for the population in the City are well represented.  We talked about how the CCG needs to be accountable for delivery for some parts of the DPH's portfolio and how Public Health will be vital in helping us to determine how we scale our services to be affordable and sustainable.  It was a positive first meeting and look forward to more ahead.

Highlights of the Week 3: It is lovely to get a thank-you and to hear about the difference that you've made to someone

This lovely card arrived in the post.  It is a thank-you for some coaching that helped the individual move forward and reconnect with what they felt to be important.

It does remind me that saying thank-you is important. I don't need much feedback to keep me upright, but I do sill love it and it is great to know that the energy I try and devote still to coaching and development is appreciated.

I have gone from a world of many coaching clients and sessions each week, to occasional sessions with a few individuals.  It is the thing I miss most about my years creating and running my business, so I do enjoy even more the time I still mark out and reserve to spending time on development activities



Highlights of the Week 4: Our Urgent Care Partnership 1 year on.  A story of success, improved relationships and realism about the challenge ahead
I Chair the Urgent Care Partnership in the Western Locality - the urgent care system that surrounds and encompasses Plymouth Hospitals. The team put a lot of effort in to ensuring this works successfully and a little over a year after we formed we spent a bit of time at the meeting this week reflecting on the progress we have made.

We are under no illusions- we know we have had an easy winter; we know that the mild weather and lack of infections combined to do all they could to offer us the best chance of success and even then we have had several moments of really significant pressure. But against that backdrop Plymouth Hospitals are the third best performing A&E against the 4 hour target this winter.

I'm not sure that single measure captures enough of the complexity of the system, but what is relevant is that after some time struggling to hit the target and being seen as poorly performing in comparison to other Trusts, they have managed to improve their performance at a time when others were really struggling.  The hospital deserves real praise for that - an awful lot of hard work from staff with determined clinical and managerial leadership.  

It is though also testament to the workings of the wider system and the way partners have discussed the right solutions and then delivered against the agreed direction.  Additional money has helped, but I do think the element of determination is the most critical.

The feedback was good - our urgent care dashboard is a stunning way to capture what is going on in the system and to predict as well as reflect on the demand pressures we face - and all members felt we had made really good progress.  We recognised that next winter will almost certainly present greater climate and infection issues and we need to spend the next few months ramping up our responses to be ready that, but some thanks to the team for the work that has brought us here.

Highlights of the Week 5: Finally I'm in print...well almost, my words in a book, but they are not the important ones to read! Well done @timrobson7

At the front of Showing Up by Tim Robson you will find these profound words.  Nice to be asked and delighted to read a proof of the book and link that to the work Tim has been doing with us on the Individuals at the Centre programme.

It has made a real difference to many people in the organisation and we have used some of the concepts consistently over the last 12 months.

In this book, I particularly have reflected on the School with Pay paradigms pondered on how similar work is to school (just with added pay).  The metaphor works well and has helped to reframe a couple of the ways that we work.

So almost a shameless plug for someone else's book, but trying to grab some of the limelight at the same time!