Highlights of the Week - 16th May 2014

If popular culture were to be believed, this week would have seen most Liverpool Football Club supporters crying in to their drinks after a prolonged challenged for the Premier League title ended in ultimate failure last Sunday as Manchester City scooped the title on the last weekend of the Season.

I am one of those supporters, albeit from a distance and with little claim (other than they were the best club when I was forming allegiances in the mid to late 70s) to a connection with the city.  The truth for me and, as far as I can make out, for many others, is that this week has actually been about reflecting on the most amazing, enjoyable and uplifting season since their heyday and I've enjoyed it immensely.

It does serve as a reminder to me that it is much more about enjoying the journey, than focussing on the end or goal all of the time, especially if that becomes obsessive.  Am I really only going to enjoy football if we win titles?  Of course success is important and there is no doubt that I would have loved Liverpool to be crowned champions this year, but that can't become the sole focus.

In the same way, I want to enjoy Monday to Friday not just as days that get me to the weekend and I want to enjoy work now as well as thinking about what I might be doing in the future.  If I'm not getting satisfaction from this week, this month, this year, what does that say about the choices I'm making about the way I live my life?

So here are some of the things that have been great this week....

Highlights of the Week - 16th May 2014 (@jeclo)

Highlights of the Week 1 : A review of contract management in the Western Locality gives great feedback and optimism 
We are currently undergoing a detailed and externally supported review of our financial position in light of the need for us to find a deliverable plan that gets us to the £14.7 million deficit that we have agreed with NHS England.  It isn't easy and we are not yet confident of our ability to deliver that financial target.

This week there was a focus on the contracts we manage in the Western Locality and our plans for transformation and savings.  The outcome was very positive; the team has worked really hard on our plan, ensuring we align levers such as headroom, the potential for penalties and payments for quality through CQUINs, to deliver our goals.  This means we are able to give more confidence and assurance about the chances of achieving key NHS Constitution targets.

We need to go further and we will be looking for ways to generate greater savings whilst protecting the services that are important, but good to get feedback that others are impressed with what the team has been able to do.

Highlights of the Week 2 : Chief Officer Leadership Group for Challenged Health Economy work is starting to align around a joint plan
This week's was the fourth meeting of the group of Health and Social Care Chief Executives across our patch in the context of the joint work as a Challenged Local Health Economy.

The first few weeks have seen us establish the structure and process and get an agreed view of the size of the financial challenge.  Thought is now turning to how we address that challenge, with a couple of clinical Care Design Groups over the last couple of weeks, and the way we will work together over a longer period when the intensive support we receive for 11 weeks disappears.   

It isn't easy to work on a collective plan when each and every organisation is under huge pressure individually to deliver their targets, held to account by Boards, regional bodies and local councillors.  But neither is it a sustainable position to cite that complexity as a reason not to do what is obvious to all and work together on a strategic plan that gets the very best out of the increasingly stretched resources we have.

This week's meeting was positive, albeit that there are issues, such as our Transforming Community Services procurement process or Foundation Trust applications that can seem to cut across a desire to create a clear and compelling direction.  We have agreed in principle to a joint programme approach and office and we will have the first draft of the commissioning strategy that will give the overarching programmes of work next week.  It feels like better progress.

Highlights of the Week 3 : Integration Board discussion in Plymouth - driving progress whilst navigating elections and CCG Governance
The ambition is clear and we are working on delivering integrated provision of care and integration of commissioning between health and social care in Plymouth by March 2015.  We recognise the sheer scale of that challenge, but we are working to drive as rapidly as we can to a model that will allow us to make the scale of changes we need to in order that we can have a sustainable health and social care system.

This week we looked in detail at the key milestones in the programme.  We have to navigate short term issues like the local elections and that impact on getting early agreements signed off; if we don't the plans begin to slip.  But we also need to ensure that decisions dates and processes are aligned between the CCG and the Council and that we understand how progress in Plymouth will affect the CCG's discussions with Devon County Council and our Transforming Community Services programme.  It is one of those situations where it soon becomes obvious that managing the timeline is absolutely critical.

In the longer term we are plotting the impact of the general election next year, both on the politics of the programme we are working on and, again, on our ability to take key decisions in early 2015.

We have a way forward and we are making good progress.

Highlights of the Week 4 : The buzz of the Individuals at the Centre programme has been present all week and I'm on to the next steps
There has been so much wonderful feedback in the organisation and beyond following the successful showcase event that was the conclusion of the Individuals at the Centre Programme last Friday.  Many a bit sad that it is all over, but the reality is that living by the values we set as an organisation isn't something that can start or finish, it is something that needs to exist constantly.

The outline plan for the second year of the programme is getting a bit more detail around it and I am keen that we inject enough ambition to build on this year's programme, rather than simply repeating the same format.  We don't want to throw out all the wonderful elements, though, so we will end with some blend of old and new.

In the immediate future, the CCG is hosting a patient experience summit on 29th May at Exeter Racecourse.  The purpose of the day is to bring our community - commissioners and providers - together with a focus on patient experience driving improvements in care and quality.  It is being led by Jenny Winslade, Chief Nursing Officer in the CCG and is born out of the Individuals at the Centre Programme, so we will be spending some time on the day looking at the process we have been through and the stimulus that has led to the success of the programme.

We think this is the kind of event we need to be doing more of as a CCG.  It isn't easy, it is much easier for leaders in provision environments to more directly connect with patients and we don't want the event to feel at all like we are taking action because our providers aren't.  What we are looking to do though is host something that delivers on our values to put individuals at the Centre and gives key leaders in our system time to reflect together on how we might improve.

So I need to capture the excitement of what we have done, but knowing that many in the audience will have done far more and the story is only important in the way it creates a positive discussion on the day.

Highlights of the Week 5:@jenniferwinslad leaving do from CCG to join SWASFT.  Enjoy a new challenge & thanks for the time working with you
Just to be clear, it is not the Jenny Winslade, our Chief Nursing Officer, leaving is a highlight, but we did have a really enjoyable leaving do and it was a good opportunity to reflect on the work we have done together.

Jenny is leaving to join South West Ambulance NHS Foundation Trust as their Director of Nursing and I have no doubt she will be excellent at that.  Jenny has patient care at her heart and was never going to be able to stay in commissioning for the rest of her career and resist the urge to be back in more direct contact with patient care services.

We will miss her.  She has a team that will ably manage the issues and we have advertised for our new Chief Nursing Officer, but she has provided really good Board level leadership and dealt with some complex and difficult issues.  The role requires someone who can maintain excellent relationships with Director colleagues in provider organisations and upwards through NHS England and the NTDA, but also someone who is able to robustly challenge when issues aren't being dealt with appropriately.

Jenny has been good at getting the balance right.  We haven't got it perfect every time, but we have learnt as we have gone through the year and I do think it is an area where we have added value.

Together we have done a lot around integrated reporting and Integrated Provider Assurance Meetings, working to ensure that we look at all aspects of an organisation's performance in one place.


So I hope you enjoy this part of your journey; this isn't a stepping stone to something else, it is a choice about the most enjoyable thing to do at this stage in your life.