Highlights of the Week - 23rd May 2014

I spent some enjoyable time with Ann James, Chief Executive of Plymouth Hospitals NHS Trust, this week.  We meet up relatively frequently and often have a range of difficult or thorny issues to resolve.  Always, though, there is time to informally and irreverently reflect on how things are for both of us and the leadership roles we play.

This week we were ruminating on the attention required to consistently have a diary that reflects the values that we hold to be important and that we tell others are the key ways that we expect them to act in the organisation.  It turns out that we don't have any tricks for this - it is really difficult when the are so many competing demands on our time - but there are some things that we both prioritise and some diary rules that we hold to.

Nothing surprising within that list, but I do make sure I get to staff briefings each month, that appraisals don't move from the day they were planned and that if I make a personal commitment of time to someone, that again has a higher level of status.  It felt for both of us like the relational aspects of leadership of our teams was high up on the list.

Plenty of interesting stories over a cup of tea!

Highlights of the Week - 23rd May 2014 (@jeclo)

Highlights of the Week 1: People do read the blog! A connection to an old friend and people booking to come to our Patient Experience Event
I ended up talking this week to a childhood friend.  We lived about 50 yards apart, went to school together, played hockey together and went on holidays today - I almost remember a fantastic 21st birthday celebration in Bude with a group of friends. I have seen Dave once in the last 20 years and that was over 10 years ago and that was the only time we talked in those years too.

But through the wonder of social media we are tenuously connected.

And it turns out Dave had started to read this blog and follow me on Twitter.  The contact was about interest in the work we have done on Strengths Based Leadership and, once we had caught up on family news, it felt great to be sharing across  two very different organisations - Dave works in System Architecture within finance.

Also this week I had a Twitter exchange with a couple of people who must have read last week's blog and were interested in our Patient Experience Summit next week.

I know that the NHS, our organisation and my generation are nowhere near exploiting the full potential of social media, but it is encouraging that there is some reach and purpose to these words!

Highlights of the Week 2: Another purposeful Locality Leadership Team meeting well trained in the Thinking Environment @NancyKline 
We have spent time in development days working on embedding Nancy Kline's 10 components of the Thinking Environment in to the way we run meetings and work as a team.  The components are not complicated and neither is the overall concept - that the quality of the things we do is built on the quality of the thinking we do first, so that the job of the team is to create a space for the best thinking possible.

In practice this is about things like attention (really paying undivided attention to the person who is talking/thinking), equality (that everyone's views are equally important) and ease (urgency destroys, ease creates).  It is not as simple as it seems!  But the results are profound.  The room has a sense of calm and purpose, people take collective ownership for the time of the meeting and it does truly allow everyone to be heard.

We are 18 months down the track from the first time we introduced the concepts (I had spent a day on a workshop led by Nancy) and this week was another reminder that with a hugely packed agenda, with 14 people in the room and with interruptions we can still discuss our business tension free.

Highlights of the Week 3: Meeting Local Chief Executives to create the joint work plan for the Challenge Local Health Economy
I have been shuttling around this week to touch base with the 5 Chief Executives who form the core scope of the work on the Challenged Local Health Economy in Devon and Plymouth.  I meet them all fairly regularly at different meetings, but having a week meeting individually with each of them and hearing their more personal views of the challenges we are facing was really interesting.

We are all working to put the needs of the 900,000 people we serve at the heart of our planning and constructing a commissioning recovery plan that is not based around organisations' needs.  I think people do really commit to that, but, of course, we each also have our own statutory requirements to deliver, held to account by Boards and regional bodies, so inevitably there is always a point where there is a degree of conflict or where the clear vision for the future comes from a certain perspective of the whole picture.

The challenge from PWC, who are working with us for the 11 week programme as our critical friend, is not that the individual leaders are not of the right quality and certainly we have huge talent and experience amongst the group, but is about whether the CCG can assume the system leadership role and whether the group will come together around a single plan.

Highlights of the Week 4: A discussion with our Communications Lead-not more content, just get better channels!
Each week I watch the email exchange in the Locality about the need to provide content for the weekly news update, the monthly newsletter of a range of other communication.  It seems to be something that we haven't managed to completely resolve.  As I sat down with our Locality Communications Lead, I knew we would once again return to this issue.

I am really clear though that we are not lacking in content; what we seem to be really poor at and very old fashioned or traditional, is our ability to turn information created for one purpose in to communications messages.  It seems to me that in the new media world we need to be expert at trapping and collating information produced across the CCG and repackaging it for a variety of different uses.

This means that the annual report should write itself from the year's worth of content and that the week would easily create from email exchanges, minutes or notes.  So we set ourselves that task this week.  How much mileage can we make from the words that I write here each week? Or the reports I write for the Board? Or by videoing the staff briefing that we give?

Hopefully that will avoid the collective moan that I feel in the Locality as the email request arrives (or the reminder ... or the urgent reminder!)

Highlights of the Week 5: The Collaborative Business Services Board is a real statement of our organisation's values
Unlike most CCGs, the vast majority of our office functions - finance, business intelligence, contracting, safeguarding, quality, referral management and HR - are managed in house, rather than via a contract to a separate Commissioning Services Unit.  This means we have over 400 staff, many CCGs have around 30 or less.

Given that we have taken a different path to many and that clearly we have some real challenges to resolve, we have to be able to show that the approach we have taken is working.  The overall numbers look right - we underspent our £25 per head management cost allowance by over £2 million last year and again this year we will use this level of efficiency to support our spend on patient care services.  In addition, over £1.5 million of the allowance is spent on our referral management services that many CCGs don't have so our like for like comparison is strong on the overall spend.

But the real question is about value and we are working with Warwick Business School on a long-term study of commissioning support.  The first report from them, one year in, gives us a very good sense of moving in the right direction and compares favourably to other models.

The Collaborative Business Services Board this week was interested in the value and metrics, most importantly though the conversation focused on how we ensure that the services and utterly aligned to support our recovery plan and financial position.


So another busy week, but I did make the coaching session, staff briefing and the three 1:1s with members of my team (albeit one on the phone).  Probably an 8 or 9 out of 10 for focusing on those key relationships.


Jerry Clough is Chief Operating Officer for Northern, Eastern and Western Devon Clinical Commissioning Group.  He is also Locality Managing Director for the Western Locality of the CCG covering Plymouth and the surrounding areas of South Hams and West Devon.

Previously Jerry has been a Chief Executive and Finance Director in the NHS before spending several years running his own business driving programmes of change and delivering executive coaching and team and Board development.