Friday, 2 May 2014

Highlights of the Week - 2nd May 2014

This is what happens now when I (occasionally) get on the bathroom scales to check how far from my perceived ideal running weight I am.  They are wi-fi enabled scales that link to an online and iPhone app (all very modern).  They recognise which member of the family I am (we all have suitably different weights), tells me my weight, displays my BMI and where this lies on a healthy range and then records that information to a cloud where I can retrieve it later - I automatically have a record of every time I weigh myself.  All very neat and fits in with my app enabled life.  

But there has been an automatic software update and now there is an added extra when it has finished telling me all the information I wanted......


It now also gives me a weather forecast; today's was rain, which, when I went out, it wasn't.

Like most slightly geeky bits of technology, half of me loves this, because it just can do it; the other half is perplexed by the value of a single icon of weather to reflect a whole day and whether telling me things I didn't want is actually a bit of an imposition (perhaps in the settings I could turn this off, I haven't checked).

Anyway it is similar to a concept that @timrobson07 has been using as part of our Individuals at the Centre programme in the CCG - all of us, everyday, have the opportunity to install updates to the way that we work, rather than just sticking with a version of ourselves that will increasingly look out of date (compare these scales to the ones I used to get forced to confess my cake addiction on at school...).  Sometimes, though, the update may not give you what you had hoped or wanted!

Highlights of the Week - 2nd May 2014 (@jeclo)

Highlights of the Week 1: Collaborative Business Services Board-A space to focus on the quality of what we provide to ourselves and others
We are one of the few CCGs to have (almost) all of our commissioning support services provided in-house.  We are part of a study on the effectiveness of approaches to business intelligence, contracting and other back office functions with Warwick Business School, so we will be able to reflect on comparisons over the next couple of years; early data is encouraging.

The Collaborative Business Services Board is our formal process both to ensure that the functions are running effectively and to give us a mechanism for checking that we are providing the level of support that our commissioning teams need.

We are in a process of financial recovery and how our referral management service works with some of the elements already described is critical to our ability to deliver the level of transformation that will help us move towards a balanced financial position.

We had a positive meeting this week and we are clear about what we are trying to achieve, the governance that sits behind that and the need to continually adjust our offering to meet new requirements.  We will never have the finished article, we can't have as things will keep changing; so we will make improvements that give us a service to be proud of.

Highlights of the Week 2: Interviews for new Public Health consultants in Plymouth a real sign of the new energy for joint working 
Delighted to be sitting on an interview panel in Plymouth today helping to recruit two new consultants in Public Health.  The team has had vacancies for a while, so it was great to be part of the process to try and give them the capacity to drive health improvement in the City.  In any case, I do like to be involved in other people's interview process- no worries about the process and not quite the same tension about the outcome, so a chance to try and add real value to the observations and deliberations.

I had nothing to do with the question setting, all the work of the Director of Public Health, but questions about the Better Care Fund and how Public Health could support a CCG that was in financial recovery were a real sign that Kelechi has a good understanding on the areas where we need to work together with his new department.

We already share one member of staff, a consultant who is also our Locality Clinical Lead for Children, Young People and Maternity, and hopefully we will be able to build on this start.  The Director of Public Health will be joining our Locality Board, which will be a really significant addition alongside the Director of People and we look forward to the contribution he will make there.

Highlights of the Week 3: Health and Wellbeing Programme Board confirms our ambition to create integrated futures and refocuses for delivery
The Integrated Health and Wellbeing Board is the title of the Board in Plymouth that, working to the Health and Wellbeing Board, is the Programme Board for the delivery of our joint plan for integrated commissioning, integrated provision and Children's services.

We have the start of our joint programme office in place and it feels like there is a building momentum now for the delivery part of the programme and I am optimistic that we will turn our intention in to reality.

This isn't without its challenges.  True integration of commissioning raises big questions for a CCG- fundamentally, what is left in the CCG if we move commissioning in to a joint vehicle?  And in our situation, what does integration in one part of our patch (Plymouth) mean for the other part (Devon) and in particular for my locality for the areas in the South Hams and West Devon.  There are also clear questions about what happens when democratic decision making meets GP membership decision making-what will our process be?

There are also plenty of small scale issues to resolve that eat away at our "jointness".  The transformation programme is not a freestanding programme as it also serves as one of Plymouth City Council's 5 transformation schemes to deliver their savings and service change.  That means that we have to tick some boxes in terms of the Council's need for consistency, so sometimes I look at the highlight report - in fairness, we all do - and struggle to see where the CCG figures.

But in our conversations we are all equally determined to get this to look and feel right and we know we will need to tolerate, on both sides, the idiosyncrasies of the other's ways of working.

Highlights of the Week 4:Leadership Team Development Day-what do we need to enhance to deliver in 14/15:everything is open for discussion
We are facing a huge financial challenge over the next few years and our first target is to determine an approach that gives us a realistic chance of hitting our control total in 14/15.  Throughout the organisation everyone is really focussed on this work and we are making progress, though there is plenty of 2 steps forward, one step back (and also times when these numbers are the wrong way round).

We have set ourselves a task as a Leadership Team to review how we have things organised and to ensure that, despite any history or justification of why we have the structures we do, we will put in place the arrangements for this year that focus our best resource on the biggest challenge and ensure we have alignment.

Whether we find a way to get to the numbers we need or not, we are clear that we must leave no stone unturned and we all need to be doing the things that add the most value based on our strengths, experience and ability.  We will know next week how radical this means we will need to be; mostly this is about which way you look at a matrix, rather than carving up what we have spent a year putting in place.  We need to put financial risks above locality structure or boundaries between our different departments.

We have come a long way and we spent the day discussing that without it feeling like we were defining our kingdoms.

Highlights of the Week 5: The team do a fantastic job on our Locality Integrated Governance Process-it works perfectly when I'm not there
Of course it does... the team are very able and we have created a real jointly held belief in the importance of having a foundation in the Locality and the organisation about the risk and assurance process that ensures we are appropriately working on the right issues.

But there must be a law that says that the time when someone is coming to look at what you do will be the one of the few times that I won't be there-it has happened many times in my life, at some very important times, so is something to be sanguine about.  In this case, one of our non-executives was visiting to see how our Locality undertakes the local process that feeds through to the Integrated Governance Committee that he chairs.

I think we do this stuff really well and the feedback was excellent.  The team, at their own direction, also decided to extend the remit of the meeting to pick up the crucial links between finance, contracting and the commissioning team to review the ways that we get that interaction right to give us the best chance of delivering our locality work plan-our part of the CCG's financial recovery.

More time to spend on that over the next couple of weeks, but great progress and everyone stepping forward to deliver their part of the overall approach.


So a week of challenge and real progress on delivery, but how exciting to be told the weather without having to look out the window.....!



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