Highlights of the Week - 27th June 2014

After months of build up in the house, hours of planning and discussion and a succession of weekend trips, this week it finally arrived, I guess in a similar way to many places up and down the country.  But this was our first experience and with a balance of ridiculous excitement, combined with a bit of uncertainty and nerves the night of the big Ivybridge Community College Prom was upon us.

I know the following comment is yet another nail in the coffin on my undeniable middle aged-ness, but we didn't do Proms in my day or perhaps, in my day at my school.  I can just about remember a sixth form leaving meal, but not anything after O levels - perhaps we did have a disco in Middle School Hall where some local DJ spun a few seven inch discs (or even a treat of a 12 inch remix....), but it doesn't stick in my memory.

But this is on a whole different scale.  So the weeks have been about dresses & shoes, handbags (I bet that isn't even the right term) & limos and hair, nails & make-up.  A steady procession of different cost options are presented as we navigate through a minefield of possibility. 

And it turns out that the Prom isn't even the real centrepiece anymore (so last year), it is all about the after Prom these days.  For our daughter and her friends this was 180 people making camp the day before in a field (one of the students' parents allowed their farm to be used for the purpose) and then partying until dawn....  What could possible go wrong.

I rescued her at 8am this morning absolutely soaking wet and therefore freezing cold.  We think the tent would have been up to the rain, but standing around outside partying as the heavens opened gave the tent and sleeping bag an impossible task.

The great news is she survived and had a fantastic night; a memory that will stay with her forever.  The benefit for me is that I'm now much better prepared for the two brothers who will come to the same point in a few years.  I'll probably sleep better tonight too!

Highlights of the Week - 27th June 2014 (@jeclo)

Highlights of the Week 1: Our Locality Board in the Council Chamber; a sign of our move towards integration and using webcasting to engage
We held our Locality Board in the rather grand setting of the Council Chamber at Plymouth City Council this week.  It is not the oldest or grandest civic building I have ever been in, but compared to our normal meeting venue it does have a touch of the theatrical about it.

The purpose of being there was to move the Board to different settings to see if the number of public attendees changes; we regularly get 4 or 5 members of the public at meetings.  It was also to test out the webcast facilities as a "dry run" before we go live with webcasting as another potential way to increase engagement.

It does also point towards our future; I spend increasing amounts of time in the Civic Centre and this is more often our norm as we move forward with plans for integrated commissioning and provision in the city.

As it turns out, we were a bit clumsy with the microphones and switches that are critical to the success of the webcast, not dreadful, just not particularly slick.  We got about the same number of members of the public in attendance, though some new faces.  It is more complex for us to organise and administer, so not an overwhelming success as a first attempt.  But we will keep trying, especially as we were made so welcome and it will give us the chance to see what impact the web will bring.  2 steps forward?

Highlights of the Week 2: Integrated Governance Committee that really made time to reflect on how key risks were moving in the CCG
Our Integrated Governance Committee is critical to ensuring we have the right assurance in an organisation that is built around devolved responsibility to a number of separate localities and departments.  We have created a much stronger platform now of cross organisational working, but the formal delegation of authority rests across a number of different Boards.

The balance that we are looking to strike is between the inevitable detail that is generated by the sheer size and scale of the organisation that is critical because getting it right for groups of patients is what creates a safe system and ensuring we have a strategic view of the key risks in the organisation.

This might look like trying to balance a CCG wide issue with something that is a particular concern in one of the three major acute hospitals in our area - the over level of cdiff, compared to the failure of a 2 week wait target in one place.

This time though we focussed much more on the question of whether the Executive team felt the overall risks to the organisation were increasing or decreasing and the discussion felt both purposeful and useful for all concerned.  We need to finishing embedding the risk and integrated governance system across the CCG as we restructure our ways of working and the Integrated Governance Committee will then be able to focus more firmly on strategic risk.

Highlights of the Week 3: Finance Committee shows the size of the challenge. We don't have all the answers, but the effort is focussing
Our finance plan carries a huge challenge for the CCG in terms of the scale of transformation we need to deliver in order to hit the financial target.  In many areas, this means us performing much better than that the average of the last few years, for example, around historic levels of prescribing cost growth or for the continuing healthcare budget.

It was clear this week that there will be increasing challenges along the way too - things that emerge during the year, new requirements and issues we simply need to resolve.  A really robust finance plan has reserves and contingencies to cover these different scenarios; the reality for us is that the cupboard was raided to get us to this point and is bare as we look for more.

What was encouraging though was the commitment of everyone present to get the very best outcome we can.  We had some very challenging conversations about what this means we may need to do which tested the intersection between our values and the financial imperative, but there is a real sense of building momentum around the size and scale of action we need and the focus of the next few months.

Highlights of the Week 4: A commitment to coaching gives me a space that is less cluttered and real valued by me and those I've worked with
I've just reached 1,000 hours of recorded coaching ... .some 550 different sessions (that is in addition to the many hundreds of hours where friends and family will tell you I get in to coaching in an entirely uninvited way!)

This week I think I was probably looking forward to the coaching sessions more than the couple of people I ended up coaching.  I think that is ok.

Whether as a coach or coachee, I do find the space hugely calming and grounding.  It is great to get a focus for an hour or two on an individual and a particular issue or set of concerns.

There is always great reflection for me afterwards about my life or my approach, but more than that, in the session itself, the focus gives a time lock away from whatever is chasing me - whether a media issue, a melee at home or a set of emails.  Focus is great: I'm at my most stressed when I allow myself the time to randomly contemplate all of the huge issues we are grappling with or the number of task I need to achieve.  When I'm busy solving the problems or making progress, things are more in balance.

I wouldn't do it if it didn't make a difference for the coachee though and this week I got good feedback about the benefit that others are experiencing.

Highlights of the Week 5: A phone call with another system to talk about our challenges of creating a system wide programme of change
As the Challenged Local Health Economy work finishes its initial 11 week phase, we are busily working to construct phase 2: the part that sees delivery over the next 18 months.  We haven't quite got as far in phase 1 as we would have liked, so we still need to do more work to be explicit about the programme of work that we are all jointly committed to and the actions that we expect to be implementing.  But we have moved forward significantly since we started.

As far as I understand it, there never has been a multi-organisational programme of work across Devon and Plymouth that attempts to plot the impact of a joint and shared vision of the future and then turns that in to a reality.  But other places have had large programmes of system wide change in place for many years.  So I turned to one of these this week to discuss what lies ahead for us.

It was a hugely helpful call and shows the value of learning and sharing, rather than trying to reinvent the wheel each time.  It also crystalised though, that for complex change it is not about adopting the "thing" that someone else has created, it is about following a similar process that engages all parties in coming to a collective view and solution.

I felt both heartened about the possibilities that can be created from the type of work programme that we are entering and slightly deflated by the discussion of the time it will take to get to the end of the journey, something though that I have previously reminded several clients about when helping them with programme leadership roles.


Another fact about Plymouth, following on from last week's theme?  It rains here quite a bit; very warm, some beautiful days, but there is some wetness.  Need to ensure all plans take that in to account - or maybe just be young, party in the rain and sleep for the rest of the day!



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.