Highlights of the Week – 12th September 2014

It is obviously a great week.  I mean, there are just some things that happen in some weeks that will, almost despite all other news, mean it is a good week.  And this week it is of course the launch of new Apple products and most intriguingly of all the iWatch.

I’m a bit of a sucker for Apple these days.  I was a firm PC man up until I left the NHS in 2007 and decided that one of the things that was going to mark out my new found freedom was running my company based on slightly less establishment IT.  I had an iPod mini as a leaving present too, so I set off in to the new world.

And then the iPhone arrived.  By that stage I had loved my iMac and Macbook; they were just great – so easy to use and worked each and every time you needed them to without fail.  But the iPhone changed everything, not just for me, but for the way we use technology and what we can do.

Whether I need all that functionality on a watch, I’m not so sure (but I do remember a conversation in which I confidently predicted that people who were moving towards buying 50 and 60 inch televisions simply wouldn’t watch films and TV on a four inch screen).  That isn’t the real excitement.  The news that Apple are working with key partners in the States to attack the healthcare market is.

What would happen to healthcare if the world’s largest company decided to use its wearable technology to change the landscape in the same way that they did with the iPhone.  I have no idea what they would do, but I can dream about something monitoring heartbeat or ECGs automatically on my wrist and predicting risk in a way that I can only dream about or automatically booking me an appointment when I’m free in my diary when the watch notices a particular reading.

I don’t know what will happen, but I do know something will and somehow it will just work intuitively for me. Exciting times.

Highlights of the Week – 12^th September 2014 (@jeclo)

Highlights of the Week 1: Organisational Resilience and Capacity Plan Face-to-Face Challenge- surely not a highlight!

The Organisational Resilience and Capacity  Plan (winter plan plus how we will hit elective targets for those not up to speed with latest terminology) for our locality (the area in the catchment of Derriford Hospital) has been designated as high risk.

We got this rating because of the level of challenge we have to deliver referral to treatment targets and it is a fair assessment, given our start point.  We also have had a few months of missing the A&E target too, following a year of really strong performance – Plymouth Hospitals had been one of the best performers on the A&E 4 hour wait last winter. So, to be blunt, you can expect the face-to-face challenge meeting to be challenging on both fronts.

The highlight was the feeling that as a community we are aware of the scale of the challenge, we know our numbers and trajectories really well and we are working collectively to resolve the issues we face.  There is not perfect harmony – compared to a winter allocation last year of £5.5 million, this year we are getting £2.3 million (and release of this is subject to our delivery), so we can’t meet everyone’s expectations and that does cause tension.  But on the day, we spoke consistently and showed the reward of the joint work we have done in planning to date.

Highlights of the Week 2: Local NHS Futures Programme moves forward and our Programme Director has (almost) started

A group of Chief Executives who will be leading projects within our “Local NHS Futures Programme –Transforming Care in Devon and Plymouth” met this week to finalise the details of the projects and arrangements in advance of the first Programme Board in a couple of week’s time.

We made real progress and we are now very much moving in to the delivery phase.  Something new is going to happen in the Devon and Plymouth health and care system with a systematic approach to large-scale transformational change.  It has happened in many other areas, but it hasn’t happened here on this scale.

We shouldn’t celebrate until there are tangible results from the programme, but it does feel like a major step forward.  We had discussions about the right way to cut the matrix – urgent care and planned care or frailty – but in the end we got passed the planning phase and it feels like there is real appetite for moving to delivery.

Mark Marriott has also joined us as Programme Director (he starts on Monday) and he will bring a real co-ordinating force that helps us to stay out of enjoyable, but purposeless and circular discussions, by staying sharp to project purpose.  It is a big challenge – lots of organisations with their own positions, but optimism is rising.

Highlights of the Week 3: Sunshine and a chance to think about creating possibilities with @annjamesnhs

There just isn’t enough time to think; rushing from one meeting to the next, stuck in air conditioned (or sweaty) boxes all day, staying out of the sunlight. 

This week Ann James and I managed to find an hour or so away from the office to reflect on how things are for each of us personally, our organisations and the NHS more widely.  The relationship between our two organisations – the CCG and Plymouth Hospitals – is a challenge; it is bound to be we are both in deficit so we never have any room to negotiate or compromise.

This week though, we did get to think of what could be different, what options their might be for different ways of working and how we could work differently to get different outcomes.  We are both interested in how the behaviours of our organisations impact on others and this was a good chance to reflect on that too.

No big agreements, no new announcements, but a sense of a few more seeds scattered on fertile ground and we may both get to harvest the result.

Highlights of the Week 4: CCG Executive meeting finishes on time- do we want to explore the relationship between numbers and speed?

I’m an advocate of small meetings; less people, stay focussed, make progress.  But of course, as an introvert that is bound to be my preference and it doesn’t mean that that is the most effective way.  As you place clinical leadership front and central to the way we run NHS organisations, there is a acceptance that there will be more people in the room, whether in CCGs or in NHS providers.

And that does mean that we are able to make more rounded decisions that take account more directly of the clinical dimensions, are better informed and hopefully place patient safety and quality to the fore.

But they are bigger and if you are not very careful, they are longer. Time can drag.

So we finished on time this week at the CCG Executive which has had a habit of running very late with a gallop over the second half of the agenda in half the time given to the first.  We all had a say, we got the information we needed and got to go home.

Now was that effective?

Highlights of the Week 5: Collaborative Services Board Development-We like what we have in house-how to make it even better

NEW Devon CCG is one of only a few CCGs that has the vast majority of its services provided by in-house staff rather than through a contract with a Commissioning Services Unit.  It works really well for us and was one of the key reasons for creating an organisation of our scale.

It isn’t the national flavour and there is an underlying concern that we will get sucked it to some arrangements that we don’t think will work as well. The development session allowed us some time out to really think about our approach and how we want it to develop.

We do buy some services in: procurement advice is one example where not only do we want specialist advice, but we also want people who have experience in other areas.

The most exciting development is our joint ownership with Plymouth City Council of a new company – Delt – that will provide IT services to both our organisations and the GP community across Devon and Plymouth. From that base we hope it will grow in terms of public sector organisations and in terms of other services.  It helps to retain high skill jobs within Plymouth and that does impact on the economy and therefore health and prosperity.

So, we are not a protective island, but we are clear on the benefits of the approach we have adopted and more to come.

Now, how will Apple change that?

ou can read other blogs related to the work of the Western Locality of NEW Devon CCG

About our workplan: Western Locality Workplan

About our Locality business: Western Locality Business

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.