I used to coach for a large part of my job; perhaps 6 or 7 sessions a week with different managers, executives and clinicians. A large part of those discussion would be the presentation of stress, the times when multiple factors hit our lives at the same time - problems at home, problems with a relationship, moving house, money, health and different situations at work.
It is not usually just one element as, often, we can cope with one part of our world being out of alignment with the balance of other bits that are working well. People would invariably feel unable to cope when a myriad of different issues were hitting them at once.
At the moment work is really challenging: three and a half days last week were spent in meetings that were entirely about the financial position and for the others it was the context; family life is hectic (and it will feel more like that as I spend a bit more time both physically and mentally at work) and we are in the middle of some internal building work at home. That means that the house is in chaos with dust and material everywhere, but there is also a project plan and we need to maintain our part of the schedule to ensure we can move out of and in to the right rooms at the right time. Sleep is more fitful.
So the brain is full - when to sand the floorboards, when to fill the cracks, the best order to decorate and where things will be stored. Physically tiring too - home from a long day and then spend three hours on hands and knees sanding.
The antidote is not easy, but running is important for me (not as easy with dark mornings, or certainly not as inviting) and interesting that Simon Stevens has highlihgted the issue of workforce fitness again this week, though I'm not sure joining gyms is the real answer. The truth is that we all need to recognise the challenges we face across all aspects of our life and, as the pressure increases, be clear that we are taking steps to manage that impact. It isn't ok for me to shout at the kids, kick the dog or find release in a bottle of wine each night; now is the time to be aware of self first of all and of others around me.
Highlights of the Week - 17th October 2014 (@jeclo)
Highlights of the Week 1: A week of true challenges but the team in @NHSNEWDevonWest has come through with flying colours
Given that I've spent three days in all-day financial recovery mode, I haven't been around much in the Locality to explain, motivate and encourage the level of effort that has been required to produce the recovery plans, action and evidence that give assurance about our forecasts.
But, as usual, the team in the Locality has responded to some fairly short and blunt requests with a collective response that has been really impressive and of great quality. They work smoothly and efficiently under pressure; no panic, just a complex and time consuming task completed speedily and relying on each person to produce an element of the jigsaw.
There is a great balance in the team, but together they invariably produce when we need them to most.
Highlights of the Week 2: A late Friday meeting with @PlymLeader sharing perspectives on the importance of integration and our joint perspective
Mostly after a difficult week I could do without a 5pm meeting on a Friday. But this week, meeting with Tudor Evans, Tracey Lee and Carole Burgoyne at Plymouth City Council to talk about our integration plans and joint work was a positive way to finish.
The financial challenge in the CCG causes ripples across our partners - they clearly want to know how our budget position will affect the plans we have to work more closely together and also how the CCG will protect resource allocation in the city at a time when recovery is the number one priority.
We agree that we need to keep our integration momentum, especially when budgets are hugely pressured - we can both point to savings we have made this year as a result of our joint work. Even more importantly, we are clear about the benefits that a pooled commissioning fund will bring from next year.
Highlights of the Week 3: A meeting with Monitor about our community services commissioning strategy. Interesting perspectives to explore!
There is a lot discussed about Monitor and their approach to competition and integration and this week we got to sit and discuss our plans for community services with a team from Monitor who came to visit.
We clearly have very different roles and therefore our perspectives are hugely different, but I didn't find them difficult, uncaring or obstructive, just with a very clear sense of their purpose and the job they have been given to do.
Our plans for community services describe approaches that would see an open competitive procurement for some services, such as urgent care, with a more restricted procurement process for services for complex adults, recognising the importance in this area of integrated pathways.
There was a lot for both of us to reflect on and there is still further clarity required on exactly how the final proposals will be received, but it felt like we had made real progress and we have a good sense of how we need to proceed.
Highlights of the Week 4: @NEWDevonWest Leadership Team day looking at integration and financial recovery: great focus on both
In the middle of the intense work on financial recovery, it was important this week to raise our heads from the immediate work to check that we are clear about what we as a team in the Western Locality are trying to achieve for the remainder of the year and that it fits with our slightly longer term ambitions.
Integration will have a big impact on the team and the staff within the CCG. We don't have the final staffing model for an integrated commissioning organisation yet and we may have some time when we work in a virtual or seconded team administering a pooled fund, but we do have a clear intention and direction that will see big changes to structure and ways of working.
We were very clear that the work was critical to our future success and we can only see the increasing importance as life looks tougher. The Leadership Team got a good grip on both the integration issues and on the financial challenges, where we worked in some detail on the next steps and actions.
Highlights of the Week 5: End the week at the Great West Run - there are different types of tiredness, but this is one that sustains
Very little training (enough running on the moors, but nothing that could be classed as sufficient or relevant to running a road half marathon), but I knew I'd be ok to get round and enjoy the feeling of running with a large group of people.
And, however slow, however hilly and however painful at times, it was a beautiful sunny autumn morning and I did spend the rest of the day with the wonderful buzz that a long-run can bring.
(even if I was back to sanding by the evening!)
You 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.
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