The Five Year Forward View (NE Essex) Collaborative: Prashant Arora Lynne Gordon Archie Kaul-Mead Judith Livesley Roisin-Aine Reade Victoria Sawtell Graham Seward @eoeleadership #eoeleadimp

Five Year Forward View: - North East Essex 15th June 2016

Introduction & Background The Five Year Forward View collaborative in North East Essex is formed of members from North East Essex CCG, Essex County Council, Colchester Hospital University NHS Foundation Trust, Anglian Community Enterprise and Health Education East of England. The collaborative was originally formed to bring together health and local government partners to develop strong leaders in each of the organisations to progress the development of the Five Year Forward View model for integrated working and care delivery. Graham

The project focus What did we want to achieve? Reduce duplication of work and address lack of shared purpose across providers and commissioners. The North East Essex collaborative agreed at the outset that it wanted to change this and create small but sustainable changes that would complement the system working already in place Vic It was recognised that within the health and social care system locally there can be duplication of work and a lack of shared purpose across providers and commissioners. The North East Essex collaborative agreed at the outset that it wanted to change this and create small but sustainable changes that would complement the system working already in place

What did we want to change? Remove barriers to joint working Reduce silo working Avoid duplication Improve outcomes for staff, organisations and service users Vic

What could we do to change things? We identified what the barriers to joint/ cross organisational working were We established the principles for good joint working, including shared values and mutually beneficial outcomes Fundamental approach of the North East Essex collaborative has been to be open and non-judgmental about each other’s organisation and to act with the joint purpose of wanting to improve the care of service users in North East Essex. Vic Working together seeking out the causes and solutions to joint working

Our approach Its been an evolutionary process….. working together collaboratively and removing barriers initial ideas for collaborative programme changed from the original brief. core product from the collaborative has been the development of a collaborative framework tool A longer term approach- the outcomes and delivery will extend beyond the end of the formal leadership collaborative Archie the core aim of working together better has remained central. We wanted to work together collaboratively and remove barriers to working together that can be created by organisational boundaries. Consideration of jointly accountable project boards; involvement in more focussed projects such as transforming care for frail patients by reducing the complexity of care pathways. for other groups to use, based on the learning from this collaborative

The collaborative framework Core Domains to assess/ test collaboration levels:- Group work Individual learning Leadership Relationships Resilience Making changes happen Staff resources Financial resources Framework has been used as a tool to benchmark the current North East Essex system leadership The aim is for systems to use the tool/ framework to assess where they are in terms of collaboration and help identify what needs to be improved. Archie

Personal/Group Resilience How it works Personal/Group Resilience 1 2 3 4 5 No ability to manage change No ability to plan change Group members reluctant to take on additional work Group unable to focus on task at hand High sickness levels Little or no commitment to group Low morale Unable to set achievable objectives No sense of purpose Group member prioritises time for self over work commitments No real network of colleagues outside of group Group disinterested in each other, not looking out for each other Limited ability to manage change Group members will only take on minimal amounts of work- quick wins Little commitment to group Disagreements about objectives to be set Unclear sense of purpose Some ability to manage change Easily diverted from task at hand Unreliable commitment to group Does not achieve objectives Group members rarely take time for self due to work commitments No network of colleagues outside of group Group reluctant to look out for each other Ability to manage change Some ability to plan change Group members take on too much work, unable to set boundaries Moderate sickness levels Regular commitment to group Variable morale Working towards agreed objectives Sense of purpose Very small network of contacts limited to direct colleagues Group beginning to look out for each other and build relationships   Able to manage change Able to plan change Some workload shared but not all Group focused on task at hand Low sickness levels Good morale Achieving some objectives Group members occasionally take time for self over work commitments Starting to build network of contacts Highly able to manage change Highly able to plan change Sharing workload Low sickness High morale Achieves objectives Strong sense of purpose Group members take time for self and balance this with work commitments Broad networks of contacts Group looks after each other Archie

Challenges and how we overcame them Not wanting to replicate other projects Changes to the membership of the group Rushing to find a solution in the form of a single project Responding to external pressures Solutions…. Adapting to changes Accepting that there didn’t have to be one ‘product’ from the collaborative Learning resilience as a group Lynne

Outcomes and impact to date Rotational posts being developed, internally and externally across organisations, improving the development of front line staff and increased the attractiveness of community posts within North East Essex. Team development models have been utilised by team members back within their own organisations to develop staff Lynne Rotational posts being developed, internally and externally across organisations in the collaborative, including within the community teams following the discussion commenced by the collaborative, which has improved the development of front line staff and increased the attractiveness of community posts within North East Essex.

Graham

The future Develop managers as well as clinical posts- have fully integrated managers who have the skills and knowledge to work across health and social care organisations. Reduced spend on interim consultancy posts by having managers with transferable skills Collaborative to continue active working as a working group to test ideas and remove barriers to joint working Roll out of the framework to help support other systems- acting as a barometer for new STP footprints and joint working. Lynne

Thank you