RCPA Annual Care Seminar 2014 The Revolution will be Improvised: New approaches to leadership and how they can help you Debbie Sorkin National Director of Systems Leadership, the Leadership Centre Somerset County Cricket Club, Taunton, 26 th November 2014

New approaches to leadership: What this presentation covers Why leadership matters: because of the external context Why leadership matters: because of the way it’s defined Systems Leadership – a new approach and a practical response Systems Leadership – research, development, support Lessons from Systems Leadership – practical steps you can take to strengthen leadership and build your service

Why leadership matters: because of the external context External environment for social care characterised by increasing complexity and difficulty Struggle to match growing demand with smaller resource pot: e.g. £3.53bn taken out of social care budgets ; over 500,000 people whose care needs are not now being met by local authorities (ADASS survey 2014) Difficulties in making the case for social care and getting a hearing at national level, and at getting this acknowledged by the public At the same time, changes in public expectations – personalisation, co-production, independent living Implications of integration – multiple stakeholders and audiences

In times of change/difficulty, good leadership can be a lifeline To help you manage the funding pressures – at just the time demand is growing: both private and public sector issue To help you do more – and more complex - with less To be comfortable working with a wider group of stakeholders – CCGs, public health, personal budget holders, housing, planning To be able to work with adaptability/innovation - reconfiguring services, working with new client groups, providing flexible care models To re-inculcate the old virtues and values – dignity, compassion – emphasised especially post-Winterbourne, Mid-Staffs: see Cavendish Review, Driving Up Quality Code, Oldham Review

The basis of leadership: behaviours Not just about authority at the top of organisations It’s a practical understanding – and awareness – about how you do what you do, and the impact on others So it’s about behaviours, and taking responsibility for them And it’s everyone’s business – people working at all levels in all sectors “People do not experience our values, they experience our behaviours” Bill Mumford, CEO, MacIntyre

Leadership in adult social care: The Leadership Qualities Framework Guide to what good leadership looks like Describes what good leadership looks like in different settings and situations Defines good leadership for people at different levels: o Front-line staff o Front-line leaders o Operational leaders o Strategic leaders Basis in values and behaviours that flow from them: written in plain English to be accessible

The model extends beyond social care – it’s the basis of a culture that works across systems Social Work Public Health Social Care Health

So you can have Systems Leadership – cross- sector, shared, ceded, partial, transformational About leading: when you’re not in charge when you need to ask when it’s complex when you have no money Systemic – i.e. not piecemeal or divided into silos - and based on shared ambition Participative – i.e. involving many people’s energies, ideas, talent and expertise Emergent – i.e. allows for partial/clumsy solutions, able to work with uncertainty...and based on trust/relationships – So back to behaviours

Lessons from Systems Leadership: research, leadership development, practice Research: Systems Leadership: Exceptional leadership for exceptional times Leadership Development: Leadership for Change Practice: Systems Leadership – Local Vision

Systems Leadership research Ghate, D., Lewis, J., and Welbourn, D., Systems Leadership: Exceptional Leadership for exceptional times. The VSC, Nottingham, UK, 2013 Synthesis paper brought together evidence and case studies from 7 source papers from England, USA, Canada, Australia and Denmark Research includes literature review, in- depth interviews with 29 leaders working across public services; case studies; reviews Key findings identified ways of describing Systems Leadership; the best ways to achieve it; personal leadership styles of people who did it well; and conditions it needed to flourish

Lessons from Systems Leadership research: factors that enable it to flourish Common vision or ambition: willingness to cede organisational goals Focus on place-based initiatives and outcomes Strong/honest relationships; accountability; allow for different views Combination of political and organisational commitment Role authority not sole source of legitimacy: influence, not power People tolerate risk and accept multiple potential pathways

Lessons from Systems Leadership research for your workforce Willingness to align around a shared purpose or ambition Able to build engagement/relationships and really listen Preference for outcomes over processes Not being bound up with role and with a willingness to take risks Able to work reasonably well with conflict and uncertainty Having a strong commitment to a service in a particular place

Lessons from Systems Leadership practice: Systems Leadership – Local Vision National programme: 35 projects in England, including 5 in SW Projects focus on integration or wider wellbeing issues Topics also include mental health, inter-generational obesity, alcohol abuse and social isolation Support via Enablers on the ground and access to networks/ information More funded projects planned – you can get involved

Examples from Local Vision and Pioneer Programmes Dorset, Bournemouth and Poole: outcomes include: ’Better Together’ programme to develop coherent local system: commitment to shared vision and pooled budgets, involving commissioning and provision; developing multi-disciplinary locality teams; joint resource planning; work with LEPs on workforce issues; bid for integrated social care record system Wiltshire: outcomes include: Health and social care coming together in overall Systems Resilience Group; three demonstrator sites for integration starting; looking at longer-term partnerships with vol sector and better T&Cs for social care

Lessons from Systems Leadership for your service: Get involved and get connected Connect with your Clinical Commissioning/wider Systems Groups: position social care as part of the solution, working with healthcare: Wiltshire:LA support for employment contracts in home care; looking at longer partnerships with voluntary sector W Cheshire:LA supporting social care providers to strengthen community links, to reduce social isolation Work with LA/Emergency Services to use data for predictive value DCLG:Role of fire services – duty of wellbeing W Cheshire:Springboard programme Connect with your Health and Wellbeing Boards: Suffolk:public support for reformed mental health services

Lessons from Systems Leadership for your service: Use the data: it may be easier than you think Local Vision programmes: Nottinghamshire MASH/W Cheshire Springboard programme New White Paper on Data Sharing: “Towards Tailored Public Services” - more data-sharing across services The Centre of Excellence for Information Sharing – – Engagement Managers who work locally with commissioners/providers

Lessons from Systems Leadership for your service: Go direct Connect with NHS Trusts and other stakeholders directly Example: Shropshire Partners in Care, working with local NHS providers and health/social care commissioners: Development Days Direct transfers between hospitals and care homes Funding located for GPs to visit care homes with emphasis on prevention Care providers brought into planning process for winter pressures Social care as source of innovation: Health hotels Community links Social assets and social capital

Lessons from Systems Leadership for your service: develop your teams See leadership as for everyone, and as a craft to be developed Think about who might have be suited to Systems Leadership, at any level Try it out – set people a wicked issue and ask them who might be in the system, what might work, what they might see Focus on behaviours/relationships Use coaching and support networks

Lessons from Systems Leadership for your service: Public Health is your friend New role of Public Health – focus on “the health of the public” New locus in Local Authorities Key role in brokering, facilitating and supporting relationships Working with social care providers on public health initiatives – e.g. Coventry Local Vision programme to raise levels of physical activity in the city PHE as data source: Older People’s Health and Wellbeing Atlas – atlas/default.aspx

Lessons from Systems Leadership for your service: Measure something Wiltshire Council Systems Thinking Unit: Children’s Service Review Police Service Review Ask your Staff, Service Users and Carers/Relatives What is interesting to you? You don’t need to be an academic or have a research grant - you can link up with Academic Health Science Networks/Education Measure something interesting and you’ll find something interesting South West Peninsula AHSN: West of England AHSN:

Lessons from Systems Leadership for your service: Celebrate and influence: stand up for social care Social care as key driver of local communities and economies Social care as growth sector Social care as local employer Social care as community hub/link Social care as source of innovation Social care as a source of good news stories for local media/MPs/ Councillors/HWBBs Social care staff as people to be celebrated

Be a Systems Leader: build and develop leadership within and beyond your organisation Base ideas of leadership on behaviours Use leadership frameworks to underpin behaviours and drive culture Use Systems Leadership approaches to go beyond your organisation/sector Start small and use what you have – often more than you think Make connections and build relationships; think beyond traditional roles Develop your people Just look to make progress; allow for time and keep going

Everyone has a part to play: Systems Leadership is about all of us Because everyone can do something about changing what they do and how they do it. So everyone can be a leader – and a Systems Leader - to some degree. Everyone can have a go, and everyone can make a difference. And everyone can be a force for change and a force for good.

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