1. Social Care Institute for Excellence NHS Leadership Academy
WEBINAR 6 DECEMBER 2018
Systems Leadership
in Integrated Care Systems Webinar
Social Care Institute for Excellence
NHS Leadership Academy

2. Agenda Timing Item Presenter 1.00 – 1.05pm Welcome and introduction
Ewan King, Director, SCIE
1.05 – 1.15pm
NHS Leadership Academy
Systems leadership - National perspective
Christina Quinn, Director, Leadership Academy
Deborah Davis, Managing Director, NHS North West Leadership Academy
1.15 – 1.30pm
SCIE research
Ewan King
1.30 – 1.35pm
The expert by experience perspective
Ossie Stewart, SCIE Trustee
1.35 – 1.40pm
Next steps for ICS and leaders
Roger Davidson, Director of Engagement, NHS England
1.40 – 1.55pm
Poll on systems leadership
Questions and answer
All
1.55 – 2.00pm
Closing remarks and what next
Ewan King and Alison Jennings, Thames Valley and Wessex Leadership Academy

3. The NHS Leadership Academy Systems Leadership Model

4. What outcomes are we seeking through our work with systems?
Change mindsets – from competition to collaboration
Change behaviours – pace to relational
Build relationships – facilitate connections and collaborations in real time in real work
Supporting and developing leaders to support systems now and in the future
Unleash transformation, creativity and the potential of our workforce
Develop a cohort of system ready health and care leaders

5. People Developing Developing Innovation Developing Collaboration
We empower people working in health and care, by developing compassionate, inclusive leaders at every point in the system, and a culture of great, evidence-based leadership.
Developing
People
Skills for system leadership
Equipping individuals and groups with the skills to transform
For individuals
Diagnostics, tools, coaching, mentoring, buddying, inclusive programmes
For groups
Building OD capability, team development, handling conflict, organisational design
Developing Innovation
A leadership mindset
Promoting a culture of thought leadership and quality improvement
Thought leadership
Evidence-based, publications, keynote speakers, 2020 and other innovation programmes
Quality improvement
Sharing evaluation and best practice
Developing Collaboration
Leaders working together
Connecting people across systems and communities
For systems
Talent management and development, experience sharing, bursaries, localised support For communities
Action learning, networking events, stakeholder perspectives and engagement
Describe some of the tangible items without reading through the whole slide

6. Thought Leadership
This work is emergent and pioneering – we are building the evidence base while doing the work
Findings of this report will directly tie into a 3 year business planning process for the National Leadership Academy
This and other system research feed into a National System Leadership network formed of the 10 Local Teams and the National Team at the NHS Leadership Academy
What are we learning from our work with systems?
How do we scale and spread what is working well?
What are the gaps?

7. Why this research?
No one solution sits with a single agency – how could we model working in partnership?
How could we encourage our local stakeholders to build learning for successive ICS’?
We need to build closer relationships with other sectors to expand and develop current models of system leadership
An OD mindset – to enquire and be curious.

8. About the research
SCIE asked by NHS Leadership Academy to research systems leadership in integrated care systems and inform long-term plans for supporting leaders. Involved literature and interviews with ICS systems leaders
Explores:
Barriers and facilitators
Features of effective systems leadership
Examples of good practice
Nature of support needed

9. Its systems leadership, but a harder version!
In ICSs, systems leadership that has been ‘turbocharged’ – encompassing more complexity, a broader span of influence and a need to focus on long term change
“Locally, good system leaders are ‘translators’, making sense of disparate policy drivers, legislation, performance requirements, regulatory systems and funding mechanisms.”

10. Different areas of focus
Increased span of influence - housing, social care, VSC, primary, mental health
Need for expertise in managing large-scale change
Growing expectation that citizens shape local plans
Re-emergence of place-based thinking
Increased emphasis on sharing resources and financial risk
Need to deepen systems leadership- Bringing the next two tiers of management along on the journey
Issues even more wicked than before – contracts, estates, out- of-hospital, workforce, prevention, winter pressures

11. Building strong relationships with other leaders
“System leaders probably spent ten to twenty per cent of their time on partnership activity ten years ago. Now it needs to be fifty per cent to focus effectively on collective aims.”
David Pearson, Lead Greater Nottinghamshire ICS

12. Mastering governance across complex systems
Leaders must also be able to establish governance structures which drive faster change, rather than being beholden to complex arrangements no longer fit for purpose. People spoke about the need to sometimes break up existing structures when they are not performing, and go where the energy is strongest. “Without a legal framework, you have to make the most of what is around you and find new ways for decisions to be taken.”

13. Having a strong focus on outcomes and population health
The focus on population based outcomes has become an important part of the systems leadership role, with a shift away from simply tracking organisational metrics, towards patient and outcomes for people. “If you start with the person and the place, you arrive at a different place to when you start with organisational KPIs. You can enable people to see the value in a shared endeavour.”

14. Setting the overall outcomes and expectations on behaviours
Systems leaders are adept at building shared visions and plans that bind organisations and individuals together around shared goals. “I think the biggest breakthrough for us was in getting everyone into a room – mental health, social care, VCSE, citizens – to develop a shared vision for the ICS.”

15. Simplifying complexity and communicating relentlessly
Leaders spoke of how important it was to be able to translate complexity into well understood plans for action. Once this vision is formed, it needs to be communicated consistently and relentlessly “We should be able to communicate our vision, actions, and achievements on one page.”

16. Coproduction and citizen engagement
Effective citizen involvement to build supportive coalitions and find solutions to wicked issues will become a more critical skill for systems leaders.
“The best results are achieved when the engagement process begins at an early stage of planning service change and is maintained during implementation.”

17. Supporting system leaders
Creation of ‘safe spaces’ for leaders
Independent facilitators to support large-scale change initiatives
Opportunities to learn from other professions and sectors
Increased focus on lower tiers of management
Masterclasses on:
co-production theory and practice
finance and risk-sharing
scaling innovation
understanding local government and social care
working across multiple layers of governance

18. Co-production
Larry Gardiner – Audio played

19. NHS England
Roger Davison, NHS Director of Engagement and Communications for Health System Transformation – Audio played

20. Our offer – National Programmes
Strategic System Leadership Programme for STP Footprints.
3 senior leaders from 10 STPs (clinical, managerial, other sector)
In partnership with Yale University.
Mary Seacole Local – first line leadership programme ‘in-place’.
Access to existing Core Programmes that range from Aspirant CEOs/ Directors through to front-line leaders.
Strategic partnerships with other arms length bodies – National Improvement and Leadership Development Board Systems Leadership Subgroup

21. A way of working with systems
Model: Systems Leadership Model, a framing of emergence, mindset and behaviours
Menu: A range of tested interventions that have evidence of impact in systems – there is no one ‘right way’
Money: Investment, seed funding, joint funding, support in winning bids or investment from elsewhere
Mandate: Permission from CEOs to release HRDs and Leadership and OD Leads to work on system priorities
Memorandum of Agreement: Governance, gives and gets, contracting.

22. Our offer – Local Academy Consultancy
Expert facilitation for strategic and challenging conversations
OD expertise to develop system OD and leadership plans for new models of care
Building capacity and capability of health and care OD practitioners to work at system level
Bespoke ‘In-Place’ programmes
Funding
Talent Management system blueprint
Thought leadership (such as this report)
Local Workforce Action Board (LWAB) membership
Primary and community care leadership development programmes

23. Find out more https://www.leadershipacademy.nhs.uk/ www.scie.org.uk
Deborah Davis – National Local Academy Lead for Systems Leadership and Director North West Leadership Academy
Christina Quinn – Director South Leadership Academies
Alison Jennings – Deputy Director of Thames Valley and Wessex and Kent Surrey and Sussex Leadership Academies (South East Region)