1. London Care and Support Forum: Leadership Event Part 2: Leading in the Local System – leading beyond your organisation Debbie Sorkin National Director of Systems Leadership, the Leadership Centre Edward Woods Community Centre, Shepherd’s Bush, London 4 th December 2014 Debbie.sorkin@localleadership.gov.uk

2. Introduction: Clenton’s story

3. A response: integration of health, social care and other services The Care Act 2014 – emphasis on prevention, re-ablement and the person at the centre – i.e. joined-up services The Better Care Fund National Reviews: Barker, Oldham, Kingsmill Health and Social Care Pioneers Systems Leadership – Local Vision projects

4. New structural support for integration New responsibilities for Local Authorities: market- shaping; prevention; assessment; information provision; and funding of self-funders Clinical Commissioning Groups Health and Wellbeing Boards The Role of Public Health

5. What this might mean for you in terms of leadership You are looking to lead in an external environment characterised by increasing complexity and difficulty Everyone is struggling to match growing demand with smaller resource pot: e.g. £3.53bn taken out of social care budgets 2010-14; (ADASS survey 2014) At the same time, you are having to build new working relationships with different commissioners, or with people who see the issue as one of procurement rather than commissioning And you are having to navigate changes to the system and a mass of new organisations whose function is not always clear So the kinds of issues with which you, as leaders in social care, have to contend with are WICKED issues, not tame ones...

6. Tame and Wicked issues Tame Issues: can be managed o Relatively straightforward o Known, familiar o Use established methods already proven to work o Can be solved Wicked Issues: need leadership o Complex o Not familiar – no ‘right’ answer o No tried and tested methods o Can‘t be solved, only progressed

7. 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

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

9. Hence 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

10. The Systems Leadership Programme: research, leadership development, practice Research: Systems Leadership: Exceptional leadership for exceptional times Leadership Development: Leadership for Change; Future Directors Practice: Systems Leadership – Local Vision Support for Pioneers/BCF

11. Progress and learning from Local Vision programmes and Pioneers LB Islington: ‘Test and learn’ sites focused around primary care but also aligned with other providers. Strong collaborative relationships built with HEE and making progress in mapping workforce development needs. Lambeth and Southwark: Developing multi-disciplinary locality teams; joint resource planning and commissioning; particular focus on community resilience and citizen leadership. LB Merton: Co-production approach to Integration pilots: aim is for rapid response and good links with Service Users/Carers/Vol Sector.

12. So: get connected, go direct if necessary, and think about data/measuring Getting connected: Cheshire West and Chester – supporting care providers/housing associations/others to strengthen community resilience; Calderdale training school pupils to conduct research Going direct: Shropshire Council and Shropshire Partners in Care Development Days – joint planning for winter pressures Thinking about data: Think about using data for predictive value Systems Thinking Units in local authorities PHE as data source – Older People’s Atlas Centre of Excellence for Information Sharing Academic Health Science Networks

13. Summary: be a Systems Leader, and build your leadership beyond your organisation Base ideas of leadership on behaviours and honesty Use leadership frameworks and Systems Leadership approaches Start small and use what you have – often more than you think; develop your people Use influence – you don’t always need formal power Make connections; build relationships; think beyond traditional roles Think beyond your organisation or service – focus on outcomes for the person using services, and aim for collective ambition across a place Just look to make progress; allow for time; keep going; no crouching!

14. So….who is in your local System? Starting point: what a System is, and isn’t

15. So….who is in your local System? On your tables and then on the outline map: Which bodies, organisations or initiatives do you know of that might be involved in your local System? E.g. Clinical Commissioning Groups Health and Wellbeing Boards System Resilience Groups Pioneers

16. Trying it out: Systems Leadership in your own System On the basis of what you’ve heard: Think of one way in which you’ve already been practising Systems Leadership, in your local System. Then think of one additional way you’re going to extend it, or try something new.

17. Systems Leadership – more information www.localleadership.gov.uk Debbie.sorkin@localleadership.gov.uk The Future will be Improvised - http://www.localleadership.gov.uk/docs/Revolution %20will%20be%20improvised%20publication%20v 3.pdf http://www.localleadership.gov.uk/docs/Revolution %20will%20be%20improvised%20publication%20v 3.pdf