Conference 2011 Session Summaries
The Minister for Health and Social Services, Lesley Griffiths AM
The Minister opened the conference with her vision for how the NHS needs to move forward in line with Together for Health. Although some of the messages of Together for Health are not new, she said, the environment we are in now means “there is a greater sense change is needed”. The Minister outlined her intentions to ensure that best practice is spread more quickly across Wales, and that there is greater transparency on NHS performance. There was also a stark warning about the crucial importance of hitting financial targets, saying “there is no margin for error”. The Minister was clear in giving her expectation that local leaders must deliver the changes and improvement necessary, with proposals built on sound engagement and changes taken forward with the trust of the public.
David Sissling, Chief Executive of NHS Wales and Director General, Department for Health and Social Services
The “big message” is about engagement, said David Sissling, as he spelled out the immediate challenges for the NHS in Wales. It is critical that we do this better. Firstly, he said, we need to be clear what transformational change means – it is about system change, not just hospital change. But even with the best technical plan in the world, unless we communicate it well, we will not succeed. The NHS must listen and reflect, and if necessary, adjust and refine its plans. He also stressed the importance of prevention, saying the NHS has been high on ambition on this agenda, but this has not been followed through on delivery. Mr Sissling highlighted the Flying Start initiative as an example of the excellent work that the NHS should be doing more of.
Chris Earnshaw, Managing Director, John Lewis Cardiff
Chris Earnshaw gave a fascinating insight of how the famously employer-friendly John Lewis Partnership empowers and engages its staff. When you have a culture of genuine staff engagement, he said, the results are powerful. He described how the unique John Lewis approach has led to the brand becoming the third most admired in the world. Staff involvement is built on a model where “partners” hold management to account though corporate staff forums that allow them to provide direct feedback to senior managers. Mr Earnshaw’s presentation revealed a number of parallels between the challenges faced by John Lewis as it continues to work through a major change programme, and the transformational change that the NHS is also undergoing. The key, said Mr Earnshaw, is investing in time and training to win the hearts and minds of staff. It will not happen overnight. Above all, he said, when going through change, you always have to remember who you are doing it for.
Andy Black, Chairman, Durrow
Andy Black gave an overview of the work he undertook to co-author “Providing Acute Services Locally.” You can have gold standard care locally, he said, but there are a number of reasons why the NHS cannot do it. The problem is often in the brief, he said: Do we define what we mean by local?; Do we establish what services are required to provide “acute” care?; Do we put proposals together after creative dialogue with local authorities about how the facilities we create can make a civic contribution? To achieve the vision of integrated acute services in a local setting, we need absolute consistency in purpose over 10 years – these are not “changes you can flip over like burgers”. You also need your best managers in the smaller hospitals, and you must insist on nothing less than gold standard care from your clinicians. Finally, he said, the financial structure in general practice must be dismantled to achieve real integration between primary and secondary care.
Sue Wallis, Assistant Director – Communications, Greater Manchester Children, Young People and Families’ NHS Network
Is it possible to take the public with you during major transformational change, even when it involves hospital closures? Yes, to some extent, said Sue Wallis who leads the communications and engagement programme for NHS Manchester’s Making it Better scheme, which has been described as the “biggest and most complete programme exercise in patient and public involvement in England to date”. In order to secure the understanding of politicians and the public, you must search for legitimacy; find the robust case that stands up to scrutiny. The involvement of clinicians is absolutely critical, as well as being able to find external validation for the changes you are making. Be creative about engaging younger people, and do not rely solely on the media. Focus on the benefits for patients, ensure your messages address people’s real concerns and then – hold the line.
Panel Debate
Carol Lamyman-Davies, the Director of the Board of Community Health Councils in Wales, gave her perspective on public engagement in transformational change. There is a clear need for a new approach to public and NHS relations, she said. Change is rarely accepted easily – continuous engagement is necessary to help the public understand the reasons for change. Ms Lamyman-Davies highlighted the role of CHCs in representing the patient voice through change. They are not “hapless do-gooders”, she said, but a credible watchdog and a critical friend.
Dr Trevor Pickersgill of the BMA presented the clinicians’ view of what it takes to engage clinicians in transformational change. Engagement, he said, is getting out of the office and into the staff forums. The important thing for chief executives and leaders is being visible – attending medical staff committees, arranging breakfast meetings for consultants so they can attend before clinic time. If the organisation shows it values its employees, then the reverse will also be true.
Jim Lawless, Taming Tigers
Our lives are full of decisions, said Jim Lawless, as he gave an entertaining session that revealed how often the decisions we take are a result of our fears and inner doubts. The “decision – action – result” cycle we go through every day can have lasting consequences for the rest of our lives. We need to make sure those decisions are not driven by the “tiger” roaring within us – the doubts that can sometimes prevent us making bold decisions. We write the story of our own lives. For most of us, our working, professional lives are the biggest opportunity to write our story. If the tiger talks us out of a decision five times a day, that’s potentially 240,000 decisions in our lifetime taken by the tiger. We need to make sure we write the story ourselves, rather than have the tiger dictate it to us. It is a learned skill to get past the tiger, but we must never give up.