Making the case, creating the culture Report Neighbourhood Network - PowerPoint PPT Presentation

Making the case, creating the culture Report Neighbourhood Network 11 th Oct 2018

The event ‘it was one of the best events I’ve ever been to be honest, the energy was amazing and the learning I took away was so valuable. I can’t wait for the next one!’ Twenty of use came together to explore the complexity of working with Neighbourhood Networks and how we might address it in bite sized chunks:- Describing the Neighbourhood’s Cultivating the story: clarifying right culture and the purpose of ways of working: the enabling the Neighbourhood right behaviours Team. We took a more coaching / action learning set approach focusing on the knowledge and expertise in the room 2

Describing the Neighbourhood’s story: clarifying the purpose of the Neighbourhood Team. World Café A set of 4 questions were set to the room and we all moved tables for each question to work with different people and hear others’ perspectives. 3

‘People already have within them the wisdom and creativity to confront even the Welcome most difficult to the challenges; that the answers we need are World Café available to us; and that we are Wiser Together than we are alone. ’ 4

‘It is in these… conversations that patterns can be identified, collective knowledge grows, and possibilities for action emerge.’ 1 What are the potential 2 What is required to purposes of achieve a well defined Neighbourhood Teams. purpose? 4 How will you know the 3 What are the purpose has been implications of having a adopted? poorly defined or not- understood shared What can you do to purpose? improve adoption?

1 What are the potential purposes of Neighbourhood Teams 6

What are the potential purposes of Neighbourhood Teams? The key messages were bringing multiple services and people together with a strong community focus. 7

These are the summary notes from this discussion… Community Self resilience • Quality Address loneliness • Different way of Coming Together • Individual focus • thinking Collaborating • Ownership / • Impactful Joined up • • belonging Accelerate Learning Sharing learning • • Disrupt archaic • Move away from a Resilience • • labelling of the referral culture Breaking down • population – Understand Need barriers • children elderly and Iterative learning Flexible delivery • • so on Bringing in • Optimise • housing, experience of living employment, in the locality schools Resources Community assets • Tardis – to connect • Efficiency – remove Focus on • • to the network waste and community and Different skill set • duplication people Savings Close to home self • • care 8

2 What is required to achieve a well defined purpose 9

What is required to achieve a well defined purpose? SUCCESS Strong leadership Time Open-mindedness Understand finances Collect and analyse data on progress Collaborative working Stakeholder/partner/community Focus on neighbourhood’s problems engagement and “buy in” BUILT ON TRUST Share resources/rewards/best practice Understand accountabilities Blur roles/boundaries Create space for staff growth Alignment, understanding and continuous monitoring of what success is and if 10 it is being achieved

Meeting neighbourhood- guided priorities? Positive citizen outcomes/ Promotion of experience? health and wellbeing? What could success look like? Effective training? Effective teamworking? Reduced A&E admissions? Different teams in each area that System working? suit each neighbourhood? 11 This Photo by Unknown Author is licensed under CC BY-NC-ND

3 What are the implications of having a poorly defined or not- understood shared purpose? 12

What are the implications of having a poorly defined or not-understood shared purpose? The overall message was that:- the multi-organisational • system and relationships would fail if individuals/ organisations work towards different goals . this would result in • inefficiency (duplication) and potentially negative staff/patient experience. 13 This Photo by Unknown Author is licensed under CC BY

Other outcomes that were discussed Need more than just a shared purpose – it’s about language, culture, the professions involved and what this means to the individual System Patients Workforce Blame culture Lack of leadership Poor outcomes No clarity of activities to Ambiguity be done Poor experience Default to what was done No teamwork before Lose trust in services Competing priorities Lack of information flow Disharmony Motivation loss Confusion Stagnation of skills Hard to evaluate Reduced staff retention Chaotic Low morale Lack of resulting impact 14 Reduced commitment This Photo by Unknown Author is licensed under CC BY-SA

4 How will you know the purpose has been adopted? What can you do to improve adoption? 15

How will you know the purpose has been adopted? Staff do “right” for the system, not their own agenda Community There is time Costs There is shared needs are for meeting are language, prioritised together saved? teamwork and collective thinking Old models are unlearned Information is There is a shared and There is a sense compassionate, If regular standardised of belonging/ trusting reviews and ownership and monitoring of forgiving progress show The public are culture it aware of the aims/ successes of There is the new Overall, there will be positive outcomes leadership at change every level for staff (e.g. satisfaction/retention) and for the community (e.g. individual empowerment to live well/ individuals get what they need) 16

What can you do to improve adoption? IMPROVEMENT Overall, make the Speed up the wheels governance to reduce the time taken to make neighbourhood “a change good place to Standardise and share information and make communication within/between organisations easier work” Run events that create a sense of place, belonging and community cohesion (e.g. Tea, Toast and Talk). Change culture to become more compassionate/ forgiving Encourage “bravery” not “blame” Understand that things will take time Give people the opportunity to think and form relationships Recruit to values and reduce egos Ensure people are able to make change without fear of being disciplined Motivate people (e.g. with elevator pitches) Invest in staff (development/ wellbeing)

Key learnings, discoveries and reflections that you had made throughout this process… ‘It is in these… conversations that patterns can be identified, collective knowledge grows, and possibilities for action emerge.’ 18

We need to create a Realised we’re all shared agenda with in this together, We should move away local government which is a from expecting A&E powerful force! admission reductions with neighbourhood working This will require a Establishing the culture change at shared care record is every level vital to enable this communication Relationships between agencies take TIME to build A change to neighbourhood working will take incremental Senior leaders should protect steps their staff and bare the brunt of Influencing from any backlashes so that staff can the bottom be brave and make change upwards will require new relationships Personalities and egos Language is vitally important - are critical to the flexible narratives should be success/failure of crafted for why neighbourhoods neighbourhoods – how are beneficial, that will appeal to can we manage this? different agencies 19

Cultivating the right culture and ways of working: enabling the right behaviours The Frimley Case Study A study revealed that for the first year after referral to the Integrated Care Teams, when compared to a matched control cohort, A&E attendance and emergency admissions increased. Why could this be? 20

Questions that were raised about Frimley… Was there a lack of training ? Were only a few staff changing their behaviour , meaning the system behaved as status quo ? Was the knowledge/ equipment needed to make change accessible and/or in the right place ? Did staff accept the changes ? What were the human aspects of change for the team (and patients )? Did the change increased demand and hence not reduce A&E admissions? Culture can be difficult to describe …so we chose to use behaviour as a vehicle to explore it 21 This Photo by Unknown Author is licensed under CC BY-SA

Cultivating the right culture and ways of working: enabling the right behaviours The common attributes of a Neighbourhood Team A set of attributes collated by the Strategy Unit were displayed to everyone and individuals gave feedback on whether they thought these were correct or if any needed to be added. 22