B1: Collaborating across barriers Dr Frederick Lewis* | Dr - - PowerPoint PPT Presentation

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B1: Collaborating across barriers Dr Frederick Lewis* | Dr - - PowerPoint PPT Presentation

Nov 23, 2022 544 likes •1.03k views

B1: Collaborating across barriers Dr Frederick Lewis* | Dr Christopher Hilton* | Dr Joanne Watson & * West London Mental Health NHS Trust & Torbay & South Devon NHS Foundation Trust www.menti.com | 13 20 2 www.menti.com | 13 20 2 By

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B1: Collaborating across barriers

Dr Frederick Lewis* | Dr Christopher Hilton* | Dr Joanne Watson&

* West London Mental Health NHS Trust &Torbay & South Devon NHS Foundation Trust

www.menti.com | 13 20 2

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www.menti.com | 13 20 2

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By the end of the session…

  • Know more about community out of hospital and

integrated models of care

  • Understand some of the challenges (and successes) of

delivering new care models involving multiple partners and complex relationships

  • Recognise the relevance of leadership skills in different

clinical settings

  • Understand how QI skills can be used as a vehicle for

culture change within departments

  • Generate ideas about how these approaches are

transferrable across the NHS in general

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Collaboration and Conflict: Real life experiences of leadership in a new model of care

Dr Freddie Lewis* and Dr Christopher Hilton* * West London Mental Health NHS Trust Correspondence emails: frederick.lewis@nhs.net, christopher.hilton@nhs.net Follow us on Twitter (@EalingHome_Ward). Watch a video about the service by scanning the QR code
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  • North west London – context
  • Home ward Ealing – concept
  • Relationships – it’s complicated
  • Observation and formulation – conflict
  • Techniques to address – QI, collaboration and

compassionate leadership

  • Next steps – accountable care, mental health

trusts and community provision

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North West London and Ealing

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Our service

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Relationship status: it’s complicated!

Internal interfaces

  • Lead, partners, s75 arrangement
  • Subcontractors, agencies
  • Teams, staff, professional groups, staff-side
  • HR, finance, clinical governance etc (x5)

External interfaces

  • Acute trust(s), primary care, nursing homes, ambulance

service, community trust(s)

  • Mental health trust
  • STP
  • Other community and intermediate care providers
  • Cross-border interfaces
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WLMHT in 2017

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Reality of Change

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(Atkinson and Rogers 2016)

Complex Adaptive (Living) Systems

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(Langley et al 2009)

How to tackle this issue?

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1 + 1 = 4

Other Strategies

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Compassionate Leadership

(Atkins and Parker 2012)

Understanding Attending Empathising Helping

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The best care At the lowest costs For the whole population

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The best care At the lowest costs For the whole population

Experience of care and quality gap Health and Wellbeing gap Finance and efficiency gap

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The best care At the lowest costs For the whole population

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The credibility gap?

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From STPs to ‘accountable care’

  • Clinical – whole person
  • Outcomes focussed
  • Incentivise best outcomes (financially)
  • Providers to collaborate to close gaps rather than

blaming commissioners or ‘the system’

  • Eg:
  • CAMHS / Forensic New Models of Care
  • Home ward Ealing
  • One You Ealing
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All sounds familiar?

  • Care planning
  • Care coordination
  • Care closer to home
  • Virtual wards
  • Integrated care
  • Integrated teams /

co-commissioning

  • Extended roles
  • Risk stratification
  • Co-production
  • Patient-centred care
  • GP at centre of care
  • 5YFV / STP
  • ~1950 – 2017 in MH
  • Care Programme Approach
  • Care coordination
  • Care in the community / shifting

settings of care

  • Crisis Resolution and Home

Treatment Teams (NSF)

  • Bio-psycho-social
  • CMHTs
  • “New ways of working”
  • Risk informed triage and care
  • User involvement
  • Recovery model
  • Primary care liaison
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#choosepsychiatry

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References:

Atkinson J and Rogers M (2016). ‘The Big Five’ of Living Systems. Accessed via http://www.heartoftheart.org/?p=2851 on 27th July 2017. Langley GL, Moen R, Nolan KM, Nolan TW, Norman CL, Provost LP (2009). The Improvement Guide: A Practical Approach to Enhancing Organizational Performance (2nd edition). San Francisco: Jossey-Bass Publishers; 2009. West, M (2016). Lecture: Encouraging staff wellbeing in health and care. Accessed via https://www.kingsfund.org.uk/events/encouraging-staff-wellbeing-health-and-care on 14/12/16. Atkins PWB, Parker SK (2012). ‘Understanding individual compassion in organisations: the role of appraisals and psychological flexibility’. Academy of Management Review, vol 37, no 4, pp 524–46. West M, Eckert R, Collins B, Chowla R. ‘Caring to change: How compassionate leadership can stimulate innovation in health care’. The King’s Fund, May 2017.
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Find the Similarities

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Leading in a Foreign Land

Dr Joanne Watson Deputy Medical Director Torbay & South Devon NHS FT

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  • Recognise the relevance of generic leadership

skills applied in different clinical settings

  • Understand how quality improvement skills

were used as a vehicle for culture change within departments

  • Generate ideas how these approaches transfer

across the NHS in general

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Story time

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Story time

  • Once upon a time….
  • Everyone went about their business….
  • Until one day…..
  • Because of that…..
  • Because of that…..
  • Until finally….
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Once upon a time

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Until one day

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Because of that

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Because of that

Our mission is to provide a service where families receive the safest care- planned, agreed and delivered in full partnership with compassionate staff who strive to achieve the best possible outcomes and experience of care.

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Until finally

Median Goal 5 10 15 20 25 year 2012 year 2013 year 2014 year 2015 year 2016 year 2017 todate Stillbirths each year from the sentinel year Number of
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Leading in a foreign land…

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Build the Team….

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Navigate- i.e. set direction

  • Find a purpose and goals which are clear and

bigger than the person or organisation

Our mission is to provide a service where families receive the safest care- planned, agreed and delivered in full partnership with compassionate staff who strive to achieve the best possible outcomes and experience of care.

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Use QI Skills

It is the learners who inherit the future. The learned find themselves equipped to live in a world that no longer exists. Eric Hoffer 1902 – 1983

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Until finally

Median Goal 5 10 15 20 25 year 2012 year 2013 year 2014 year 2015 year 2016 year 2017 todate Stillbirths each year from the sentinel year Number of
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Leading in a foreign land…

"If your actions inspire others to dream more, learn more, do more and become more, you are a leader." John Quincy Adams

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Over to you now…..

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  • Find someone near you that you don’t know

and discuss themes which resonate in the area in which you work (5 min)

  • Speak to others on your table to identify any

common themes (5 min)

  • Feedback (verbal and via menti.com)
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By the end of the session…

  • Know more about community out of hospital and

integrated models of care

  • Understand some of the challenges (and successes) of

delivering new care models involving multiple partners and complex relationships

  • Recognise the relevance of leadership skills in different

clinical settings

  • Understand how QI skills can be used as a vehicle for

culture change within departments

  • Generate ideas about how these approaches are

transferrable across the NHS in general