A different weeknote format because I spent most of the week on the NHS Leadership Academy Nye Bevan Programme – a 3-day residential followed by a 1-day learning set meeting.
I’m learning loads, from the course directors Naomi and Majid, the guest faculty, our learning set facilitator Caroline, and of course all my peers in the learning set and wider cohort. This note is also my first go at structuring what I learned, and what I’m going to do differently starting next week.
What did I learn?
- I work in a complex multi-layered system – spanning national policy to individual interactions, with local service in between. (I knew that much already.) It’s a “web of interdependence.” But complex systems can have simple rules.
- Leaders, boards, and organisations can approach this complexity as “policy victims” or as “policy entrepreneurs”. I know which of those I want to be, and what kind of organisation I need to work in.
- The characteristics commonly associated with success in whole systems [King’s Fund PDF link]:
- Go out of your way to make new connections.
- Adopt an open, enquiring mindset, refusing to be constrained by current horizons.
- Embrace uncertainty and be positive about change – adopt an entrepreneurial attitude.
- Draw on as many different perspectives as possible; diversity is non-optional.
- Ensure leadership and decision-making are distributed throughout all levels and functions.
- Establish a compelling vision which is shared by all partners in the whole system.
Shorter version: be curious, clear and courageous, which reminded me a lot of the #OneTeamGov principles too.
- Definitions of co-production and co-design are muddled everywhere. In my drafts folder I have a set of definitions of my own. Maybe it’s better that we drop the jargon and talk specifically about what we’re going to do differently to involve people high on Arnstein’s ladder of participation.
- To work in partnership with a community, we have to cede some power. We heard powerfully about this in the example of Millom.
- A metaphor I like: “The sunlit part of the garden” is what you see when getting only reassurance, as opposed to true assurance.
- One I’m not so sure about: the “burning platform”. Everyone has one, it seems.
- The Happenstance Learning Theory of John D. Krumboltz:
“What-you-should-be-when-you-grow-up need not and should not be planned in advance. Instead career counselors should teach their clients the importance of engaging in a variety of interesting and beneficial activities, ascertaining their reactions, remaining alert to alternative opportunities, and learning skills for succeeding in each new activity.”
- The role of the chair in NHS organisations – something I now want to explore further in my learning.
What does this mean for me?
- I reflected on how it feels to work across a network: social, rewarding, but fragile.
- I’m trading some of my “new power” (the social, open, collaborative kind) for some “old power” (seats on programme boards, and the authority to shape national standards). I need to be comfortable with that and use one to amplify the other.
- I need to dig deeper into the assumptions beneath quality improvement and service redesign in health and care. I’ve said I’ll do this in a spirit of humble enquiry.
What will I do or do differently?
- Cultivate my curiousity about people as well as ideas.
- Keep thinking and talking about my own organisation’s role in system leadership.
- Talk further with my team about how we keep each other in touch with what each of us is focusing on.
- Read HSJ.
- Think about who I look to for coaching and as a mentor.
What else inspired me this week?
- New accessibility guidance on the NHS digital service manual.
- NHS designers working in the open and responding to feedback.
- Hearing briefly from Rochelle about new work on cancer screening.
- Continued progress led by Tero on service definitions, service maps and a service list.