Monthnote: 26 September to 21 October 2022

View through window of field, trees, and clouds at sunrise

Catching up on “weeknotes” after a few weeks that were a bit of a blur…

  • I was asked to lead design work on a part of our organisations’ merger plans
  • A family member was involved in a car accident (they’re making a good recovery; the car was a write-off)
  • I enjoyed a day at the first in-person UK Health Camp in 3 years
  • Took delivery of a replacement car (slightly newer version of the old one)
  • I caught a cold and had to take a day off work.

What did I learn?

Listening to colleagues in workshops about our new operating model, it’s clear that we will only be efficient as a new organisation when we create a culture of mutual respect and trust across the old boundaries. We’ll no longer be grouped into customers and suppliers, or commissoners and providers, but the habits that came with that style of management are deeply engrained. We will perpetuate old inefficiencies unless we deliberately choose to work differently together.

We have an opportunity to make this change at a whole organisation level and beyond. I’m encouraged by the leadership behaviours contained in the new NHS England operating framework:

  • Work as ‘one team’ across the NHS (ICBs, providers and NHS England) with our partners, being collaborative and empowering each other – but also being clear about who is accountable for what.
  • Seek co-creation and co-ownership of our strategy, priorities and support offers – both within the NHS team and with partners – and demonstrate collaborative leadership.
  • Be inclusive and value diversity – make sure that no one feels excluded and listen to all perspectives.
  • Work at pace when appropriate and be agile – streamlining how we make decisions, avoiding duplication and multiple layers where we can.
  • Learn by doing – acting, evaluating and continuously improving.
  • Be transparent and honest – in all our interactions and activities.

Meanwhile I’m reallly enjoying working with my NHS colleagues and the team from Public Digital, who are supporting our work on the new operating model. In particular, they’ve reminded me of the value of stripping our language back to the simplest possible common terms, and getting away from the jargon that often accretes around digtal transformation.

What do I need to take care of?

The contradition at the heart of my work right now is as follows:

  • I am personally impatient to bring about a new way of working, one that can only succeed in conditions of high psychological safety
  • but we must implement that model in the context of potential redundancies and arbitrary shifting timelines – features that are well known to trigger rational threat responses.

No one is coming who can square that circle. It’s up to us to deliver the best we can for patients and frontline staff, with the people who are with us for this journey, and looking after ourselves as we go.

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