We aim to develop talented compassionate and inclusive, collective leadership behaviours at all levels so that a culture of high quality, high performing systems is established to improve care, population health and wellbeing and value for money. Engendering pride and joy in our work. Developing leadership at every level, capable of coaching cultures and team development.
How we do it
Our focus for programme and bespoke work is in developing individuals and teams.
Health and care depend heavily on the people who deliver our services. CLIC exists to support and develop those individuals and teams to be able to improve the work they do and improve the collective leadership of our North Cumbria system for health and care.
The model above shows how we balance the three elements of vision, method and culture to support the change.
The vision and direction is detailed in our Sustainability and Transformation Plan leaders of our system need to be able to bring this vision alive for their teams by paying attention to the plan, using it to inform and guide the team objectives and reminding their teams how they contribute to this plan through what they do.
The methods within the Cumbria Production System provide us with the tools to:
- become more productive,
- to enable our teams,
- Understand behaviours we encounter and
- Enable more collective and respectful behaviours in our teams.
The culture, how we do things round here, is shaped by leaders across our system. The things leaders attend to and the things they expect from their teams drive the culture. The Berwick report 2013 detailed the culture shift required by the NHS.
Berwick Report 2013 A Promise to learn: A commitment to act
We use this to inform our programmes and team development work
Collective leadership means everyone taking responsibility for the success of the organisation as a whole, not just for their own jobs or work area.
Collective leadership cultures are characterised by all staff staying focussed on continual learning and, through this, on the improvement of patient care. This requires high levels of dialogue, discussion and debate to achieve a shared understanding about quality problems and solutions.
(King’s Fund 2012)
Michael West describes the six elements that enable collective leadership.
- Vision and purpose – clearly stated and often repeated
- Clear and challenging objectives for teams and individuals
- Robust HR processes providing fair and equitable staff management. Staff enabled to engage and contribute
- Understanding and use of continuous service improvement methodology
- “Real team” working where cooperation and integration are the norm
- Underpinned by a values driven approach
What we do
We have a range of training programmes which aim to equip our staff with the leadership skills they need to do their jobs. The programmes are evidence based and reflect the frameworks our partners use. These include:-
- Collective leadership approach, everyone taking responsibility for working together to improve care for our population. Michael West’s work identifies the elements necessary for teams to deliver high quality care
- NHS Healthcare leadership model and the Leadership Qualities Framework. Both are behaviourally based frameworks for leaders at any level across our system
- The Berwick Report –“ A promise to learn and commitment to act”, which describe the culture shift needed by our system
- Humble enquiry described by Edgar Schein as the way to engage by asking questions to which you do not know the answer. Authentic enquiry to build trust and understanding.
- Adaptive leadership Ron Heitfetz and Marty Lynski. They describe how to recognise and address the complex shifting problems (adaptive) that face us day to day when working across a system. Avoiding the common failure of leadership which is to think of all issues as technical requiring a technical solution, missing the need for an adaptive solution.
Core Development Programmes for people and teams are currently:
- Influencing and implementing Improvement
- Improving leaders
- Wellbeing and resilience
- Coaching conversations for leaders
Within the Developing people and teams strategy we constantly work collaboratively with our partner organisations to ensure that over time we plan, deliver and support our system in a more collaborative manner. To this aim we plan to move our work towards being totally collaborative in in its approach. We currently collaborate on 60% of all programmes and delivery of interventions to teams. We aim year on year to increase this by 20%. So by the end of 2017/2018 we will be 80% collaborative and 20% uni-organisational.
Health Foundation Award for Relational Coordination
In November 2016 CLIC was awarded £75000 from the Health Foundation for Innovation for Improvement. The project will study the use of relational coordination as a tool to facilitate and enable change in two pathways of care. One pathway is a system level pathway across multi agencies and communities working to improve mental health crisis management. The second is within our acute trust and will focus on chemotherapy pathway of care. The project will gather learning of the impact the survey has on each system and seek to understand how relational coordination helps to improve working of each pathway.
Integrated Care Communities
During 2016/2017 financial year CLIC has led on the delivery of leadership development support to ICC development across what is now Morecambe Bay CCG.
Early in 2015 CLIC was successful in acquiring funding from NW Leadership Academy to support the development of a programme to develop system leaders. CLIC commissioned Develop Change and Belinda Weir to develop this programme with learning taken from the Millom ICC. Millom were seen to be making progress to change the way health and care is delivered, having engaged their community and adopted a solution focussed approach. Utilising the learning from this piece of work and the evidence base for system leadership is what underpins our approach.
We have designed a flexible and adaptive set of interventions, rather than a formal structured programme, to reflect the complexity of System Change and the different start points of each ICC. Our approach offers a blend of learning and development opportunities, ranging from formal teaching, which draws on the evidence base for systems thinking and collaborative leadership, to personal skill development, bespoke workshops, team development activities, learning sets and coaching. It will also include and encourage best practice seeking and sharing within the Bay area, the North West, the North East and elsewhere in the UK.
This is an experiential programme, providing space and time for participants to focus on emergent and real time issues that have the potential to be solved through working collaboratively. We envisage that each ICC will undertake core elements from the programme in the Laying Foundations Stage but beyond that, reflecting the Taking Control Together stage support will become increasingly tailored to each ICC’s emerging needs, based on an understanding of existing knowledge, skills and capabilities and the ICC ambitions and objectives.
Our methodological approach encourages enquiry, supports experimentation, helps participants be ‘risk aware’ but not ‘risk averse’. It enables them to work with uncertainty and adapt as they learn. Throughout we will maintain a focus on building networking capability, enabling participants to work across organisational, cultural and professional boundaries and to learn from and with each other with the end users always in mind.
CLIC use a collaborative and networking approach by working alongside other partners using best practice and existing methodologies, to deliver impact for our system.
Our aim is that participants using this system leadership approach will:
- demonstrate increased confidence and competence to lead system integration of care services
- improve cross-agency/sector leaders’ capability to learn and to work more effectively together
- create a network of critical-friends to benchmark the scale, pace, outcomes and benefits of their programmes of work on integrated care
- construct a map of the journey towards system-level leadership and transformational change across the BCT geography throughout the programme
- build transferable skills, capability and capacity for leading system-level change in other areas
- have protected time, safe space and support for reflective practice and peer-to-peer learning
The approach is based on our understanding of the dimensions of effective system leaders drawn from practical experience and, from models such as the Local Vision Integrated Leadership model and the AQuA System Leadership framework, both of which our team has extensive experience of using to support system thinking and collaborative leadership.
Lancaster University Partnership - CETAD
Press release 27 June 2017
Postgraduate Diploma in Professional Practice
Cumbria Learning and Improvement Collaborative (CLIC) has established a range of leadership and improvement programmes to respond to the emerging development needs of team leaders working to achieve improvement in health and social care across Cumbria.
Funded by Health Education North West, CETAD is working closely with CLIC to deliver a postgraduate programme to clinical staff which offers an opportunity for participants to gain credit for their leadership training and build on it to achieve a postgraduate qualification, consolidating and extending their leadership learning and supporting them to put this into practice through the delivery of clinical leadership projects.
One of the students on the programme has said:
"This programme has been hugely satisfying, it has given me confidence in my professional skills and the opportunity to explore new concepts directly relevant to my work. I have been challenged, validated and have grown personally and professionally. My learning through this course has enhanced my professional practice and provided a springboard for new career opportunities: I am already being considered for a more senior role as a result of putting my reflection and learning into practice"
 See, for example, http://www.virtualstaffcollege.co.uk/wp-content/uploads/VSC_Synthesis_exec_complete.pdf and Appendix
 See, for example, http://www.kingsfund.org.uk/publications/system-leadership