This document outlines the key points in a presentation about developing a place-based integrated care approach. It defines a place-based integrated system as different organizations collaborating to manage shared resources and improve health outcomes. The presentation covers how to develop a place-based approach through aligning goals, empowering teams, and establishing clear roles. It also discusses challenges like large geographic areas and different organizational cultures, and opportunities to tackle shared problems and invest in prevention. The next steps outlined are continuing stakeholder involvement, testing plans, developing new skills, and strengthening leadership.

1. Andrew Fearon, 16 November 2018
Management of a place based integrated care
approach to community care

2. PRESENTATION CONTENTS
1. Place based Integrated System – Definition
2. How would I develop a Place Based Integrated
System working approach?
3. How would I develop the role
4. Challenges and Opportunities
5. Next Steps

3. PLACE BASED
INTEGRATED SYSTEM
– DEFINITION

4. DEFINITION
Providers of services should establish
place-based ‘systems of care’ in which
they work together to improve health
and care for the populations they
serve. This means organisations
collaborating to manage the common
resources available to them.
Effectiveness hinges on the ability of
leaders to work collaboratively in an
environment where they may have less
authority than has often been the case
in the past.
‘Kings Fund’

5. You are accountable for delivery, but do not own the resources to
do so.
Leadership is through influence, not
authority
Devane Ciaran, Leadership In
a Matrix, NHS Confederation
Matrix organisations are grid-like organisational structures,
commonly used in the management of large projects and product
development processes, drawing employees from different
functional disciplines for assignment to a team.

6. HOW WOULD I
DEVELOP A PLACE
BASED INTEGRATED
SYSTEM WORKING
APPROACH?

7. HOW WOULD I
DEVELOP A
PLACE BASED
INTEGRATED
SYSTEM
WORKING
APPROACH?

8. HOW WOULD I DEVELOP A PLACE BASED
INTEGRATED SYSTEM WORKING
APPROACH?
 Ensure agreement on organisational goals
 Empower the team for decision-making to
enable slick and efficient delivery
 Engage with the right people at the right
times; this is what gets the job done.
 Ensure that responsibilities aren’t blurred
and that accountability is clear
 Empower teams and support them in
delivery
 The desire to collaborate and communicate,
confidence in making decisions
autonomously and an ability to genuinely
work as part of a team are vital attributes.
 Devane Ciaran, Leadership In a Matrix,
NHS Confederation

9. HOW WOULD I DEVELOP A PLACE BASED INTEGRATED SYSTEM
WORKING APPROACH?
 Achieve alignment –Health unit and wider health and social care
organisations
 Strategy –
 Structure – and how people communicate
 Systems – process used that add value
 Skills and capabilities of the Public Health Team and
 Culture values, norms, values and assumptions that shape
behaviour
 Aligning an organisation is like preparing for a long sailing trip. First
you select the destination (Derbyshire STP), then the route (Strategy).
Then you establish what boat is needed (structure), how to outfit (The
systems), and the crew mix (the skills). Then, during the journey look
out for reefs that are not on the charts.

10. HOW WOULD
YOU DEVELOP
A MATRIX
WORKING
APPROACH
 Create Coalitions – CCG, Public Health Team and
wider health and social care organisations
 Influencing people – Coalition Building Cycle
 Vertically and
 Horizontally and with key players
Gaining
Allies –
helps with
Recruiting
others –
which
increases
Resource
Base –
which
increases
Likelihood
of
agenda’s
success
Which
helps in

11. HOW WOULD I
DEVELOP THE ROLE

12. HOW
WOULD I
DEVELOP
THE ROLE
WITHIN
ONE
HALTON
Recognition of my past successes but
don’t bring these forwards into the new
position – identify the differences
Transition commences on
offer/acceptance not day 1.Develop learning agenda
Soft information – how things get done
Hard facts – public health data, public
health legislation, Derbyshire Sustainability
and Transformation Plan
Understand Public Health Context
Start-up / realignment (re-inventing)
Balance my Learning / doing

13. HOW WOULD I DEVELOP THE
ROLE WITHIN ONE HALTON
 Identify quick wins
 Understand what a quick win is to organisation
 Focus on key strategic activities
 Understanding the people, process is equally
important to the quick win
 Negotiate Success
 Clarify expectations
 Agree action planning and timelines – the main
problem to be solved
 I take 100% responsibility to make relationships work
 Maintain effectiveness
 Adopting success strategies
 Enforcing personal discipline
 Building support systems

14.  Delivering Change
 Problem Driven Iterative Adaptation
 Local Solutions to Local Problems – local nomination,
articulation and prioritisation od problems
 Create environments that encourage experimentation
 Try, Learn, iterate and adapt – evidence driven feedback
 Develop a system that encourages experimentation
 Ensure that we don’t use the same hammer for driving a
nail and drilling a hole
HOW WOULD I DEVELOP
THE ROLE WITHIN ONE
HALTON

15. CHALLENGES AND
OPPORTUNITIES

16. CHALLENGES
AND
OPPORTUNITIES
 Challenges
 STP footprints are large (Urban and Rural
 Culture and priorities – NHS v Local Authorities,
Appointed V Elected
 Extent of History of Collaboration
 NHS is complex – organisational
performance/financial control
 The role of commissioners needs to change – larger
areas and budgets need to be pooled
 Collaboration requires negotiation – changes in
autonomy/responsibility – sharing power
 STP plans are part of a long-term process of
improvement – can the proposals be delivered
 Financing – which organisations budget
 Focus on prevention when budgets are under
pressure
 The plans cover everything

17. CHALLENGES
AND
OPPORTUNITIES
 Opportunities
 Place based system allows NHS and Local
Government to tackle the problems that they
are faced with
 Development of shared vision and shred
values on how to move forward together
 Different options for collaboration can be
explored
 Emphasis on prevention – investment in the
future
 Wider determinants of health – possible for
improvement
 Prevention – focus on key strategic issues –
top priorities

18. NEXT STEPS

19. NEXT STEPS
 Continue to develop involvement in the plans –
clinicians, local authorities, voluntary sector, public –
collaborative relationship
 Continue to test and further develop the plans
 New skills for staff
 Strengthen leadership and governance
 Incentives and performance management now need
to change?
 Develop relationships
 Develop Diplomacy

20.  In my experience collaboration between
NHS and other health and social partners
can lead to positive changes and
ultimately improves peoples lives

21. Thank you and any
questions