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Transforming Care:
Building clinical commissioning group
capability for large scale change
Jo Godman
Senior Associate
Mark...
 Introduce NHS Improving Quality
 Explore the complex challenges faced by
CCGs
 Describe NHS Improving Quality’s experi...
Improving health outcomes across England by
providing improvement and change expertise
The driving force for improvement
a...
Building capability capacity
The How and The What
P
r
o
g
r
a
m
m
e
s
CCG
Complex Complicated
Chaotic Simple
Emergent practice Good practice
Best practiceNovel practice
Snowden D & Benford RD. The...
www.changemodel.nhs.uk
NHS Change
Model
Three dimensions of large scale
(transformational) change
Depth
of change vis-à-vis
current ways of thinking
and doing; a....
Our model of LSC
Identifying
need for
change
Framing/
reframing
the issues
Engaging/
connecting
others
Making
pragmatic
ch...
Our findings…..
Work with partners
Commitment v. compliance
Impact of shared purpose
Loose – tight properties
Learnin...
Transforming Care Programme
Framework for transformational change
The first four workshops are about building effective foundations for change.
These ...
How can we help here ?
1. Help you develop your vision for transforming care
2. Help you develop a statement of Your Share...
CCG transformational change
challenges
Urgent care
Primary care
7 day working
Mental health
Children's services
Mate...
Heat map
Thank you
Contact:
London – Mark Jennings mark.Jennings@NHSIQ.nhs.uk
Midlands and East – Mani Dhesi mani.dhesi@NHSIQ.nhs.u...
CCG transforming care programme
CCG transforming care programme
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CCG transforming care programme

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Transforming Care: Building clinical commissioning group capability for large scale change

Jo Godman, Senior Associate and Mark Jennings, Senior Associate - 26 March 2014

Presentation from Commissioning Live 2014, London:
Transforming Care programme for CCGs. The programme offers supported learning for CCG and partner organisations to address large scale change.

Developed by NHS Improving Quality and NHS England’s commissioning development directorate, the Transforming Care programme is designed to empower commissioners to lead change across boundaries and improve outcomes for patients. So far, the programme has been taken up by more than 50% of CCGs.

Published in: Health & Medicine, Business
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CCG transforming care programme

  1. 1. Transforming Care: Building clinical commissioning group capability for large scale change Jo Godman Senior Associate Mark Jennings Senior Associate 26 March 2014
  2. 2.  Introduce NHS Improving Quality  Explore the complex challenges faced by CCGs  Describe NHS Improving Quality’s experience of working with CCGs to apply large scale change techniques that seek to use a social movement approach to change through commitment rather than compliance  Facilitate a discussion about the opportunities and issues raised Objectives
  3. 3. Improving health outcomes across England by providing improvement and change expertise The driving force for improvement across the NHS in England
  4. 4. Building capability capacity The How and The What P r o g r a m m e s
  5. 5. CCG
  6. 6. Complex Complicated Chaotic Simple Emergent practice Good practice Best practiceNovel practice Snowden D & Benford RD. The Cynefin Framework. Cause & effect relationships exist, are obvious to most people & predictable & repeatable. Can be known in advance. Cause & effect relationships exist, but not obvious, so require analysis/investigation +/- expert knowledge. Cause & effect only obvious in hindsight, with unpredictable, emergent outcomes. No cause & effect relationships can be determined. Probe. Sense. Respond. Sense. Analyse. Respond. Sense. Categorise. Respond.Act. Sense. Respond. Disorder Better processes More time/resource for analysis Bring in lots of perspectives Do what you’re told!
  7. 7. www.changemodel.nhs.uk NHS Change Model
  8. 8. Three dimensions of large scale (transformational) change Depth of change vis-à-vis current ways of thinking and doing; a.k.a cognitive-behavioural or paradigm shift Pervasiveness of change; does it affect whole or only portion of the system? Size of system experiencing change; e.g. geography, numbers of people Refs: Mohrman A. et. al. Large-Scale Organizational Change. Jossey-Bass, 1989 and Levy A. Second-order planned change: definitions and conceptualizations. Org. Dynamics. Summer 1986, 15:5-20
  9. 9. Our model of LSC Identifying need for change Framing/ reframing the issues Engaging/ connecting others Making pragmatic change in multiple processes Attracting further interest After some time Settling in Possible outcomes 1. sustainable norm 2. plateau 3. run out of energy Living with results and consequences Maybe later Repeats many times in hard to predict ways Time delay
  10. 10. Our findings….. Work with partners Commitment v. compliance Impact of shared purpose Loose – tight properties Learning through doing
  11. 11. Transforming Care Programme
  12. 12. Framework for transformational change The first four workshops are about building effective foundations for change. These seek to provide and support confident use of new frameworks for undertaking improvement, building an improvement culture, deepening partnerships and ensuring clarity of shared purpose. They cover six key components of successful large scale change: Purpose Vision NarrativeCultureStrategy Measure
  13. 13. How can we help here ? 1. Help you develop your vision for transforming care 2. Help you develop a statement of Your Shared Purpose 3. Help you outline a change plan to support your vision and purpose 4. Help you collaborate to agree and begin to implement a strategy and specific interventions 5. Guide you in the choice and use of metrics to promote change and improvement 6. Help you be clear about the narrative you use in engaging others, and think about how culture might need to change. with further support if you want it …. engagement, patient involvement, process mapping, modelling, demand / capacity
  14. 14. CCG transformational change challenges Urgent care Primary care 7 day working Mental health Children's services Maternity Safety and quality Integrated care
  15. 15. Heat map
  16. 16. Thank you Contact: London – Mark Jennings mark.Jennings@NHSIQ.nhs.uk Midlands and East – Mani Dhesi mani.dhesi@NHSIQ.nhs.uk North – Neil Simpson neil.simpson@NHSIQ.nhs.uk South – Elaine Latham Elaine.latham@NHSIQ.nhs.uk

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