Leading through purpose (Next Generation GP)
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Presentation 9 May 2017 on the power of shared purpose to lead through commitment rather than compliance
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Leading through purpose (Next Generation GP)
- 1. @robertvarnam@robertvarnam Dr Robert Varnam Director of General Practice Development @robertvarnam robert.varnam@nhs.net Leading with purpose bit.ly/170509nextgen
- 4. @robertvarnam@robertvarnam Leading improvement Being an improver is a noble calling with a guarantee of challenge after challenge. Whether it’s successful or rewarding is mostly down to how you approach it. Learning objectives Challenge our thinking about leadership and hierarchies Apply key lessons from the social movement paradigm of change to our own attempts to lead change
- 6. @robertvarnam@robertvarnam One of the earliest experiences every improver has is of trying to get people to do what you want. It’s also one of the hardest. Leading improvement
- 10. @robertvarnam
- 11. @robertvarnam Who’s paid them? Who told her to do that? What is the performance management framework? Who’s running this?
- 12. @robertvarnam Where to start? “Here’s what you need to do” versus “I have a dream”
- 13. @robertvarnam From compliance to commitment From Compliance To commitment States a minimum performance standard that everyone must achieve States a collective goal that everyone can aspire to Uses hierarchy, systems and standard procedures for coordination and control Based on shared goals, values and sense of purpose for co-ordination and control Threat of penalties/sanctions/shame creates momentum for delivery Commitment to a common purpose creates energy for delivery Extrinsic motivators Mechanistic approach to change Intrinsic motivators Values-based approach to change
- 15. @robertvarnam
- 16. @robertvarnam
- 17. @robertvarnam
- 18. @robertvarnam The NHS has been instructed to improve access to general practice. Far-reaching changes are required in every local community, including new patient pathways, extended opening hours, changes to the workforce and greater use of technology. By March 2019, every part of the country is expected to be providing improved access, supported by a new investment of £6 / patient and monitored through measurement of appointment activity and patient satisfaction. Extrinsic motivators Mechanistic approach to change Intrinsic motivators Values-based approach to change
- 19. @robertvarnam
- 20. @robertvarnam@robertvarnam What is good access?
- 22. @robertvarnam Developing the art… You need to know: • what the important shared values are • which ones are most likely to drive action • how to tap into the emotions most likely to lead to positive action • what the most common misconceptions will be • what the most pernicious defacto purposes are
- 23. @robertvarnam
- 24. @robertvarnam Resources • The power of one, the power of many. bit.ly/powerofonemanypdf • Start with why. youtu.be/IPYeCltXpxw [short] youtu.be/qp0HIF3SfI4 [long] • Leading with purpose. vimeo.com/103429228 • Motivation at work. bit.ly/12g66zh • The Edge. theedge.nhsiq.nhs.uk • School for Change Agents. theedge.nhsiq.nhs.uk/school/
- 25. @robertvarnam
Editor's Notes
- SETUP Audio PEV for Flipchart (wordcloud) Volunteer for coaching in the room - specific thing you'd like to improve / have been involved in - hard / failed
- My aims. Career. So much about CHANGE – so many failures!
- How about YOU… ever thought something could be improved? tried? found it hard?
- Think about LEADERSHIP Reflect + share – where are you? Where SHOULD a leader be? Hold those thoughts …
- 2 wards PW … Delays rising, sickness rising. Worst staff survey in hospital / region. Improvements (small no.) designed & planned 3/12 … everything worse Discuss: list every possible reason
- VOLUNTEER: your topic / improvement What do you want people to do?
- in the absence of central control, how is this working?
- DISCUSS - What’s different about 2nd?
- Extrinsic – Intrinsic Mechanistic – Values based
- Set scene … She’s come to tell them what they should do Already knows they don’t want to Q : what has she done? How has she told them what to do?
- Successful SM leaders start with WHY – then the WHAT / PLAN Having a CLEAR and ATTRACTIVE PURPOSE is essential
- My visit to the ward… DE FACTO PURPOSE
- Shotton Walk woman
- Good access is at the heart of good general practice. Yet too many efforts to improve access have been rather one dimensional, focusing on speed often at the cost of other aspects of quality such as continuity. The Prime Minister’s GP Access Fund (originally called the “Challenge Fund”) involved 2,500 practices collaborating in 57 schemes across England to improve access and care. Their approach was very different. Patients and professionals have always recognised the central importance of access in providing good care. Yet getting the right model for access is more complex than is often acknowledged. Access is a multifaceted aspect of value, but initiatives to improve it have often been rather one dimensional, focusing for example on speed alone or promoting a one-size-fits-all solution. Schemes in the GP Access Fund can be seen to have worked on introducing ‘right access’, ensuring patients get access to the right care from the right person at the right time and through the right channel. This is more holistic than just focusing on providing rapid appointments, and it acknowledges that there is no “one size fits all” approach – in particular, some patients place high value on speedy access to an appointment, whereas others prefer to wait to see their own GP. A ‘right access’ appointment system allows for both. GPAF schemes often made wide-ranging improvements to the model of care for patients. They considered the whole patient journey, starting before someone becomes ill. Innovations were introduced to help prevent ill-health and educate people about how to use health services wisely. When patients contacted their practices, new systems and staff training helped to actively signpost them to the most appropriate source of advice or help. Consultations themselves were undertaken in innovative ways including online and on the phone, and using text messages and group consultations to help people manage their longterm conditions better. Access was also improved by broadening skillmix, incorporating pharmacists, advanced nurses, physiotherapists, paramedics and care navigators into the practice team.
- YOUR TURN – TRY IT
- Hierarchies … SJP explaining talent Mx form
- Where are you? How does it feel now? What next for you? TRY IT