Transforming the organisation to work collaboratively with other care providers - Mark Watson,Chief Technology Officer, Brighton and Hove City Council
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Transforming the organisation to work collaboratively with other care providers requires building partnerships based on trust, openness, and shared values like valuing individuals over processes. Lessons from agile practices emphasize responding to change through collaboration and iteration instead of following rigid plans. Partnership principles of peer relationships, trust, and openness can help design systems that address complex user needs through simplicity and avoiding duplicated effort.
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Transforming the organisation to work collaboratively with other care providers - Mark Watson,Chief Technology Officer, Brighton and Hove City Council
- 1. Transforming the organisation to work collaboratively with other care providers Mark Watson CTO Brighton & Hove City Council
- 2. Building partnerships in a climate of complexity If we are together nothing is impossible. If we are divided all will fail. - Winston Churchill
- 3. Why?
- 5. “being comfortable with chaos”
- 6. • Cultures • Assumptions • Doxa Partnership
- 7. Cultural lessons from Agile We value Individuals and interactions Outcomes Collaboration Responding to change over processes and tools Documentation Contract negotiation Following a plan
- 8. • Partnership Principles • Peer to peer relationships • Trust • Give without guarantee of receiving • Openness • Show what you value
- 9. • Design Principles • Design for complexity • User needs first • Do the hard work to make it simple • Don’t repeat effort • Iterate, iterate, iterate
Editor's Notes
- Because increasing demand across health and care paint the same picture, growing population, people surviving and thriving, put a growing demographic demand on local “systems” Barnet graph of doom holds true for Local gov and NHS, rising demand for care and health services eclipse available money
- We have a complex of public services all aiming to support individuals, their carers and communities to thrive and survive, but who operate in very different ways – Public, Private, Voluntary, Family, Friends, Health, Care, Government etc. all with their own cultures, language, assumptions Health and Social Care have their own “big” cultures, plus many micro cultures Health has its cultural hierarchies with consultants in hospitals at the top Then you have the public private/volunteer divisions in social care All of whom surround the person at the centre of care – can’t even agree what to call them patient, client, service user, customer . . . .
- Change needs to happen but how do you lead change in this environment Kings Fund report named “The Practice of System Leadership” but more importantly . . . . . .”Being comfortable with chaos” Chaos theory has three common principles: 1: Sensitive to initial conditions the butterfly effect 2. Systems will mix over time – like dyes in water 3. They commonly have strange attractors with dense orbits of activity around them (see Lorenz attractor above (and we’re back to the butterfly)) Social Care and Health are Strange attractors in a chaotic system Small changes can feed through to large impacts over time They are becoming ever more mixed, complex and diversified over time They each act as a gravitational mass pulling towards the money
- Each of these strange attractors has their own cultures, built on their own assumptions Much of this will be unspoken, undocumented and only come out through open face to face discussion, watch for the conflicting use of language – person, client service user, patient. My favourite is health’s use of the term “clinical”, which runs deeply through the culture and always requires translation. It also sets the boundaries and limits and excludes
- So build your partnerships, as an ICT person abandon all your old waterfall habits, you can’t sit back and wait for your key customer to outline their requirements, Firstly who is the customer? Who is the user? What do they need? If you wait. . . you will do nothing, then be expected to deliver “the answer” fast, although nobody will have quite agreed what the question is, or even what language it is in Partnerships will involve all the different cultures and finding a way to navigate and part please most . So learn from agile approaches abandon certainties and embrace ambiguity and change
- Develop partnerships like you would the best digital social networks be loosely coupled, open, social, connected, encouraging participation, giving and individuals to show what they value and what is important to them, Most importantly build trust. Do the small tactical things that help each other out to build confidence and trust
- Use key design principles to steer your collective and individual organisation choices: Complexity – the environment, network politics etc. will remain complex, so design for that environment – e.g. Networks need to be available at any location, for any organisation, for as yet unknown purposes and outcomes, put the efforts into partnerships that support User – the user is ultimately the individual who need service – the patient, client user etc. you have a hierarchy of user needs with them first, not driven by the competing cultural hierarchies of the organisations, sit with and listen to all your users and understand what they are trying to achieve, spot where this could be the same as other users Simple – to make it worthwhile its worth putting the effort into the early negotiations and understanding to make the solutions you try out in this complex environment as easy for users to adopt as possible, the cultural barriers adoption are naturally high Don’t repeat effort – where there are existing solutions covering part of problem areas, work with them, build on them, don’t waste effort fighting over the perfect solution for all, but extend and grow Iterate, the landscape will continue to change around you with initiatives and personalities, no single plan will survive long in this environment
- Partnerships involve giving up territory, whether you are from business, ict, whoever, but its gradual not dramatic, its not about gaining power but about creating value, but it risks being washed away if you act as a group of competing suppliers you all lose, as no-one on their own can actually answer the question of Care, The NHS and Everything, To help solve it you have to be part of something and help to make those small choices that will steer this complex chaotic system towards something more mixed, blended and brilliant