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Contents. Contents. Participants. Introduction. What we know so far. Creating the future role of clinical leadership. How would this work in reality?. Developing Our Opinion. Close. Participants Introduction – Stephen Singleton What we know so far – John Burn

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  1. Contents Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close • Participants • Introduction – Stephen Singleton • What we know so far – John Burn • Creating the future role of clinical leadership • Team Alpha • Team Bravo • Team Charlie • Team Delta • Team Echo • Team Foxtrot • Team Golf • Team Hotel • Team India • Team Juliet • How would this work in reality? • Outcomes, Continuous Improvement and Innovation • Function of Clinical Senates • Service Configuration & Support & Advice • Voice of Clinicians • Divergence of Practice, Assurance and Variations • Model of Networks • Clinical Commissioning Groups • Function of Networks • Health and Wellbeing Boards • Principles of Clinical Leadership • Developing our opinion • Outcomes, Continuous Improvement and Innovation • Service Configuration & Support & Advice • Health and Wellbeing Boards • Clinical Commissioning Groups • Model the Relationships • Function of Clinical Senates/Configuration of Senates in the North East • Principles of Clinical Leadership • Model of Networks • Function of Networks • Close

  2. Participants Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close Alison McLaughlin Alistair Gascoine Andrew Cant Andrew Kilner Andy Roberts Andy Robinson Annette McAdam BolescawPosmyk Brendan Hill BridgidJoughin Carl Parker Carol Hardy Carol Hedland Carole Kaplin Caroline Grayson Caroline Thurlbeck Chris Brown Clare Scarlett Cynthia Atkin DoraisamyParthasarathy David Beaumont David Bottoms David Evans David Landes David Thorne Dominic Slowie Edward Kunonga Elaine O'Brien Elizabeth Moody Emma Champley Gerry Stansby Gillian Johnson Henry Waters Hilary Lloyd Ian Pattison Isabel Gonzalez Jackie Kay Jane Bowie Jane Leigh Jane Mullholland Jean Freund Jeremy Henning John Burn John Costello John O'Donoghue Jonathan Berry Jonathan Smith Joyce Lovell Judith Stone Judith Thompson Julie Turner Kamini Shah Kathryn Dimmick Kyee Han Laura Robson Lesley Durham Lesley Jeavons Louise Wilson Lynda Dearden Margaret McQuade Marion Usher Mark Lambert Martyn Boyd MauryaCushlow MartynFarrer Melanie Brown Michael Milner Michael Norton Mike Guy Mike Prentice Namita Kumar Neil Reveley Nicholas Land Nick Roper Paul Hanson Paul Moffat Paul Staines Peter Mercer Richard Barker Robert Wilson Robin Mitchell Roy McLachlan Ruth Evans Sam Cramond Sarah Rushbrooke Sharon Haggerty Simon Eaton Stephen Cronin Stephen Singleton Stephen Sturgiss Sue Prout Suresh Joseph Tony Gibson Yvonne Evans

  3. Introduction – Stephen Singleton Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close The timing of this is important. Now is exactly the right time to have a conversation about change management. One of the things to reflect upon as we pass to the new system is what are the things that have been successful, and what hasn’t. Consider what can we do to influence the future. This is not a drive-you-hard-until-4 o’clock-and-give-me-the-answer kind of day, but a day to have the conversations we need to have. I was in a meeting last night, talking about the major trauma network. We are down to only a handful of patients a day who at the moment go through the wrong pathway, get the wrong care, and die. We need to make the right decisions and not confuse leadership with a strong CV.  This is a fundamental point. Clinical is not code for doctors. Clinical means the 55 000 odd people who see patients and directly influence patients through their care. How this voice and majority voice influences the system. Clinical is how we mobilise these conversations of influence.  How we see things, how we change things and make them better for the whole system. We need to have systems centred around people and patients. We do this by having real vision, and real method to change. It could be by clinical senates, or networks. The method could be anything you like. What we’ve learnt in the North East is that it is about vision, ambition, and culture. This thinking is part of the reason is why the North East does relatively well.  Most of our people believe any of the breakthroughs we have are due to science. For example a new operation or procedure comes along, or medicine. A lot of what networks have been doing already is managing these breakthrough strategies. What is absolutely crystal clear is that if you leave it up to just the science, nothing will happen. You need strategies in place to get breakthroughs. I see the potential of clinical senates and networks to manage these breakthroughs. Can we find a way of developing better breakthrough strategies?  To paraphrase Einstein: ‘If the world was going to end in an hour, I would spend 59 minutes trying to work out what the problem was, and 59 seconds working out the solution.’  I am a little like the emperor in gladiator, lying in his tent, dying, and has the idea – ‘I know, ill hand Rome back to the Senate!’ The SHA is dying, so I’ll hand over to John. He’s the general. To view Stephen’s presentation click here

  4. What we know so far – John Burn Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close • We can network. An example of this is between Bill Cunliff, and Elizabeth Kendrick. Elizabeth is not only is the mother of two sets of twins under the age of 5, but manages to lead a clinical innovation team. The difference here is that leadership is not about a CV but the ability to lead a service. •  Bill Cunliffe took a look at practices regarding patients undergoing bowel surgery. He determined that our reasoning was flawed and outdated. By challenging and changing some of our assumptions, the patients mostly get to go home sooner. Not because we are kicking them out, but because they are getting better quicker. It can be done. We can make these breakthroughs if we want and if we are willing to look at ourselves, and challenge ourselves to change. •  Some of the questions we need you to address are: • The clinical network – should we integrate clinical networks? • What is a network? • How do you measure this? How do we now if they are failing, or doing their jobs well? •  Many of the problems we have in the North East are self-inflicted, and we pick up the pieces. What can we do to get upstream from these health issues and stop the supply to these problems? •  Clinical senates. We want the whole clinical community to contribute to the health of the North East. How many of these should we have? How do they interface with networks, CCGs, HWBs, Las and FTs? •  Ill go back to the first slide – the big picture. In the land of the blind, the one eyed man is king. To view John’s presentation click here

  5. Creating the future role of clinical leadership Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM ALPHA Alison McLaughlin Andy Roberts Carol Hedland David Bottoms David Evans DoraisamyParthasarathy Michael Milner Mark Lambert Nick Roper Suresh Joseph Additional Materials Larger copies of walls Assignments

  6. Creating the future role of clinical leadership Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM BRAVO Carol Hardy Cynthia Atkin David Landes Ian Pattison John Costello Jonathan Smith Judith Thompson Peter Mercer Sharon Haggerty Additional Materials Larger copies of walls Assignments

  7. Creating the future role of clinical leadership Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM CHARLIE Carl Parker Chris Brown David Beaumont Dominic Slowie Henry Waters MauryaCushlow Paul Moffat Stephen Cronin Sue Faulkner Additional Materials Larger copies of walls Assignments

  8. Creating the future role of clinical leadership Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM DELTA BridgidJoughin David Landis Gillian Johnson Jeremy Henning Robin Mitchell Ruth Evans Robert Wilson Stephen Singleton Yvonne Evans Additional Materials Larger copies of walls Assignments

  9. Creating the future role of clinical leadership Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM ECHO Alistair Gascoine Brendan Hill David Thorne Joyce Lovell Julie Turner Laura Robson Lesley Durham Lesley Jeavons Sarah Rushbrooke Additional Materials Larger copies of walls Assignments

  10. Creating the future role of clinical leadership Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM FOXTROT Gerry Standby Jane Mullholland Jean Fruend John O'Donoghue Lynda Dearden Mike Prentice Neil Reveley Paul Staines Tony Gibson Additional Materials Larger copies of walls Assignments

  11. Creating the future role of clinical leadership Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM GOLF Andrew Cant Boleslaw Posmyk Clare Scarlett Gill Rollings Jonathan Smith Kyee Han Louise Wilson Marion Usher Mike Guy Additional Materials Larger copies of walls Assignments

  12. Creating the future role of clinical leadership Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM HOTEL Caroline Grayson Emma Champley Hilary Lloyd Kamini Shah Margaret McQuade Martyn Boyd Namita Kumar Nicholas Land Sam Cramond Additional Materials Larger copies of walls Assignments

  13. Creating the future role of clinical leadership Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM INDIA Carole Kaplin Caroline Thurlbeck Elaine O'Brien Jackie Kay Jonathan Berry Martin Farrer Richard Barker Roy McLachlan Stephen Sturgiss Additional Materials Larger copies of walls Assignments

  14. Creating the future role of clinical leadership Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM JULIET Christine Briggs Elizabeth Moody Isabel Gonzalez Jane Leigh John Burn Kathryn Dimmick Paul Hanson Simon Eaton Additional Materials Larger copies of walls Assignments

  15. How would this work in reality? Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM ALPHA Outcomes, Continuous Improvement and Innovation BridgidJoughin Carole Kaplin David Beaumont Jean Freund Kyee Han Lesley Durham Mark Lambert Neil Reveley Additional Materials Larger copies of walls Assignments

  16. How would this work in reality? Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM BRAVO Function of Clinical Senate Alistair Gascoine Andy Roberts Jonathan Smith John Burn Lynda Dearden Michael Norton Mike Prentice Suresh Joseph Additional Materials Larger copies of walls Assignments

  17. How would this work in reality? Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM CHARLIE Service Configuration & Support & Advice Carol Hardy Caroline Grayson David Landes DoraisamyParthasarathy Julie Turner Tony Gibson Additional Materials Larger copies of walls Assignments

  18. How would this work in reality? Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM DELTA Voice of Clinicians Andrew Cant Jane Leigh Jeremy Henning John O'Donoghue Lesley Jeavons Martyn Boyd MartynFarrer Yvonne Evans Additional Materials Larger copies of walls Assignments

  19. How would this work in reality? Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM ECHO Divergence of Practice, Assurance and Variations David Evans Emma Champley Hilary Lloyd Louise Wilson Roy McLachlan Stephen Singleton Additional Materials Larger copies of walls Assignments

  20. How would this work in reality? Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM FOXTROT Model of Networks Alison McLaughlin Brendan Hill Gillian Johnson Henry Waters Isabel Gonzalez Judith Thompson Richard Barker Stephen Sturgiss Additional Materials Larger copies of walls Assignments

  21. How would this work in reality? Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM GOLF Clinical Commissioning Groups Chris Brown Dominic Slowie Gerry Stansby John Costello Joyce Lovell Kathryn Dimmick Nick Roper Sue Prout Additional Materials Larger copies of walls Assignments

  22. How would this work in reality? Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM HOTEL Function of Networks BolescawPosmyk Cynthia Atkin David Thorne Ian Pattison Jackie Kay Paul Staines Sarah Rushbrooke Stephen Cronin Additional Materials Larger copies of walls Assignments

  23. How would this work in reality? Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM INDIA Health and Wellbeing Boards Caroline Thurlbeck Clare Scarlett Marion Usher Melanie Brown Michael Milner Paul Hanson Peter Mercer Ruth Evans Simon Eaton Additional Materials Larger copies of walls Assignments

  24. How would this work in reality? Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM JULIET Principles of Clinical Leadership David Bottoms Kamini Shah Margaret McQuade MauryaCushlow Nicholas Land Robin Mitchell Additional Materials Larger copies of walls Assignments

  25. Developing our opinion Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM ALPHA Outcomes, Continuous Improvement and Innovation Additional Materials Walls Teamlist Assignments

  26. Developing our opinion Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM CHARLIE Service Configuration & Support & Advice • Service configuration issues • How bodies seek advice • How commissioners ask for advice • Relationship with other bodies – local/national • Statutory services • Politics – local/national • Advice being challenged... How to prepare for this • Why have some issues not been resolved? • Self interest • Perverse initiatives (e.g. status) • Organisational interests (money, recruitment/retention. NB: sometimes services loses money but reputation and ‘house of cards’ argument and research magnet) • Public opposition • Assumptions about safety • Self interest about local services • Barmy people • Therefore Senate has to be very clear about what it can do and what it can’t. • Reconfigurations • Senate won’t, can’t and shouldn’t be a substitute for competent local work and needs to react clearly when asked to do something ie ‘in scope?’ – yes or no • Can arbitrate/honest broker when • Technical advice isn’t definitive • Local solutions vary from national advice • Danger of a purely commercial decision by provider • Senate needs to be sufficiently robust * to give advice that a provider or commissioner can follow without increasing their risk • Clear division of labour between senate and IRP and NCAT • Clear relationship with OSC power to refer • *avoids being too susceptible to judicial review • Role between network and senate is clear: • Network: technical, specialist, evidence et • Senate: Arbitration, balanced advice etc (politics) SoS IRP College etc Senate OSC NB Senates can’t do much about this = provider/CCGs will still have to do consultation/education Additional Materials Walls Teamlist Assignments

  27. Developing our opinion Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM INDIA Health and Wellbeing Boards • So... • A health and wellbeing board might seek advice from a clinical network on matters related to the JSNA and W&Wstrategy. • A clinical network night nudge or challenge a health and wellbeing board towards better/best practice • Sufficiently noisy question from health and wellbeing board might prompt the creation of a new clinical network • The relationship should/will be dynamic given the cross membership between CCGs and FTs JSNA Nudge challenge Clinical Network H&WB Strategy Health and Wellbeing Board Questions help related to HAWES CCG Health Watch Patients Additional Materials Walls Teamlist Assignments

  28. Developing our opinion Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM GOLF Clinical Commissioning Groups • Senate • Clinical advice • Advice of all networks • Role is authorisation = CCG meets behaviour requirements not direct regulation • Advise communication board • Independent advice and second opinion • 20 people possibly populated from another area – active/credible and respected • Potential conflict of interested could be influencing providers in response to questions • ?conflict between Senates dependant on number of senates – regional and nationally • Local arbitrator on tough decisions Potential tensions, professional representation/task required Could be a pool of people multi disciplinary professions. • Questions • How funded? • Top sliced? • CSU to host? Additional Materials Walls Teamlist Assignments

  29. Developing our opinion Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM ECHO Model the Relationships DH NCB ? Regional Outpost Any qualified providers Regional or Sub Regional? Supervises ?Advisory with Authority? Advise way forward CP Issue and discussion Unresolved issues “Federation” CCG & HWB representatives Senate CCG HWB Tasks Clinical Networks Major changes across providers / areas Task with questions Local ???? CCG HWB Independent advice re key areas needing attention CN CN CN CN CN Raise issues Additional Materials Detailed opinion , evidence and argument regarding way forward to Federation Walls Teamlist Assignments

  30. Developing our opinion Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM BRAVO Function of Clinical Senates and Configuration of Senates in the NE Providers Sub Senate Providers The Network CCGs For big difficult issues Resource ? Oversight ? Performance Mgt ? £ NHSCB The Clinical Network Secretariat/Admin • RolesAll to have: • Spec terms • Governance and board structure • ?Advice to providers? • ?Q/A CCG Prov Audit performance Individual networks Senate ? Type of Network ? Power ? Work streams ? Funds Additional Materials Walls Teamlist Assignments

  31. Developing our opinion Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM JULIET Principles of Clinical Leadership • Inappropriate self selectors – weeded out! • (management ≠ leadership, loudest voice ≠ best leader etc) • Important characteristics • Humility • Charisma • Personal insight • Comfort with uncertainty • Comfort with accountability • Ability to articulate and communicate passion and vision • Ability to be the voice in the wilderness • Innovative – creativity/new ideas • Listening • Principles • Honesty/trust • Integrity • Authority – earned/delegated • Time limited tenure • Well and appropriately networked • Measured risk taking • Organisational workplan to identify: • Passion • Vision • Strategic thinking • (no nepotism) • PDP – talent spotting • talent grooming Appraisal • Development programme • Coaching • Mentoring • Feedback – continuous improvement • Opportunities for leadership – graded facilitated Additional Materials Walls Teamlist Assignments

  32. Developing our opinion Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM FOXTROT Model of Networks CCGs • SoS • NHS Comm Board Private Providers FTs • Comparison • NICE • Authoritative • Of the system • Power?? • Questions • Facing up/down? • Influence • Advisory but open to public scrutiny • Netag model – multidisciplinary, authoritative, independent senators leave their ‘bag’ at the door • Empowered to co-opt experts • Agenda setting? accessible but focus on issues of broad relevance • Broad church • Need skilled secretariat HWBs 20 • Senate will only work if: • Listens to • Owned by • Works on behalf of • CCG/HWB • - where accountability rests(NCB & FTs) • Clinical effectives of senate relies on: • Communications • Courtesy • Consideration • Cooperation • Connectivity • Conciliation • Consensus • Courage LAs Networks 3rd Sector MPs Appointed Elected - Respected NHS CB HWBs FTs What is the work plan? Proactive or reactive? Senate 12 CCGs FTs Additional Materials The Clinical Network Walls Teamlist Assignments

  33. Developing our opinion Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close TEAM HOTEL Function of Networks • Function of network • Perform/meet/facilitate National Mandate • Provide advice/not statutory recommendations • Provide single point intelligence - NICE • Provide independence • Provide evidence base • Honest broker role • Maintain integrity • Pathway orientated • Facilitate equity of access • Advise of: • Saving lives • Saving money • Improving patient experience • Create/assist in service planning to support commissioning • Improving quality standards/outcomes • (operational function) • Federated CCG and Senate • Very useful to some Neworks but not all • One size doesn’t fit all (National versus Local funding) • Network issue • Resource availability Senate Networks NCB CCG LA LA LA CCG CCG HWB HWB FT FT FT Additional Materials Walls Teamlist Assignments

  34. Close – Richard Barker Contents Participants Introduction What we know so far Creating the future role of clinical leadership How would this work in reality? Developing Our Opinion Close The more organised we are the more we can bring about change and effect the way we work. Hopefully this will be a valuable milestone, there was a large consensus gained throughout the day on what we need to do going forward. Thanks everyone for all the hard work

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