Doing something new, by its very nature, is a venture into the unknown – so if we haven’t done it before, how can we be sure it will work? When it comes to transforming NHS services, there is a fine balance between the need for change and fear of the unknown, particularly when failure can have significant consequences.
Doing something new, by its very nature, is a venture into the unknown – so if we haven’t done it before, how can we be sure it will work? When it comes to transforming NHS services, there is a fine balance between the need for change and fear of the unknown, particularly when failure can have significant consequences.
Delivering the type and pace of change envisioned in the Five Year Forward View, requires a huge amount of collaboration and an ability to see and respond to the whole system. Increasingly, this means developing more integrated ways of working to benefit patients, whether that’s enabling different clinical specialties to coordinate care and develop shared processes, or enabling greater integration between health organisations and local authorities and the voluntary sector. Operating in organisational or clinical silos is not a viable or sustainable option.
However, there are fundamental differences in the way social care teams and health service commissioners and providers have traditionally approached services. While the NHS has tended to organise the way it delivers services around clinical conditions, local authorities tend to look at causes of dependency as a whole. In addition, we each have our own language, culture and technical jargon that can unwittingly create barriers to joint working, simply because there is insufficient clarity about what we do, how and why.
So the first step to innovation is developing a collaborative environment based on trust, integrity and values. This requires providers, commissioners, health and social care professionals and patients to take the time to listen to each other, breaking down those barriers to develop a clear understanding of the values that drive us. This enables us to develop a shared vision, with clear goals and objectives.
Delivering that vision through new and innovative ways of working means we have to be prepared to take risks. The consequences of those risks will vary significantly for different stakeholders, which is where trust and integrity become key. Working together with shared objectives allows us to build trust in both individuals and organisations, giving teams the confidence to take calculated risks.
Naturally, tools such as a memorandum of understanding, risk assessment and clear definition of roles and responsibilities will always be necessary to underpin collaborative working, but it is shared trust, values and integrity that will give professionals, providers and patients the confidence to transform health services.
Wendy Lane, consultancy services director, NHS Arden & GEM Commissioning Support Unit.
