1
Contents
Contents
Participants
1.
2.
3.
4.
How would this
work in reality?
Developing Our Opinion
Close
Team Alpha
Team Bravo
Team Charlie
Team Delta
Team Echo
Team Foxtrot
Team Golf
Team Hotel
Team India
Team Juliet
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
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7.
Creating the future role of
clinical leadership
How would this work in reality?
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6.
What we know so far
Participants
Introduction – Stephen Singleton
What we know so far – John Burn
Creating the future role of clinical leadership
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5.
Introduction
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
Alison McLaughlin
Alistair Gascoine
Andrew Cant
Andrew Kilner
Andy Roberts
Andy Robinson
Annette McAdam
Bolescaw Posmyk
Brendan Hill
Bridgid Joughin
Carl Parker
Carol Hardy
Carol Hedland
Carole Kaplin
Caroline Grayson
Caroline Thurlbeck
Chris Brown
Clare Scarlett
Cynthia Atkin
Participants
Introduction
Doraisamy Parthasarathy
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
What we know so far
Creating the future role of
clinical leadership
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
How would this
work in reality?
Louise Wilson
Lynda Dearden
Margaret McQuade
Marion Usher
Mark Lambert
Martyn Boyd
Maurya Cushlow
Martyn Farrer
Melanie Brown
Michael Milner
Michael Norton
Mike Guy
Mike Prentice
Namita Kumar
Neil Reveley
Nicholas Land
Nick Roper
Paul Hanson
Paul Moffat
Developing Our Opinion
Close
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
Team Members
Alison McLaughlin
Andy Roberts
Carol Hedland
David Bottoms
David Evans
Doraisamy Parthasarathy
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
Team Members
Carol Hardy
Cynthia Atkin
David Landes
Ian Pattison
John Costello
Jonathan Smith
Judith Thompson
Peter Mercer
Sharon Haggerty
Additional Materials
Larger copies of walls
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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
Team Members
Carl Parker
Chris Brown
David Beaumont
Dominic Slowie
Henry Waters
Maurya Cushlow
Paul Moffat
Stephen Cronin
Sue Faulkner
Additional Materials
Larger copies of walls
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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
Team Members
Bridgid Joughin
David Landis
Gillian Johnson
Jeremy Henning
Robin Mitchell
Ruth Evans
Robert Wilson
Stephen Singleton
Yvonne Evans
Additional Materials
Larger copies of walls
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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
Team Members
Alistair Gascoine
Brendan Hill
David Thorne
Joyce Lovell
Julie Turner
Laura Robson
Lesley Durham
Lesley Jeavons
Sarah Rushbrooke
Additional Materials
Larger copies of walls
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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
Team Members
Gerry Standby
Jane Mullholland
Jean Fruend
John O'Donoghue
Lynda Dearden
Mike Prentice
Neil Reveley
Paul Staines
Tony Gibson
Additional Materials
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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
Team Members
Andrew Cant
Boleslaw Posmyk
Clare Scarlett
Gill Rollings
Jonathan Smith
Kyee Han
Louise Wilson
Marion Usher
Mike Guy
Additional Materials
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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
Team Members
Caroline Grayson
Emma Champley
Hilary Lloyd
Kamini Shah
Margaret McQuade
Martyn Boyd
Namita Kumar
Nicholas Land
Sam Cramond
Additional Materials
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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
Team Members
Carole Kaplin
Caroline Thurlbeck
Elaine O'Brien
Jackie Kay
Jonathan Berry
Martin Farrer
Richard Barker
Roy McLachlan
Stephen Sturgiss
Additional Materials
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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
Team Members
Christine Briggs
Elizabeth Moody
Isabel Gonzalez
Jane Leigh
John Burn
Kathryn Dimmick
Paul Hanson
Simon Eaton
Additional Materials
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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
Team Members
Bridgid Joughin
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
Team Members
Alistair Gascoine
Andy Roberts
Jonathan Smith
John Burn
Lynda Dearden
Michael Norton
Mike Prentice
Suresh Joseph
Additional Materials
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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
Team Members
Carol Hardy
Caroline Grayson
David Landes
Doraisamy Parthasarathy
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
Team Members
Andrew Cant
Jane Leigh
Jeremy Henning
John O'Donoghue
Lesley Jeavons
Martyn Boyd
Martyn Farrer
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
Team Members
David Evans
Emma Champley
Hilary Lloyd
Louise Wilson
Roy McLachlan
Stephen Singleton
Additional Materials
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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
Team Members
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
Team Members
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
Team Members
Bolescaw Posmyk
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
Team Members
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
Team Members
David Bottoms
Kamini Shah
Margaret McQuade
Maurya Cushlow
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
Situation / Issue
Role of the Clinical Senate
Role of Clinical Networks
Role of CCG’s
Network Priorities for example
Enhanced recovery (ERP) vs
Hyperactive Stroke or gaps in service.
Spot gaps in Network coverage
compared to population need and
expenditure and consistency of
approach
Develop ERP and support
implementation
Specify ERP in commissioning brief
Example of things that could be
sorted with a different approach;
Commission + Decommission
networks ?(starting and stopping
them)
Supporting QIPP workstreams
• Obesity Prevention  30 SUCS
• Vascular services
Determine number and scope of
networks
Standard setting and monitoring
A better connection between clinical
improvement and potential for
saving money
Evaluation of services and
improvements (Statutory
Responsibility)
Evaluation of specialised services
(e.g. ICNARC)
Showing the benefits of
improvements
Managing cover for interventional
radiology
Walls
Additional Materials
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.
SoS
IRP
College
etc
OSC
Senate
NB Senates can’t do
much about this =
provider/CCGs will still
have to do
consultation/education
Reconfigurations
1. 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
2. Can arbitrate/honest broker when
• Technical advice isn’t definitive
• Local solutions vary from national advice
• Danger of a purely commercial decision by
provider
3. Senate needs to be sufficiently robust * to give
advice that a provider or commissioner can follow
without increasing their risk
4. Clear division of labour between senate and IRP and
NCAT
5. Clear relationship with OSC power to refer
6. *avoids being too susceptible to judicial review
7. Role between network and senate is clear:
Network: technical, specialist, evidence et
Senate: Arbitration, balanced advice etc (politics)
Walls
Additional Materials
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&W strategy.
• 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
Clinical
Network
H&WB Strategy
Nudge
challenge
Health and Wellbeing
Board
Questions
help related
to HAWES
Health
Watch
CCG
Patients
Walls
Additional Materials
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?
Walls
Additional Materials
Teamlist
Assignments
29
Developing our opinion
Contents
Participants
Introduction
Creating the future role of
clinical leadership
What we know so far
TEAM ECHO
Model the Relationships
How would this
work in reality?
Developing Our Opinion
Close
DH
NCB
?
Regional
Outpost
Any qualified
providers
Regional or
Sub Regional?
?Advisory with Authority?
Advise way forward
Local
CP Issue and discussion
CCG
HWB
CCG
HWB
Unresolved issues
“Federation”
CCG & HWB
Senate
Tasks Clinical Networks
Independent
advice re key
areas needing
attention
CN
CN
CN
CN
Task with
questions
Major changes across
providers / areas
CN
Detailed opinion , evidence and argument
regarding way forward to Federation
Raise issues
Walls
Additional Materials
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
Senate
CCGs
Providers
Sub
NHSCB
Resource ?
£
Oversight ?
The Clinical Network
Secretariat/Admin
Roles
All to have:
• Spec terms
• Governance and
board structure
• ?Advice to providers?
• ?Q/A
The Network
Performance Mgt ?
CCG
Individual
networks
? Type of Network
? Power
? Work streams
? Funds
Prov
Audit
performance
Senate
Walls
Additional Materials
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
Appraisal
Organisational workplan to identify:
• Passion
• Vision
• Strategic thinking
(no nepotism)
PDP – talent spotting
talent grooming
•
•
•
•
•
Development programme
Coaching
Mentoring
Feedback – continuous improvement
Opportunities for leadership – graded facilitated
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
Walls
Additional Materials
Teamlist
Assignments
32
Developing our opinion
Contents
Participants
Introduction
TEAM FOXTROT
Model of Networks
Clinical effectives of senate relies on:
- Communications
- Courtesy
- Consideration
- Cooperation
- Connectivity
- Conciliation
- Consensus
- Courage
What is the work plan?
Proactive or reactive?
How would this
work in reality?
Developing Our Opinion
Close
CCGs
SoS
NHS Comm
Board
HWBs
Senate will only work if:
- Listens to
- Owned by
- Works on behalf of
CCG/HWB
- where accountability rests(NCB & FTs)
Creating the future role of
clinical leadership
What we know so far
Private
Providers
FTs
20
LAs
Networks
3rd
Sector
MPs
Appointed
Elected
- Respected
NHS
CB
HWBs
FTs
Senate
12
CCGs
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
FTs
The
Clinical
Network
Walls
Additional Materials
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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)
Senate
Networks
NCB
CCG
LA
LA
LA
CCG
HWB
FT
CCG
FT
HWB
FT
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
Walls
Additional Materials
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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
35