Working in health and care against the backdrop of COVID-19 has led to significant changes for practice, priorities, and people. There is no doubt be many lessons have emerged from this time and will continue to do so over the coming months and years. Not least how the workforce, together with the community, came together (despite being physically distant) to respond with courage, creativity, and a determination to adapt where possible. Here we share how NHS NWLA supported the Next Generation GP Lancashire (NextGen Lancashire) team adapted their approach, looked for the opportunities and embraced the learning to emerge from working virtually.
WORKING WITH NEXT GENERATION GP LANCASHIRE
Next Generation GP is a programme of emerging leaders in general practice designed by and for a group of early career GPs and trainees. Led locally by experienced GPs; the NHS North West Leadership Academy were delighted to be able to support this programme as part of our commitment to the development of primary care leadership.
In March, four GPs leading NextGen Lancashire were in the process of organising events according to the existing model as well as initiating support from the NHS NWLA for facilitation skills development (the aim - to build on existing experience of facilitation to collectively consider the approach for NextGen Lancashire).
WORKING DIFFERENTLY – TEN TOP TIPS
Shortly before lockdown, the group led in their decision to continue planning the NextGen Lancashire approach virtually. The NHS NWLA contributed to exploration around virtual facilitation, community building and leadership. Ten top tips emerged from working together:
#1 Recognise the transition points indicating when to work differently
The first step the group took was sensing early that large-scale meetings were unlikely to be able to take place as planned and deciding to postpone events. This enabled the group to communicate clearly and provide clarity with their upcoming attendees in a wider context of uncertainty as well as start to plan a different approach. Look out for transition points not only at the start of a shift in circumstances, but also throughout the process of working with a community in an emerging context.
#2 Look for and work with the opportunities the context gives you
In the first conversation following this decision, the group centered around what are the most meaningful first steps to take considering the local context, the local community and the local approach. The group immediately looked to opportunities which enabled the conversation to progress ideas into actions for next steps – internally (within the group) and externally (with the community).
#3 Use time to reflect on your lens and how you shape the approach to design
One opportunity to emerge for the group was using the time to better understand individual and collective influence on the direction of NextGen Lancashire. There is a positive in being able to slow the pace of implementation and take time to create strong foundations for future practice. By reflecting on preferences, impact and what is visible to you (your lens) alongside expanding your view of what is required to meet the future demands for leadership in primary care, it is possible to impact how Next Gen is led locally.
#4 Recognise the demands on your community
Another opportunity emerged from exploring the relative merits of spending time talking about the context with the community. The group decided to recognise the impact of COVID-19 and ask the community how they would like to continue with in this time. From a facilitation point of view, this enabled the group to act without assumption and only if there is perceived readiness/value in doing so.
#5 Build on feedback
Reflecting what was heard from collective responses and what that means for the local approach is a chance to demonstrate listening and acting on what the group values. NextGen Lancashire asked for feedback on both local leadership needs and local community needs, now and into the future.
#6 Create community principles
This is an opportunity to build on what the community has said they would like to use the space for and create the conditions (expectations/standards) for using the space in that way. The point is to remove as many barriers as possible to using the space for the defined purpose and make it as easy as possible for people to engage. The time taken early on to create the foundations with the group you are working with will hopefully make any further engagement easier.
#7 Transition from creating the community space into relationship development
Once the principles are established and it is agreed who is responsible for upholding them (often the community itself), the conversation can flow into relationship building. Relationship building should still keep in mind the purpose of the space and build in ways that enable members to connect socially. This may take the form of creating the conditions for reciprocal sharing (e.g. introducing a topic for discussion which enables community members to demonstrate an appropriate level of personal sharing). For NextGen Lancashire one idea to be discussed was - sharing video introductions of self/ thoughts on leadership.
#8 Transition into relevant content
Create a topic for discussion that starts to bridge personal experience with relevant content. For example, the suggestion for NextGen Lancashire was to create the space to share reflections, observations build on introductory videos in a way that progresses the leadership conversation.
#9 Create a ‘social learning architecture’
A further idea to continue the virtual conversation was to create a structure to link wider development opportunities (e.g. national webinars), with local conversation (e.g. zoom clubs) and everyday practice (e.g. captured via group chat). This is referred to as creating a ‘social learning architecture'. Thinking about structure in this way may help you to design different spaces and maximise existing resources.
#10 Practical tips for facilitating virtually
Firstly, and applicable to any facilitation setting, it may be helpful consider your principles beforehand (such as – what is the purpose and ethos driving the approach?) The values of Next Generation GP are an initial guide to base your design (e.g. how will your approach energise, engage and empower?) Use a checklist to help your thinking. Secondly, intentionally choose your platform(s). What will align with your values and be most impactful in helping reach the goal? Thirdly, identify who and how many will facilitate. Like in-person events, it can often be helpful to have more than one facilitator so roles can be divided (e.g. one may focus on content and another on technical support or welcoming/meeting attendee needs) or you can run sessions simultaneously by opening up multiple online meeting rooms. Fourthly, consider and test every detail in each stage of the facilitation process. Think both conceptually and practically (e.g. the group agrees to keep the conversation confidential (concept). Follow up by asking, what does confidentiality look like for this virtual meeting? (practical). Finally, join virtual sessions being run by others so you can see virtual facilitation in action and experience being a participant.
In a final note it is worth saying that although the top tips are written as a list they almost certainly will not always be applied in a linear way. We are working in complex adaptive system environments and so it will only be natural that the need for each step may emerge at different points each time. Facilitation is not an exact science, there are many different modes of thought, approaches, activities, processes available. You will learn through doing to find a way that uniquely works for you and your audiences.
With thanks to Amy Boydell-Smith, author, on behalf of the NHS North West Leadership Academy; and Next Generation GP Lancashire leaders
- Aaron Poppleton, Salaried GP - Cornerstone GP Practice, Blackburn; NIHR In Practice Fellow - University of Manchester
- Kirstie Caine, Salaried GP – Irwell Medical Practice, Bacup
- Nicola Cooper-Moss – GPST3 Academic Clinical Fellow, East Lancashire CCG; Honorary Lecturer – University of Central Lancashire
for their contribution to this article.