How an energised movement of people, committed to taking a collaborative system leadership approach to working on integration of local health and care services, has taken root in South Manchester (SM). A participant-led programme of activity focused on building relationships and developing system leadership has led to a number of projects increasing the scale and pace of partnership working across the locality.
What they did
In 2016, the former University Hospital of South Manchester NHS Foundation Trust (now Manchester University NHS Foundation Trust) and Manchester Community Central (MACC) successfully led an application for a NHS North West Leadership Academy grant. The proposal set out a plan to deliver a series of interventions to develop leadership skills with a system focused mind-set, which sought to help participants to build relationships and trust, exchange views and expertise, and start to work collaboratively. The overarching goal was the creation of a “sustainable network of diverse, self-selected teams to deliver a range of collaborative projects which share a locally agreed purpose for community health and social care integration and improvement in SM”.
Taking a different approach
The programme aimed to not only support participants to develop an asset-based, collaborative style of leadership, but to enact this form of leadership in designing and delivering the programme of activities. Programme leads began by holding a workshop on the theme of ‘using system leadership to create change’ at which they invited participants to co-produce the future programme of activities.
Individuals actively working on the local integration of health and care services were a key target audience, but the workshop was purposefully opened up to “anyone who was interested” within the community. A non-hierarchical, inclusive approach was taken to support participants to work together and share ownership of the programme. Over 90 people attended the day where they explored common frustrations with current leadership styles and ways of working, and began to develop ideas for the ongoing work.
A system leadership party
Participants agreed to pursue informal ways of getting together that utilised community spaces with the next event set up as a “party”. The party successfully established a forum in which people felt able to contribute ideas and build relationships with colleagues from across the system. Seeds were sown for a number of new system-wide ideas and collaborative initiatives that soon began to take root.
Following on from the party, participants agreed a series of events building on the theme of system leadership that were delivered to over 200 people over subsequent months. Some of the events and activities included:
- Additional ‘Using System Leadership to Create Change’ workshops
- ‘Values-based leadership’ sessions
- “Brew and Biscuits” cross-sector matching scheme linking people up for visits and support
- Ted Talks Cinema Club
What outcomes were achieved?
After taking part in the programme, participants reported improved levels of confidence in their leadership skills, linked to recognising their own leadership behaviours as demonstrative of ‘system leadership’. This helped them to validate themselves as leaders within organisational cultures that often ran counter to these ways of working; along with an increased sense of confidence in their ability to influence change across the system, recognising the difference that small changes can make. Comments included greater confidence to “speak up”, “take action”, “be assertive”, and to “try even if they fail” as well as reflecting improved resilience in leading within uncertain, shifting and ambiguous spaces of system working.
Another key outcome was an enhanced understanding of the complexity, breadth and diversity of the wider system, with the opportunity to meet previously unknown “supportive and influential leaders in the local area”. Learning more about the roles, responsibilities and ways of working in the voluntary sector was found to be particularly valuable, underpinning the development of new cross-sector relationships and initiatives. Becoming more attuned to the role of patients and citizens in transforming health and care services was also identified as an important learning outcome.
The creation of a wider “support network” of people that share similar values was considered to be a crucial outcome of the programme. The network was credited with giving people the confidence to practise system leadership and generating an increase in energy, motivation and momentum for forging collaborative relationships. One of the programme leads described the emergence of a “willing coalition” based on a shared sense of community, vision and trust through which partnership working began to take shape.
What was the impact?
The programme is understood to have “galvanised and catalysed partnerships and projects”, increasing the innovative leadership capacity and capability in South Manchester and accelerating healthcare integration and transformation. Overall, over 100 discrete “place-based” projects are estimated to have come out of the system leadership work, some of which are described below:
- GPs, re-ablement workers, social workers, community therapists, practice managers and community nurses are working together to share clinical experience and discuss opportunities for devising new clinical care models for managing people with complex conditions.
- Care Navigators have joined community nurses and colleagues from the North West Ambulance Service, local befriending schemes and housing providers to explore issues of loneliness and isolation. Community nurses now attend home visits alongside neighbourhood health workers to open up conversations with people about engaging more with their local community.
- Respiratory nurses and staff from Citizens Advice Manchester jointly visit patients about home heating assessments and the impact of cold, damp homes on conditions such as COPD.
- Health, housing and community services have developed stronger links, with a number of projects now progressing that had previously been difficult to get off the ground. For example, health and housing organisations are now working in partnership to address hospital discharge issues.
Sharing the learning
The success of the SM Leadership Programme has been recognised at a local, regional and national level, with programme leads invited to present and publish their work. The programme is starting to influence a much wider audience about the system leadership approach. Within the city, the SM ‘neighbourhood partnership’ approach is influencing Manchester Local Care Organisation’s neighbourhood model and additional funding has been provided to share the learning and explore how to implement a system leadership approach in Central and North Manchester. News continues to spread, with continuing demand for repeat delivery of some of the workshop sessions. There has been a growing number of people registering for the ‘Brew and Biscuits’ cross-sector matching scheme and a number of Ted Talks Cinema Club sessions are scheduled.Download case study