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Leadership in Action Event: Update from Lothian

Leadership in Action Event: Update from Lothian. 29 January 2009 Alison Jarvis Project Manager. December 2008. NHS Lothian decided that future work will concentrate on a team approach in supporting patients, children and families Will not continue with the development of the CHN role

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Leadership in Action Event: Update from Lothian

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  1. Leadership in Action Event:Update from Lothian 29 January 2009 Alison Jarvis Project Manager

  2. December 2008 NHS Lothian decided that future work will concentrate on a team approach in supporting patients, children and families Will not continue with the development of the CHN role NHS Lothian will continue to be one of the pilot sites

  3. Why? • assessment of risk • particular concern around the care of vulnerable families with complex health needs • despite the best efforts of key staff, a lack of acceptance of the CHN role by major groups • changes in the senior leadership

  4. What now? There is widespread agreement that the current model will not be sustainable in future Now have to consolidate what has been achieved Explore ways that services can be delivered more effectively to meet the outcomes set out in VAIC

  5. Community nurses in Lothian will contribute towards: • the shift in the balance of care away from the hospital into the community • the change in emphasis from illness to wellness • a move to anticipatory, less fragmented care • a move away from reactive care • a shift to a focus on families not just individuals • lower staff numbers with greater service demands • a focus on development of workforce as opposed to recruitment

  6. Achievements • Increased readiness for change • Engagement of key stakeholders – especially the operational managers who have been pivotal in supporting staff to date and the processes of change management • Support from Partnership Forum representatives • in attending meetings and hearing the views from staff • Workshops and working groups have begun to demonstrate a willingness to question current daily routine and assumptions

  7. Achievements continued • Establishment of project structure • Beginning to address some of the barriers to change • Despite all the frustrations and anxiety around the CHN role many staff are open to change and have been willing to engage in the workshops and the ensuing groups that have met to progress work

  8. How? • Revised project plan will concentrate on a team approach in supporting patients, children & families • Build on cluster working & skill mixing of teams that is underway • Will explore how services can best be provided flexibly – including possibilities of generalist working at band 5 level • Consider recruitment & retention issues • Continue to work with CPPD & Napier university to provide educational infrastructure

  9. Challenges! • Address barriers to change that have been identified in project to date • Recognise that process of co-creation may come from the existing service paradigm • Consider what added value nurse-led care may provide and the broad range of skills needed to meet the diversity of needs across NHS Lothian

  10. Opportunities • Build on sense of practitioners being heard, to bring about change (doing different things) as well as operational change (doing things differently) and embed changes in practice • Assess and address the issues and concerns • Ensure that organisational objectives (HEAT targets, Single Outcome Agreement) are seen as drivers to change, are a focus for service re-designs and are embraced by teams

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