Systems Leadership under the Spotlight - A Reflection

Claire’s talk was a brilliant illustration of how system leaders have to “… effect change for the social good across multiple interacting and intercepting systems, resting on the assumption that better and more efficient public services can result from more joined up working across multiple service sectors.” (Ghate, Lewis and Welbourn)

As both a GP and a system leader Claire journeyed from the micro-picture of individual patient care to the macro view of becoming “Gold Command” for the handling of the COVID19 Pandemic response across Surrey.

In common with so many dynamic system leaders Claire described a close association with her local “place” – the geography of Surrey-  together with a leadership drive born from personal family experience, to improve health and wellbeing, reduce health inequalities, and improve how health and care services join up around the individual patient or citizen.

She explained how, at the outbreak of COVID19, the NHS resorted to traditional line management reporting lines, leaving her feeling redundant as an ICS leader and without any power of influence. Then suddenly she found herself in the pivotal role as ‘Gold command’ for the whole pandemic response across Surrey, bringing her to work ever more closely with new colleagues from Police and the Fire Service as well as existing colleagues from the Council and wider NHS through the Local Resilience Forum (LRF).

Her role included connectivity and resilience support to NHS leaders through the crisis, and fascinatingly described a mix of formal and informal, (even subversive!) channels to get stuff done, a classic systems leadership response in the middle of ambiguity and uncertainty.

Claire’s approach illustrated the various aspects of NHS leadership Academy Systems Leadership model in action

The LRF and health and care system saw massive change and innovation during the unprecedented demand. For example, the Mary Seacole Rehab centre was established, converting am almost derelict site to a functioning Covid19 rehabilitation centre in just 35 days. Claire’s own General Practice surgery went from in-person consultations to consultations by phone, text and video-call “almost overnight”, reducing to a couple of in-person consultations per clinic.

We heard from other participants about similar public service rapid responses – the DWP for example dealt with 1.5 million universal credit applications in one day at the height of demand – compared to a usual 4000 per day!!!

We heard how barriers to collaboration came down rapidly as finance and the “who pays?” question became redundant. One of the big questions we were left with was how can we avoid the barriers going back up?  How can we rework financial incentives and flows to promote collaboration in a more restrained and “normal” environment?

Other big messages emerging from the webinar participants were around:

• The learning and innovative practice that will stick for the future is that rooted in practical front-line improvisations such as in primary care and A&E.
• Health inequalities – the intermingling of the pandemic and the Black Lives Matter movement had highlighted the disproportionately poor experiences and outcomes of BAME and minority communities.
• Workforce – how can we lead and support a physically and emotionally exhausted workforce even as we plan and prepare for a second wave and winter?

Claire’s account of ‘Systems Leadership under the spotlight’ underlined the importance of emotional intelligence, basic humanity and care for colleagues through the crisis, and beyond organisational boundaries, as more than compensating for any lack of formal power in leading a system of multiple statutory organisations.

For accompanying information, why not download the slidesed below?

Systems Leadership under the Spotlight Aug 2020 – report