Tricordant Collaboration Series Spring 2021: Lenses on designing the future Integrated Care System.

Dr Nicola Decker, an experienced GP clinical leader, shared her early thoughts on the challenge of ICS leadership which she sees as creating an environment where people feel they can be their best, quoting Simon Sinek.

• A team effort to create the right conditions for every person and organisation to contribute and influence.
• Build trust (it’s about relationships)
• Embed a culture of learning (psychological safety) and accountability throughout Hampshire & IOW.
• HIOW to be the best place to live and work!

She outlined how she saw this could be achieved through building everyone’s sense of belonging and contribution. She explored how Covid had accelerated the system development as it was and is an ‘adaptive’ change to use Ronald Heifetz term.

• It is fundamentally different –our repertoire of usual responses won’t work.
• It requires new approaches and innovation.
• It requires a change in our values, beliefs,and assumptions on how care is delivered.

She summarised her ‘lens’ for building an ICS as;

• Be authentic –role model!
• Spot the networks and work with them (and the influencers)
• Support the “boundary spanners” –who will connect the different networks.
• Listen (it’s about people), Communicate, Learn and Share
• Trust and be trusted (as a clinical leader/ as a person-your authentic self)

Her closing message was ‘It’s about people’. We need to ‘be human’ (not heroes)!After a further discussion in plenary and small groups, Dr Roger Greene, summarised the webinar. He noted the 3 different lenses interplay closely–the systems levers such as funding influence, the behaviours, which influence the relationships, which influence how well the structures work. This echoes the alignment expressed by the Tricord model.

The big themes were about:

• finding the WHY? and common purpose.
• Building trusting relationships.
• Design with autonomy.

He noted that the cost of collaboration can be high so it must be made to count. It has an opportunity cost as well as a direct cost. So too must change: the fear of change as well as the scale of change impacts on success.