Leadership lessons from an NHS Development Champion

The challenges faced by the NHS are many and well documented. Limited resources with an increasing and insatiable call on those resources.

Someone winning recognition for bringing solutions to this area is bound to be noticed (as indeed Donal Collins was when invited to No.10 in December 2015 on the announcement of extra funding for the NHS).

WHAT DID WE LEARN?

With the NHS such a hot political potato, I am sure we are going to hear more about Donal’s team and their new way of working. I felt particularly struck and inspired by the following

1. Sometimes the force or inspiration for change is that the iceberg is indeed melting. People realize they can no longer be complacent and that staying as they are is no longer an option. Things falling apart can be the driver for change.
2. The importance of an overarching purpose to keep you going when things are tough.
3. The cost of non-collaboration. How silo-ed organisations waste resources and energy in protecting territory instead of focusing on their unified purpose.
4. The clear definition of goals which were holistic when you put them together – i.e. it was about patient outcomes and worker safety and well-being. Often we have competing goals or goals that are unfair to one party and so we unconsciously sabotage their advancement from the outset.
5. Donal’s courage in pushing through the vulnerability he felt in sharing and then acting on his ideas. Fear of rejection often keeps our ambitions small and yet Donal’s vision has brought big and much-needed change to an area that affects us all.

If you would like to know how to create an inspired purpose for your organisation and how to implement joined-up thinking, contact us here.

After 25 years in the NHS Donal will be taking a position as a medical Director for LIVA healthcare- an Irish company involved in the prevention of disease which is Donal’s passion. He leaves a legacy of pioneering, purpose-led work in the NHS which will continue in his new venture.

* Business Secrets of the Trappist Monks: One CEO’s Quest for Meaning and Authenticity by August Turak.

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Donal Collins GP was the 2015 Development Champion of the Year as voted by the Thames Valley NHS Leadership Development academy.  Since then the work his practice has done has led to a place in the final of the 2019 HSJ (Health Service Journal) awards.

I wondered what could be learnt from Donal and what might be inspirational and useful for leaders everywhere.

Why did you win the award? What have you achieved?

The most outstanding achievement is framing a discussion across many organisations to change their culture towards an outcomes-based system with patients at the centre. This purpose overrides organisational structure, taking us towards a system without walls from a system which abounds in silos.

• We have enabled strong collaboration between organisations that previously may have competed against each other. Now we see the success of the other as a success of the whole system
• We have developed a mission vision and values for the local town that is now inspiring partner organisations as our combined vision.
• Same day access service is now up and running and successful. On this everything else will be built such as nursing home services, home visiting, mental health. And in the 3-year plan for health campus that will wrap around this to include space for the voluntary sector, CAB, employment housing etc.

 In short, I came up with an idea to get people to deliver something that in previous years wouldn’t have been possible. We’ve brought a multi-disciplinary team together to work in a way that’s never been done before and it’s making a difference.

Why wasn’t it possible before?

There was too much of a comfort zone. GPs are now under such pressure. 85% of the current trainees don’t want to be partners so the old solutions of simply bringing in new blood are no longer an option. A new urgency has been created to work with the resources we have in a different way.

So what have you agreed to do that’s different?

1. Agree to work at scale which means working up to 7 days when it is needed
2. Multi-disciplinary teams working in a way that has never been done before

How are you able to do this?

We have linked three practices to a single IT system. Within this HUB there is a central system that can dip into other systems (with due Information Governance). We have many specialisms of community provider within the hub.

So for example, under the old method, if you had back pain you’d wait 2 weeks to see your GP who would then refer you to a Physio who you’d see in another 5-6 weeks whereas with the HUB the patient and the need is triaged to the community provider required and an appointment can be made the same day. By improving access to all via the HUB, we improve efficiency within the system. Facilitating entry actually frees up workloads reducing footfall by about 10%. Although this may seem counter-intuitive, treating a small problem before it gets to be a big problem oils the system.

It delivers the 2 clearly defined goals we set for our work:

1. To improve patient outcomes
2. To foster worker safety and well-being

The really exciting thing is when the system is really sustainable you can prevent disease and reduce the tsunami of costs. In our area alone the over 85 population will double in 15 years. Not doing something is not an option.

What has been your proudest moment?

I told one of my naysayers my goal was to see him going to work with a smile on his face and he emailed me to tell me this had happened.

Tell me some of the things you’ve learned along the way?

• Walk away from fights – don’t waste energy – go with the willing
• When you know it’s not about profit but about the vision then you carry on- knowing why you’re doing something is important to keep pushing through
• Crazy ideas we have are not so crazy after all – dare to articulate and act on them

What changed or inspired you?

The business model of the Trappist monks* – they were achieving things in their industry that normal business could not explain. It’s about joined-up thinking and working to an inspiring purpose.

After 25 years in the NHS Donal will be taking a position as a medical Director for LIVA healthcare- an Irish company involved in the prevention of disease which is Donal’s passion. He leaves a legacy of pioneering, purpose-led work in the NHS which will continue in his new venture.

* Business Secrets of the Trappist Monks: One CEO’s Quest for Meaning and Authenticity by August Turak

It is incumbent on those who lead to tell the truth, use language wisely (with a view to consequences) and behave with responsibility and respect.

This is not about being politically correct

It is about being more conscious of the words we use. Because words, and how we say them, have the power to connect or to distance one person from another, one tribe from another. They lay the basis for relationships. They can nurture or break already tenuous bonds.

We learn how to communicate in our early years, by practicing what we hear from people in influence like our parents, family members, our teachers. When a small child can’t get what it wants to satisfy its needs it makes itself heard. Toddler tantrums are the outburst of frustration when needs are not met. If some adults don’t progress past this stage, are they to be reprimanded or pitied?

Our early years’ programming may not have given us all the best starting point in life. We may still feel unable to express our frustration and disappointment in times of stress because words fail us.

So, how can we manage difficult situations while remaining respectful?

As human beings, we all have a choice. To be conscious of how we react, or not, to any given situation.

In our communications work with people in organisations from all walks of life, we help them find ways to be more conscious – of their words and their responses.

The ability to choose these at any given moment can be trained. There are lots of ways and models to do this and what people take away has to be something that works for them.