Department of Health and NHS

The North Staffs HAZ team had attended our Large Scale training and we had designed a special session for them. They asked us to support them in working with a neighbourhood to look at how services could be joined for delivery in a District Centre that was being built.

The planning team wanted to set out what had been done and identify issues that still need to be addressed to make the district centre a reality as well as developing a shared vision with multiple stakeholders (some 150 people) which would shape future planning.

To bring together those involved in delivering and using services within the new District Centre to identify how we join up services to meet the needs and priorities of local people to ensure improvements in quality of life.

This was one of the first large group interventions/ whole systems events the King's Fund had delivered. It was based largely on Future Search although it had over 100 participants. It was seeking to bring together the whole system in Croydon around Quality of Life for Older People. VISTA supported the work by giving advice on logistics and acting as stewards on the day.

"A King's Fund Event"

This event involved over 150 people from the HAZ Network, DOH and Social Services looking at the Partnerships in Action White Paper and beginning map out what flexibilities would be needed to make it happen. VISTA, working with Tony Jamieson, facilitated the design team and the event. We also introduced polarity management to many of the HAZ team at a mini workshop before the event started.

DOH, HAZ Network and Social Services working together to begin to develop plans to turn 'Partnerships in Action into a reality.

We worked at a series of meetings to facilitate the various HAZ Teams sharing what they were doing on involvement. It included a 'learning fayre' at Edgbaston Cricket Club. This included the HAZ exhibiting what they were doing, a variety of workshops in involvement and a speech from a junior Minister of Health.

"To come together as a cross-section of the whole community to share information and ensure that we set ourselves up for success as in developing HAZ involvement"

The design team for this event wanted to develop a shared understanding of direction and purpose and the roles Health Action Zones played within the bigger policy picture. They designed an event that would enable them to share learning, celebrate success and established shared understanding of the realities facing them, see the opportunity of doing things differently and generated a sense of excitement. They networked and made connections. The event design was a combination of structured sessions and Open Space.

"To launch the Second Wave and develop a shared vision of how HAZs can make a practical difference at policy development, service integration and community levels"

This two-day workshop invited over 60 people from several HAZs to experience and learn about LGIs. The planning team wanted to build an understanding of:

• The background, categories and methodologies,
• The underlying principles, models and values that enable effective whole system change,
• The practical components of an interactive whole system intervention and wider implications,
• The nature of the roles required for successful interventions and
• When to use or not use whole systems approache

They wanted to apply the methodologies to practical situations and build confidence and identified where to find support in Whole System methodologies as well as being challenged and having fun!

A modified version of this was also delivered for North Staffs HAZ

"To introduce participants to and build capability in whole systems methodologies"

We ran this workshop in partnership with Robert Jacobs and an internal team. They wanted to develop understanding and appreciation of the possibilities of large group engagements to support change. They wanted to build on the work they were already doing in this area and identify practical tools and frameworks that will add value and explore ways in which they could use large group engagements to create a modernisation movement.

The workshop ran twice with over 30 people at each.

"To further inspire us in meeting the challenges of accelerating change throughout the NHS and increasing our confidence in delivering on our 2005 targets."

We ran these in partnership with Barry Johnson. They were designed so that people would learn how to recognise and work with polarities. It was expected that this would give people a new perspective and way to approach important issues and develop some concrete plans for addressing these issues. We introduced the concepts and then worked through them with some live issues.

These workshops have been repeated many times for the Modernisation Agency and for some Strategic Health Authorities. See our Polarity Management page.

"To increase effectiveness in handling complexity, addressing chronic problems, radically reducing resistance to change, capitalizing on diversity and intervening in conflicts."

This workshop explored how to use graphics to:

• record and facilitate meetings and conferences
• draw out creative solutions for teams and organisations
• build group memory
• provide graphic records of meetings and conferences

"To explore how graphics can facilitate whole systems working in small and large groups."

This was a merger of two Trusts who each had very different cultures. The planning group identified that they wanted to identify what we have done well / achieved so far and the current tensions within Mental Health management/Board functioning that may prevent corporate governance. Then they wanted to explore practical solutions to minimise those tensions and develop clarity around roles and responsibilities as well as starting to develop an action plan to establish full, collective corporate governance. We used polarity management to explore some of the tensions.

"To work as a team in diagnosing the issues facing us and develop a plan to build collective management responsibility for the service."

This event (photo 1 & photo 2) involved some 500+ nurses, midwives and health visitors from across the London Region. The lively design team wanted to feel they had a voice and that it was good to be a nurse in London. They wanted to leave up beat energy, inspired, with something to take back and a sense that meaningful work was progressing forward. We did an exciting turnaround of ideas over lunch, which was touch and go!

"To celebrate and participate in the Standing Conference for Nurses, Midwives and Health Visitors in London."

This involved some 200+ people from across the London region interested in work force development. We used an Open Space format and asked the question - how can we promote and improve intra and inter agency collaboration on workforce planning and development.

A Conference on securing and developing a workforce equipped to promote and sustain the health and well being of Londoners

The design team wanted to generate a sense of urgency, and build on what everyone agreed about the NHS. They designed to ensure everyone would feel heard and been able to build networks. People developed a shared understanding of the intended approach in London and confidence that the plan was possible. They identified and generated some short term wins across different stakeholders and levels of stakeholders and stimulated broad based action.

To generate broad based action to put people at the centre of a 21st century service.

When PCTs were set up they appointed a PEC body to enable clinicians to contribute to strategy. This was a new role for AHPs and the Leadership Centre wanted to enable them to make a full contribution. The design team planned an event that would enable participants to develop a common understanding of where to get the knowledge and skills we need, ideas of what some best practices were. They developed confidence in their own ability to contribute and impact and influence things positively. A network was set up so that they would develop a sense that we are not alone, there is a network of support to go to.

"To work together as a community of AHP and HCS to expand our confidence in our ability to positively impact and influence our PECs and the success of our PCTs."

In Eastern Birmingham the PCT was formed from 5 organisations joining into one. We worked intensively in the Trust for the first three months and have continued on a support basis for key events. The Events in included:

• An open exhibition in the first week of the Trust's existence to begin sharing learning and invite people to begin envisioning for the future
• A Leadership Alignment Session to explore Vision, Mission and Values and reflect on the roles of the three key bodies
• A large multi-stakeholder event to map the environment and develop Vision possibilities
• Development of the overall Vision, Mission and Strategy by a cross section (design team) using the information form all the previous events
• Adoption of the Vision, Mission and Strategy by the board and structuring to deliver the strategies
• A simu-real for developing the plan further
• An Open Space Stakeholder Event with 250+ people to review progress
• A Team development event for the Public Health Team
• A development event for the Board and PEC
• A partnership event with the local health trust

"To use a whole systems approach to build a participative and inclusive organisation and set the PCT up for success in improving the health of local people"

Workforce Development Confederations were set up in 2001, to drive forward at a local level the programme for creating an integrated approach to developing the workforce needs of the health and social care sector.

VISTA supported the design and facilitation of the launch event. The design team wanted this to provide a clear understanding of the new structures, how they fit into the broader NHS picture and what we need to communicate. They thought participants would need to build confidence that people can see a role for themselves in shaping the arrangements and making them work. The event was designed to show a strong sense of a multi-disciplinary team of professionals working together as a community with common purpose and shared issues. People left with a clearer picture of the way forward, of how the new arrangements will work, and some clear stepping-stones for everyone to start to work on.

We also did a Large Group Engagement session for this community in partnership with Robert Jacobs (see NPAT LGE Workshops)

"To introduce the new workforce development structures and work together as a community to address some of the key NHS workforce issues"

Leading Through Learning - a Stakeholder Conference
This event of around 80 key stakeholders from across the Confederation came together to reach a consensus on key leadership questions and the impact on individuals and their organisations. The event was designed to help participants build a consensus on where to focus their energy to make a difference and to better understand the complexity of their functional map.

When the Department Of Health was doing a major reorganisation of their department they wanted to engage in meaningful consultation with staff. They planned for 2 events in London and another 2 in Leeds. We held two design teams connected by video conference. They wanted concrete, new information about timetables and numbers, an appreciation of the business drivers and an honest statement of key priorities and expectations. Prior to the event all staff were invited to say what their concerns, hopes and prouds were. The themes from these were displayed as posters.

"To work together to shape the change process in order to find out what it means for me and actively influence the design of the department."