- What does being a vanguard mean to you? I see it as an opportunity to improve our way of working both in my own organisation and across the organisations in our area, the opportunity to work together more closely and the chance to try things that we think will improve our services for our people in Erewash
- What problem did you want to solve? Many! I hoped to reduce the duplication that happens across our services and to provide our patients with an easy way into our services, I wanted to see better working together across services and organisation and I wanted to help people become less dependent on our services so we could focus on those who really need us.
- How did you go about it? Building on the way that we already work in Erewash; multi agency meetings, there’s been a lot of talking about the what to do, and there has been staff engagement (within my organisation) we have introduced some different services and some different ways of working The care home support service has been different to anything we have done before, and the mutli-agency enhanced team is still evolving while it provides a service day to day. We have had weekly meetings to keep us on track in our own work stream and monthly meetings with a much wider group.
- In practical terms what difference have you noticed and has the way you work on a day-to-day basis changed at all? We have created some efficiencies within services, we have made an impact on practices by reducing their input into care homes, we are seeing the benefits of multi-agency working together at meetings and in the enhanced team, we are providing a much more coordinated response to urgent calls in the community.
- What has the reaction and what has the level of staff engagement been like? In my opinion we haven’t got the staff engagement right, the reaction to changes has been very mixed, the care home service has been very well received but there is a real mixed bag of enthusiasm and cynicism/ resistance to the ideas of working across service boundaries there is still a big cultural shift required with the staff to step away from organisational boundaries.
- How would you explain the way your new care model works to members of the local community? A lot of this work has come from the personal and community resilience workstreams who have engaged with the people of Erewash to find out what they want from health services, we have also worked with Patient participation groups aligned to the practices. The message we want to get across is that people are responsible for their own health and wellbeing and that our services are there to help not to take over we need to get people seen by the right service/clinician.
- What is already having or what is going to have the greatest impact and value for patients as a result? People being seen in a timely way by the right clinician would lead to better results for people but the real success will be if we can get people less dependent on our services for low lever health needs
- Do you have any great case studies that immediately spring to mind or can you tell me what your most satisfying day at work has been since becoming a vanguard? I felt very proud the other day when I sat in on the enhanced teams MDT handover, clinicians from each agency were talking about the people they had seen who had been in crisis and they were sharing information, ideas and advise on shared goals for the patients and because the staff were all together IT was not a barrier and actions were being quickly agreed.
- What do you think has been the most difficult challenge or barrier to overcome? There are so many, engaging the staff across organisations that I don’t influence, knowing what is the right direction to move in when there is so much disagreement, tackling organisational barriers when trying to work something differently, not knowing what funding we have going forward, recruitment, reporting soft outcomes that cannot be captured in figures, trying to provide direction when there is no clarity and numerous different opinions.
- Vanguards are leading on developing new care models that will act as blueprints for the future of the health and care system in England. What advice would you give to anyone looking to adopt your new care model? Try and involve as many people as possible across the organisations involved and don’t forget to keep clinicians involved
- How are you sharing learning? We are working on this as an MCP we know we haven’t shared much – it feels like we are too busy trying to make things work
- What do you think your vanguard and the service it delivers will look like in 12 months’ time? I hope we will have even more closer working , we could well be a vanguard of 2 halves ( or places ) that start to work things slightly differently but I feel our challenge over the next 12 months is to make a cultural change within each organisation in Erewash so we become one movement.
- From your work so far, what's your one top tip (or learning) that you could share right now with us that we could learn from and implement within our work areas? I would say it is key to have people from each organisation who have the vision the energy and the ability to make changes in their organisation and that these individuals need to come together regularly to keep the momentum
NHS Arden & GEM Commissioning Support Unit has been working with vanguard sites in supporting the development and critique of their value propositions. Adopting a ‘logic model’ approach, they have combined their extensive knowledge of the NHS and local delivery dynamics with leading academic and private sector expertise. This analysis provides an invaluable assessment of the various elements involved in developing a robust new model of care www.ardengemcsu.nhs.uk