Autumn In-Brief 2018 V10 FINAL - Flipbook - Page 11
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3. The development of services which meet the
needs of local people in a manner which people
think will be helpful. The best people to decide upon
how services should be designed and delivered are
local people who may or may not have lived
experience. By using co-production we can work
alongside people to develop services in a manner
which they believe will be more effective for them.
The challenges associated with co-production:
1. Requires knowledge and behavioural change to
have impact. There is a risk that although an
organisation will set out how it intends to introduce a
culture of co-production, the reality is that little may
change in clinical and other encounters between staff
and service users, carers or local communities.
2. Timescale. The transition to working in this different
way is not something that can just happen. It requires
a cultural change which requires strong leadership
and time.
3. Requires additional funding/resource. It can often
be the case that service users are not paid for their
travel or time when attending meetings. This can lead
to inequity straight away between staff and service
users and carers. The reality is that resolution of
some of the challenges may require funding for, for
example, holding meetings in more accessible
venues or paying for taxis or for interpreters.
Our top tips for supporting the principles of coproduction:
• Consider the profile of the local population you serve.
How connected and engaged are you as an
organisation with the various communities making up
the local population? Are there communities or groups
that you could start to develop a relationship with a
view to engaging with them more closely in future?
Make the time and make it a priority to do so.
• Identify and engage with your local private and
voluntary sector organisations.
• Reflect on your leadership style. A change in
leadership style from one that may be hierarchical to a
more facilitative style is required.
• Encourage and support people to have a voice and
listen to what they have to say.
• Support innovative practice and new ideas. Don’t be
resistant to change. Pilot projects are a good way to
start.
• Agree the outcomes that people want to focus on and
how progress in achieving the outcomes will be
measured.
Sue Salas MSc, MSc, BSc (Hons),
RGN, RMN. Sue is a Senior
Consultant at Niche
Sue.salas@nicheconsult.co.uk
Does clinically led mean well led?
The role of Medical Director/Clinical Director in any
healthcare organisation is one which is fraught with
challenges. The Faculty of Medical Leadership is doing
more to help candidates to aspire to these roles: but do
these roles, at first glance, actually look attractive?
Let’s examine the key points of your job description…
• providing leadership to a whole cohort of disaffected
medics who find the concept of ‘being led’ a
somewhat offensive gesture;
• develop a clinical strategy… which there is very little
chance that you will be able to deliver due to its
complete disconnect with actual activity;
• … perhaps worse, you will be asked to deliver the
clinical strategy of your predecessor;
• despite the fact that 30% of Trust staff are employed
in this role; ‘admin and management’ is what you
are doing at 2am;
• realise, with increasing alarm, that ‘trust me, I’m a
doctor’ isn’t having the traction you’d hoped with
regulators;
• continuously have to make decisions which, in your
clinical capacity, you would never support due to the
risks and the lack of an evidence-base;
• try to remember, in vain, the time in your career you
thought it was all about ‘saving lives’;
• desperately try to hang on to your clinical workload,
whilst adding everyone else’s incidents and
complaints to your own;
• understanding that the organisation’s entire
disciplinary framework for consultants is centred on
“a conversation with the Medical Director”; and
• do all of the above without any (or very little)
training, development or support. In fact, you will be
thrown to the wolves.
But you are still reading this – so you may be up for a
challenge. And indeed it is an interesting, challenging
role to think about taking on, with immense benefits for
the patient, the organisation and staff. The balance
between part ‘critical friend’ on the Board, part clinical
‘shop steward’ is not easy, and for some, negotiating
these elements will make this role an unattractive
proposition.
Successful and aspirant Medical Directors must
recognise that they need to learn some fundamental
skills of management (and extensive skills of corporate
governance) to thrive in this role and some of these
skills may not come naturally from their previous
experience. However, if executed in the right spirit, with
the right executive colleagues and with more than a
layer of Teflon coating, this can be a deeply rewarding
role. Hopefully, we will avoid reverting back to the time
when medical leaders were anointed to serve their
three year term rather than appointed as the best ‘man’
(sic) for the job.
(by Kate Jury, Partner – Niche)
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