Learning from local systems reviews

Featured article - 03 July 2018
By Tony Hunter, SCIE chief executive

Head-shot of the author, Tony Hunter, SCIE chief executive

Commissioned by Department of Health and Social Care, SCIE has been providing tailored support to localities following the completion of the CQC system reviews in twenty areas where delayed transfers of care and associated metrics have indicated potential for improved arrangements. Our support has been in preparing for summits responding to QQC findings, and then acting as a critical friend during the production of action plans.

The challenge is often how to distinguish between symptoms and root causes. And that is critical in order to know where to focus improvement effort. As one system chief executive said, for the first time she and her colleagues had "a credible, robust and independent" basis to develop a better working system.

So what did we at SCIE learn about how leaders put in place sustainable cross-system improvement plans? Firstly, as one of our consultants put it, "Leaders at the summit recognised that whatever the quality of the plan they had to be sure they had the capacity, capability and commitment to deliver it." Wise words - we all know of too many cases in which implementation of plans have floundered because of inadequately resourced delivery or because the burning platform shifts elsewhere.

Secondly, many areas showed determination to build shared momentum around improvement by identifying quick wins which could then become a platform for addressing more deep-rooted and complex areas, most commonly around workforce planning and development, and market capacity.

Finally, several areas recognised that a hallmark of real sustainable improvement is the greater involvement of experts by experience as well as wider citizens. Applying co-production principles can help keep the focus where it needs to be and away from introverted organisational approaches. As a thoughtful member of our Co-production Network said: “Services only exist because people use them – so they need to be built around those people, not the other way round.”

It’s been an eye-opener engaging in this work. It’s quite humbling to reflect that health and social care arrangements are ultimately an accident of history. However much we know this to be intuitively true, the clear message emerges yet again that no one single agency, profession or discipline has all the answers. Using the insights, perspectives and advice of those experiencing health and care services is the key to getting us get beyond traditional boundaries and focusing on what matters.

Media Contact

Steve Palmer, Press and Public Affairs Manager
Tel: 020 7766 7419 | Mob: 07739 458 192 | Email: steve.palmer@scie.org.uk