The voluntary and community sector has long been at the heart of initiatives to transform the commissioning and delivery of public services. The aim now, recently enshrined in the Care Act and the NHS Five Year Forward View, is to integrate services, focusing on health and wellbeing of individuals and local populations.
This is difficult work. One way that organisations across the voluntary, community, public and private sectors are looking to tackle it is through using Systems Leadership approaches.
Systems Leadership is about how you lead collaboratively across boundaries. It describes the way people need to behave when they face large, complex, difficult and seemingly intractable problems; where they need to juggle multiple uncertainties; where no one person or organisation can find or organise the solution on their own; where everyone is grappling with how to make resources meet demand which is outstripping them; and where the way forward therefore lies in involving as many people’s energies, ideas, talents and expertise as possible.
Over the past three years, there has been a national Systems Leadership programme, backed by (amongst others) Think Local Act Personal, the Social Care Institute for Excellence, the Local Government Association, NHS England, Public Health England and the Department of Health. The programme has included commissioning national and international research on what works in Systems Leadership, the kinds of factors that enable it to flourish and the kinds of behaviours that support it; developing joint leadership programmes for people across sectors; and the creation of a pooled fund to offer support to places across the country, under a programme called Systems Leadership – Local Vision.
There are currently over 40 funded Systems Leadership – Local Vision projects around the country, all looking to create new ways of working and achieve measurable achievements in health, care and wellbeing. We are also providing Systems Leadership support to the first and second wave of health and social care Integration Pioneers, and to some places implementing Better Care Fund plans.
In each place, support is made available through having one or more trained Systems Leadership Enablers – people with a background in leadership, coaching and working at senior level in particular sectors – to work closely and regularly with people on the ground. They bring people together, strengthen their leadership capacity, coach them to build relationships, support difficult conversations, and enable them to make real progress on gnarly and complex issues. There is additional support for learning through access to networks of other Systems Leadership programme participants, with quarterly network meetings.
The projects cover a broad range of issues, from integration of health and social care through to more general well-being, including reduction of inter-generational obesity levels, increasing physical activity across a population, and reducing social isolation and loneliness.
In many cases, they are closely linked with implementation of the Care Act, or of Better Care Fund plans; or with specific health and social care integration initiatives (as in the Pioneer programme). They are commonly underpinned with simple acknowledgement of financial constraints across the board, and the resulting need for better use of a common public pound.
More information about the projects, as well as initial findings, has been published in the report, The Revolution will be Improvised. There are also case studies from Pioneer sites in the Pioneers’ Annual Report 2015 – the case study from the LB Islington Pioneer, in particular, demonstrates the value of the approach and the Enabler support provided.
Many programmes have taken a broad view, working across housing, welfare and other sectors alongside health and social care, and many have actively involved the voluntary and community sector.
For example, in Cheshire West and Chester, the issue was reducing social isolation and loneliness. The original model of social isolation focused almost exclusively on older people, but through the Local Vision programme, they identified around a dozen separate cohorts of people and developed tailored, community-led approaches to tackling isolation that they would not have done had they gone down their original route. Part of the work has centred on improving the built environment, including streets and public spaces, so that they are more attractive and people feel safer in going out to meet others. The new approaches also actively involve many different sections of the community, including four local housing associations, charities, voluntary befriending groups, schools, local businesses and faith groups, and are designed to build community links and resilience.
Similarly, the Local Vision programme on The Wirral was about creating better health and wellbeing outcomes through food, and to reduce food poverty. Local Vision saw the setting-up of Better Food Wirral, a community-led initiative to address these issues. Outcomes included bringing in community researchers to capture what was happening locally and develop more effective relationships within and across communities; defining a Wirral Food Plan; and starting to implement it, for example through cookery classes to help people eat well on a minimal budget; a food network run through the voluntary and community sector; and better connections between local people and local food markets. Wirral is now extending its Local Vision programme to look at alleviating worklessness.
Systems Leadership is a practical, grounded approach to integrated working. We will be looking to expand the number of Local Vision programmes in 2015-16, and would welcome proposals from the voluntary and community sectors. It’s not a silver bullet, but if you have a group of organisations in a place working together in pursuit of a truly shared ambition, we know that it can help effect real, sustainable change. If nothing else, it’s a useful tool to have in your armory.
For more information on any aspects of the Systems Leadership work, or to discuss potential involvement, please contact either Debbie Sorkin or John Jarvis at the Leadership Centre: firstname.lastname@example.org or email@example.com.