A good place to start this week is on collaboration. Different groups are approaching this in different ways; however it’s pretty clear that without collaboration we are limited in what we can achieve. Performance is a product of capabilities, incentives and constructive relationships; with the constructive relationships having a power effect. I.e.:
Sustained performance = (Capabilities * Incentives) Constructive Relationships
This is just illustrative but demonstrates the powerful effect of constructive relationships. The importance of this is illustrated in this month’s Harvard Business Review. It is a double issue with a focus on collaboration. There are some important messages for us in there. One of the articles by Adler et al discusses how to build a collaborative enterprise and expands on the four basic building blocks of:
- Defining and building a shared purpose
- Cultivating an ethic of contribution
- Developing scalable processes for co-ordination
- Creating an infrastructure in which collaboration is valued
We are in the process of developing new organisations, and the above are useful guides in that journey. The ‘Pause’ spoke a great deal about the need for cooperation and my observations around the country are varied, with some groups working extremely effectively across the different clinical groups in their local areas and others with very limited collaboration; indeed viewing collaboration as a risk. If we look at the above bullet points, ‘to define and build a shared purpose,’ is fundamental to most of the work we are doing in commissioning and in particular QIPP. Without a shared purpose different groups will head off in different directions that will eventually lead to conflict.
Developing a collaborative approach is really hard, as so many forces act against it. It is not a panacea; it certainly doesn’t apply in all activities and one of the difficulties is knowing when collaboration is best used and when other approaches are required. It’s probably one of the most challenging leadership tasks to achieve; however it is one that emerging clinical commissioning groups ought to be investing time effort and development in, as it will be crucial to our future. Have a look at the HBR; it’s a good issue
Whilst I have your attention I’d also like to bring up Paediatric and Maternity services. Earlier this week I met with Dr Sheila Shribman the DH lead for Children, Families and Maternity. She is very keen to work with Pathfinders on how we can improve the quality of care through commissioning. She has approached a few groups with little response. I have certainly come across groups that recognise their importance and are looking at these service areas. Can those of you who are working on these important areas please get in touch so we can put you in touch with Sheila to develop this National work.