Hampshire County Council and CCGs
An OD intervention working with 5 CCGs and the County Council aiming to achieve a shared OD Plan to enhance integrated commissioning
What was the issue?
The Hampshire Better Care Fund programme included a work stream to deliver integrated commissioning with the aspiration that 4 local integrated commissioning ‘hubs’ would be established across the county. Integrated commissioning is a key component of the wider Out of Hospital care strategy, that many health and care economies have been pursuing over recent years.
Hampshire County Council and its 5 partner CCGs were seeking an OD partner organisation to enhance their own strengths, capabilities and capacity to deliver a coherent OD programme which would run through their own programme work-streams as a coherent ‘golden’ thread.
The aims of the project were:
- An OD plan owned by all partner organisations to enable a ‘joined-up’ and integrated health and social care system
- To capture the honest views and ambitions of all key stakeholders to the stated approach to integrating health and social care commissioning in our approach
- To begin to develop the leadership behaviours and relationships that will model and sustain the required culture and system change
What did Healthskills do?
- Undertook a quick review of the case for change by highlighting recent national research and evidence for improving services to patients, users, carers and relatives by joining up commissioning
- Produced a simple checklist of success criteria for integrating commissioning which emerge from this research and evidence, spanning leadership, organisation, and system wide factors
- Conducted a series of 20+ semi structured interviews with stakeholders in the system to explore assumptions, aspirations, success factors and challenges, which were thematically analysed using the checklist of criteria
- Facilitated a number of perceived ‘difficult conversations’ between partner organisations and different professional perspectives. This helped to surface underlying concerns and differences on how the shared vision should be achieved, and helped to steer dialogue in a more honest and collaborative approach
- Distilled a set of outstanding questions and activities that will support the development of joined up commissioning and the overall capacity and capability within the system
What is different as a result?
A sense of collaboration has emerged that has provided a solid foundation on which to build the STP process.
An OD plan that summarised the key steps to be taken on the journey to wider service integration was shared with all partner organisations.
The partner organisations and key decision makers recognised the value to taking time to increase their face to face contact, building levels of trust and transparency between organisations across the system.
Specifically, they identified:
- Further work was required to agree a shared definition of, and goals for, integrated commissioning across the stakeholders
- There was a need to clarify what should be delivered at scale e.g. county-wide, on a sub county level, and locally determined (CCG or smaller locality)
- The complexity of agreeing a common pace and scale of desired change across the stakeholders, and a view on whether change should be incremental or of a larger more radical scale
- New initiatives such as Vanguards and devolved powers were seen as either helpful or confusing depending on which part of the system you were talking to. Further engagement work was needed to mainstream these initiatives into governance and strategic planning processes
We proposed that a number of organisation and system development interventions be considered beyond our project to develop and support the process of achieving a ‘joined-up’ and integrated Hampshire health and social care commissioning system, these were:
- System wide learning network
- System leadership development and planning
- Strengthened Governance systems between organisations
- New Ways of Working across professional and organisational boundaries
- Developing a common data platform