ihv regional conf: sabrina fuller - health visitors as leaders in the transition to public health...
TRANSCRIPT
www.england.nhs.uk
Health Visitors as
leaders in the
transfer to local
authority
commissioning
Sabrina Fuller
Head of health improvement
NHS England
27th February 2015
www.england.nhs.uk
• Context
• What is leadership?
• How can you apply leadership principles in the context of the transfer?
• Challenges?
• Opportunities?
Health visitors as leaders: leading through influence
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www.england.nhs.uk
• October 2015 commissioning (not employment) of 0-5 PH services transfers to local authorities
• Local authorities already commission range of 0-5 services including early years and social care.
• Local authorities already commission public health services including 5-19 services.
• Local authorities are democratically accountable to their electorate.
• Certain universal checks and reviews will be mandated for time limited period.
• Many local authorities face considerable financial challenges
Context: transfer of 0-5 PH commissioning
www.england.nhs.uk
• A four-tiered progressive model of delivery• Community• Universal• Targeted packages of care• Multiagency working to meet complex needs eg safeguarding,
troubled families
• Delivery of the evidence-based healthy child programme• 5 mandated checks and reviews: antenatal, NBV, 6-8 weeks, 12
month, 2-2 and a half year.
• Improved outcomes for young children and their families• E.g. 6 high impact areas: maternal mental health, early
attachment, breastfeeding, healthy weight, child development and school readiness, accident prevention
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What are health visitors leading?
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• Health visitors already lead skill-mixed health visiting teams.
• Many health visitors, as the early years experts and HCP leaders, are now leading wider teams including early years staff.
• The future is the wider team – with health visitors leading on improved health and wellbeing outcomes for young children and their families.
• The wider team includes early years workers, local authority commissioned workers, primary care, voluntary sector and many others.
• LEADING THROUGH INFLUENCE RATHER THAN LINE MANAGEMENT RESPONSIBILITY.
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Who are health visitors leading?
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• What were we born with? Our own natural tendencies to lead (or not).
• Transactional, transformational, autocratic, participative, laissez-faire.
• What motivates us to lead (a desire to make a difference: to give the best opportunities to all children and families?)
• What are our existing strengths, weaknesses and development needs?
• What resources will help us develop our strengths and address our development needs?
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Our own leadership journey: reflecting on who we are, who we can become and our own leadership style
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• These individuals have had a significant effect on how regular people live their lives today and have had a large impact on how modern society works.
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Significant leaders or good leaders?
Of course, significant doesn’t always mean good………
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• Self awareness – how can you optimise the way you come across to others?
• Working with others – building and maintaining relationships
• Managing the resources available – people, budgets, and realising potential resource
• Improving services: safety, evaluation, improvement, innovation, transformation
• Setting direction: context for change, knowledge and evidence, making decisions and evaluating
NHS Leadership Academy
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What makes a good leader?
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• Are you shaping the future or despairing about it?
• Do you take opportunities to communicate what it is you contribute?
• Do you take opportunities for self development (work-based and outside work, as well as CPD)
• Do enjoy what you do?
• Are you seen to act with integrity?
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Self awareness
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• Shared purpose and understanding each others’ contribution is critical:
• What are the local priorities? How do 0-5s fit?
• Shared outcomes
• What does the evidence base tell us re effective interventions?
• What competencies are needed to deliver to who?
• So agreeing most effective and cost-effective roles, contributions and pathways (see core HV spec)
• Building and maintaining relationships
• Building and using your networks
Working with others
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• Planning: know your local authority priorities for 0-5s; working in the context of their Starting Well strategy; know your data and use it to inform the local authority’s priorities
• Performance: know your service specification; plan to deliver against performance managements requirements; ensure decent data systems
• Resources: know your budget, service costs (and fill your vacancies)
• People: take a wider view of the resource available to you –working with the wider team.
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Managing services
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• Safeguarding is major local authority priority – ensure the preventive elements eg early attachment, parenting skills, are valued.
• Critically evaluating: parents’ and staff perspective on what you do well. Using your data. Building intelligence.
• Encouraging improvement and innovation: use that intelligence for continuous improvement.
• Facilitating transformation: plan to meet requirements of service specification – the 4, 5, 6 model.
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Improving services
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• Context: JSNA, joint health and wellbeing strategy
• Applying knowledge and evidence: leading delivery of evidence-based interventions.
• Making decisions: in partnership with commissioner and other providers – developing pathways
• Evaluating impact: demonstrating your value
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Setting direction
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• Promoting secure attachment
• Baby friendly in the community across the system
• ASQ 3
• Incredible Years Pre-school Basic - parenting groups
• HENRY: tackling childhood obesity
Setting direction: leading effective intervention
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• Use case studies of health visiting impact at different levels for commissioners
• Local councillors are interested in people
• Explain how your service meets LA priorities:
• safeguarding
• promoting a positive home learning environment, school readiness, attainment
• early intervention, troubled families
• addressing inequalities.
Setting direction: comms
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• Joined up working with early years and children’s social care services; for joint care planning and delivery – child centred.
• Joined up working of 0-5 public health services with 5-19s services to allow a family centred approach.
• Closer links to early intervention services such as Troubled Families
• The ability to contribute effectively to public service reform through the evidence base on early attachment, school readiness, attainment and its links to building local economies.
• Ability to affect the wider determinants of health through links to commissioning of housing, planning etc.
• Full potential of expertise and leadership role that health visitors can offer in improving health and wellbeing outcomes for 0-5s and their families.
Opportunities
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www.england.nhs.uk
• Take responsibility for making a success of transfer of commissioning
• Understand your local authority priorities and how you deliver to meet them.
• Work closely with partner organisations around agreed priorities and evidenced based delivery.
• Ensure that commissioners and elected members have the opportunity to understand what you do.
• NHS England is supporting you!
Health visitor leadership
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