This post is by the Leadership Foundation programme director Doug Parkin, and is based on a DVC/PVC Network event, which was an exchange between senior leaders from higher education and the NHS, to explore the nature of creating and leading in an innovative culture. The Leadership Foundation hosts this network for senior higher education leaders twice a year, and the themes and topics for discussion are recommended by network members.
Building innovative practice to meet the fast changing needs of patients, families, communities and policy makers is a challenge the NHS has faced at an ever increasing rate over the last twenty-five years or more. Alongside this the risks, accountabilities, expectations, and levels of scrutiny have grown with care quality, compassion and patient dignity now as much in the headlines as any chronic disease or new source of infection. But implementing strategic change within organisations as large and complex as an NHS Foundation Trust at the same time as preserving the energy and commitment of staff is far from easy. How to approach this in terms of lessons learnt, insights gained, obstacles overcome and pitfalls to avoid was very much the objective in terms of the shared learning this event focussed upon.
The day was attended by DVCs and PVCs from 24 higher education institutions. There was clear recognition from the outset that the opportunity for transferable learning was high and the value of considering transformational change ‘through the eyes of another sector’ could be of great benefit.
Setting the scene
To set the scene for the day there was a short review of the strategy landscape surrounding both sectors. This highlighted many of the similarities in terms of the pressures, challenges and drivers for change that become quickly apparent when higher education and healthcare in the UK are looked at side-by-side. With the possible exception of mortality rates (though students ‘dropping out’ may present a parallel) the ideas and issues to do with patient-centred care and student-centred learning has many overlaps. The student experience and the patient experience are equally high on both strategic agendas and operational imperatives. Over the last few years when politicians and policy makers have talked about “tough times”, “radical reform” and the need for “big decisions” in a “complex and uncertain world” their rhetoric could have been aimed at either sector. Funding, governance, demographics, community engagement, staff empowerment, the relationship with the ‘user/customer’, rights and risks, growing public expectations and discussions about where the care/study should take place are all factors driving innovation and change in both higher education and the NHS.
Thinking about what should not change as well as what should/could is an important, but sometimes overlooked part of any strategic conversation. To highlight this the group took a moment early on to reflect on the core purpose and the enduring principles that lie behind the establishment of both sectors in the UK context. It is timely, fifty years on, to reflect back on the Robbins principle (1963) that Higher Education should be “available to all qualified by ability and attainment” and to contrast this with the words of Bevan (1948) that healthcare should be “free at the point of delivery” and that “no society can legitimately call itself civilised if a sick person is denied medical aid because of a lack of means”. Perhaps this gives a true insight into the meaning of ‘widening participation’.
The heart of the day
The day was led by three excellent speakers:
- Professor Judy McKimm, Dean of Medical Education, Swansea University
- Rohna Kearney, Consultant, Cambridge University Hospitals NHS Foundation Trust
- Deborah Jenkins MBE, Chair, South Tees Hospitals NHS Foundation Trust
The day was framed by a comprehensive review of how universities are responding to the challenge of preparing professionals to meet increasing expectations from patients and students within a rapidly changing service landscape and also heightened economic constraints. Judy McKimm used developments in medical education and training in the UK to illustrate how professional attributes such as care, compassion and resilience are finding prominence within already crowded curricula to ensure that tomorrow’s health service leaders are equipped to model and promote these core qualities. A wide range of implications flow from this in terms of the balancing act university programmes need to achieve between tailored training with close support for the individual student and robust quality assurance processes that ensure ‘fitness to practice’ criteria are systematically met. This has led to changes, for example, in curriculum design, new ideas around the use of technology for learning and fresh thinking with regard to the assessment of both academic attainment and professional values and competency.
Inspirational case studies
Rohna Kearney and Deborah Jenkins presented contrasting case studies, both inspirational in different ways, which provided a strong stimulus for discussion. Rohna took the group through a fascinating user-centred model for self-managed care of a minor procedure. This example showed how the energy and commitment of one individual championing a new approach, focussed on empowering the user and challenging accepted norms, can lead to both better outcomes and a freeing up of expensive specialist resources. A powerful message that came from this was that a relatively small investment in the right project at the right time can create a model of change with the potential to be taken-up on a much wider scale. The user-centred nature of this change was very striking!
From the perspective of an influential chair of a large NHS Foundation Trust, Deborah Jenkins put across very powerfully an organisation-wide perspective on how challenging it is to keep user engagement firmly at the centre of a complex change agenda (a very resonant message for universities at the current time). The leadership challenges were brought to life with a combination of humour and passion looking at everything from difficulties of communication through to local community involvement and how to interact with staff at different levels. Some key messages around priorities such as “sort the mundane and aim for the extraordinary” gave a new twist to strategic thinking and tips on implementing strategy such as the importance of sticking with identified improvements clearly struck a chord with the audience.
Reflection and application
Through table discussions the network group were invited to reflect on the ideas and approaches that had struck them from the case studies and to draw parallels with examples of/opportunities for user-centred change in their own institutional settings. The discussions were wide-ranging and included everything from improving assessment and feedback through to the integration of student services and the realignment of academic priorities. Similar challenges were identified across the two sectors in terms of empowering staff, freeing up senior strategic resource and crucially how to take a whole-organisation approach to leading change and inspiring innovation.
The next DVC/PVC event will take place on Tuesday 10 June 2014 and will be on Student-centred change: Harnessing the new dynamic. To register for a place contact marketing coordinator, firstname.lastname@example.org