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Published on March 19, 2008

Author: Renzo

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Developing a Shared Vision This guide explains the importance of having an LHC wide strategic vision, and illustrates through case studies the role of visioning in empowering Local Health Communities to achieve successful service transformation :  Developing a Shared Vision This guide explains the importance of having an LHC wide strategic vision, and illustrates through case studies the role of visioning in empowering Local Health Communities to achieve successful service transformation A Practical Guide for the NHS The Power of an LHC Wide Strategic Vision :  The Power of an LHC Wide Strategic Vision A good vision is not an idea, it’s not even an important idea, it is a force in people’s hearts, a force of impressive power. At it’s simplest level, a shared vision is the answer to the question - ‘What do we want to create?’ An LHC wide Strategic Vision provides a picture of what your health and care system will look like in 5 to 10 years from now. It should have a time horizon of up to a decade or more. It should be ambitious and represent a dream that is beyond what you think is possible. It is a reflection of the values and beliefs of the people who created it. Listening to and engaging staff, patients and the public is therefore an essential part of creating the vision that will be the future health and care delivery system. Individual health and care providers may be successful in their particular activities, but there is a tremendous advantage and a powerful synergy that develops when the whole health and care community works together to describe its vision for the future and bring that vision to reality. The strategic visioning process focuses and channels the energy and the creativity and ideas of the public and the leaders into a powerful strategic vision and action plan. It builds on the many good things that are happening across the LHC, aligning them in a common direction and creating new impetus for their completion. The vision must be both strategic, because it anchors plans and actions in the context of your specific environment, and ambitious, because it is what is needed to inspire commitment and action. It should stretch beyond your current state – but cannot be ‘pie in the sky’, which is merely an illusion. Strategic thinking Thinking hard about your particular setting and anticipated future. Looks at LHC strengths, weaknesses, capabilities and forces and trends that impact. How to take advantage through selected focussed effort. Strategic Planning Applies strategic thinking to a systematic process of planning for the future. Anticipating changes, setting goals and action plans. Often extends the present into the future by focussing on problems or limiting plans to current resources. Strategic Visioning Is a strategic planning process that includes a compelling description of the desired ‘future state’ ( a vision) and generates a plan and resources to realise the vision. It leads to deployment of resources and focussed development of effort. An LHC wide strategic vision inspires people to deliver positive change Slide3:  10. Somebody sneezes and dusts flies off your old plan. 9. Half of your community doesn’t know if you have a Strategic Plan. 8 The other half doesn’t care. 7 Your health economy is under pressure, there is a general sense in the community that the health and care system is failing. 6. You know in your heart that the Local Health Community is capable of great things if you could all come together in a common effort. 5. Your existing plan is not really a plan, it is a list of activities that it would be good to do, rather than a systematic examination of your Health community, a strategic vision for the future, an action plan with responsibilities assigned and a timeline for completion. 4. Your existing plan is not really strategic. It is a template borrowed from another community that does not build on the strengths and capabilities or an understanding of the emerging issues that will affect your community. 3. Your existing plan has no vision, it is an extension of the status quo based on existing resources, rather tan a compelling image of the desired future that energises your community to take charge of its future. 2. You don’t want to look back in ten years time and wish that you had taken action now. 1. You realise that a strategic vision and action plan that is bold, compelling and embraced by the entire community is one of the most powerful engines to drive a Local Health Community towards long term successful service transformation . Envisioning and communicating a better future When there is a need to achieve transformational change, and in order to achieve such a beneficial, future state, the leaders of a change programme must describe a clear vision of that future and then communicate it consistently. Managing Successful Programmes: OGC A clear and articulated vision is a foundation and focus for the transformational change programme. It is the basis for the outcomes and delivered benefits and is a key enabler for the buy-in, motivation, activity and alignment of stakeholders. Ten Reasons for a Strategic Visioning Process What Does A Good Strategic Vision Look Like?:  Use the following criteria to evaluate your own Strategic Vision Forward looking Does your Vision Statement provide a powerful and positive picture of what your health and care system will look like in 5 – 10 years time? Ambition Is it ambitious; does it represent a dream beyond what you think is possible now? Is it all about excellence ? Motivating Does it clarify the direction in which your provider organisations needs to move? Does it clarify the future commissioning direction? Does it clarify the user focus for commissioning decisions and service provision? Does it clarify the capabilities commissioners and providers will need to develop? Purpose-Driven Does your vision statement give staff a larger sense of purpose? Is your vision statement worded in such a way that staff see themselves as "building a cathedral" rather than “cutting stones“? Inspiring Does it create enthusiasm, inspire and engage people? Does it provoke emotion and excitement? Does it pose a challenge that inspires and engages people in the community to embrace the need to change? Capitalises on Unique Competencies Does it build on the LHC’s collective strengths, unique capabilities, resources and assets? ‘Success is about maintaining the vision even through the most gruelling details’ A story from the Middle Ages Three stone masons were hard at work when a visitor came along and asked them what they were doing. The first stone mason was working hard, sweat beading his brow - ‘I am cutting this stone’ The second man though less distraught sighed and said - ‘I’m building a parapet’. The third man replied with a radiant face – ‘I am building a beautiful cathedral that will glorify God for centuries to come’ Author unknown What Does A Good Strategic Vision Look Like? Slide5:  The more broad based involvement there is up front in the visioning process, the more likelihood of success in bringing that vision to reality. Organisations, which include independent sector, public sector, local authority, non profit organisations, voluntary sector, each have : A collection of resources, financial, human, technology An agenda A vision of their desired future A leadership structure A set of allegiances to that agenda and leadership The potential to be a partner in development efforts in the community. The potential impact of these organisations being aligned into a common vision and action plan is a recipe for successful transformation. If the vision is not shared or supported, or if there are conflicting visions, the result will be a chaotic collision of competing priorities and failure to meet local needs. For more information and top tips read the Stakeholder Engagement Practical Guide Liverpool PCT say : ‘ Be inclusive ‘ Following the visioning event to develop a year of care model for schizophrenia wider feedback highlighted that families and carers felt excluded, as a result a further event was held to ensure their views were heard and responded to. “Vision without action is merely a dream. Action without vision just passes time. Vision with action can change the world.” Author: Joel Barker- The Power of Vision A good Strategic Vision is owned by the Local Health Community Strategic Visioning: The Process :  Strategic Visioning: The Process Describe an accurate picture of the current reality for the LHC Draw a strategic map of your LHC Use demographic and public health data to show current strengths and weaknesses. The gap between where you are and where you want to be will be the creative tension that helps pull you towards your vision. Examine the emerging local, national, global trends Be creative ask - What if? Make sure that your vision includes the whole care continuum from heath promotion and prevention through care and treatment to review and rehabilitation. Feedback is given in the form of a summary Think of different ways of communicating the messages Create a powerful case for change. Use language that reflect people’s values and beliefs to win hearts and minds The ISIP Care Delivery Principles may be a useful starting point. Visual awakening Where are you now ? Visual exploration Explore the possibilities Vision creation Where do you want to be? Dare to dream Visual communication Show before and after? What if ? Demonstrator Experience: Nottinghamshire PCT Model of Diabetes Care:  Demonstrator Experience: Nottinghamshire PCT Model of Diabetes Care Visual awakening Where are you now ? Visual exploration Explore the possibilities Vision creation Where do you want to be? Dare to dream The aim of the Visioning event was to establish a compelling case for change in the context of local service provision. This event was designed to involve and engage a wide group of local stakeholders who commission, provide and use current services. It was important for us that we built on existing good practice and the extensive work of the Central Nottinghamshire Diabetes Network. We brainstormed all the good things that were already in place. We wanted to get a view of the current service provision so we used data and we asked our users for their experiences. Visual communication Show before and after? What if ? What if we used policy drivers and local incentives to change the way that services are currently delivered, offering more choice and services closer to home? Both primary, community care and acute practitioners recognise and accept that it is important to create the right conditions to change services to increase quality, improve access and make the best use of the resources available (people, technology and finance). Visioning event – a half day event was held with input from local GPs, consultants, National Diabetes Support Team and ISIP. Delegates included users, doctors (GPs and consultants), nurses allied health care professionals, diabetes network members and managers. Service that empowers and enables patients and users to self care Patient Experience Workforce Communication Transfer of knowledge, skills and support to both patients and health care professional Different ways of working, competent workforce in the community Demonstrator Experience: Liverpool Vision for Schizophrenia Year of Care:  Demonstrator Experience: Liverpool Vision for Schizophrenia Year of Care We spent time preparing for the event, gathering data to really understand the current state. We decided to use the Walt Disney Circle of Creativity in a facilitated workshop to develop our vision for the Year of Care. . What if ? Walt Disney Circle The critic asks ‘what if problems occur, what could go wrong?’ The Dreamer says ‘anything is possible - no constraints’ The realist says ‘How do I / we want to do that’ The Circle of Creativity was developed by R. Dilts based on the successful strategies of Walt Disney. The approach was developed through individual interviews with friends and colleagues of Disney. It is a model for effective and creative development of personal and professional plans. It helps you to transfer an idea into the input for a plan. http://www.change-management-oolbook.com/tools/pm_02.htm l The Vision was taken to the Mental Health Consortium Committee and they have made a number of comments on it . We held a second workshop to look at the comments and agree actions. Need to place “family” along this whole model If the needs of families and informal support networks are not considered within this planning stage the focus will be narrow and gaps will remain. Visual awakening Where are you now ? Visual exploration Explore the possibilities Vision creation Where do you want to be? Dare to dream Visual communication Show before and after? What if ? NHS ISI Experience: Wiltshire PCT Reforming Community Services:  NHS ISI Experience: Wiltshire PCT Reforming Community Services . The current range of community health services in Wiltshire did not fit with the PCTs ambitions for modern NHS healthcare. Wiltshire Primary Care Trust has a new vision for the future. What if people lived healthier lives, care was delivered much closer to people’s homes, people had greater choice over where and how and when they receive NHS care, and we could provide care when needed in modern facilities? People will be actively encouraged and supported in adopting healthy lifestyles Eleven new neighbourhood teams will enable more older people to live in their own home Fewer people will need emergency admission to hospital Local access to clinical assessment and diagnostic services in Primary Care Centres Reduced attendance at Accident and Emergency Departments and reduced non-urgent ambulance call-outs Local and integrated support from the 11 new neighbourhood teams will reduce Length of Hospital Stay Improved recuperation through better use of Community Hospital beds Faster access to clinical professionals and treatments in five new NHS Primary Care Centres Reduced need for patients to travel to main hospitals for diagnostic tests or therapy services such as intravenous therapy, blood transfusion, blood tests, and rehabilitation, as they will be available in the community through the new NHS Primary Care Centres. 500 people attended a series of stakeholders’ assemblies to discuss the proposals 3,000 people attended public consultation meetings 600 staff provided their views 790 people completed anonymous questionnaires 700 other comments were received by telephone, letters, fax and email Visual awakening Where are you now ? Visual exploration Explore the possibilities Vision creation Where do you want to be? Dare to dream Visual communication Show before and after? What if ? Key messages :  Key messages Involvement and inclusion of stakeholders is key if transformational change is to become a reality. Listen to stakeholders and package their thoughts into a vision that can be understood and embraced by all concerned with systems of care. Make sure that your vision appeals to hearts and minds of the people affected by the change - a benefits led approach helps to engage stakeholders and create the case for change. Visioning events can unlock the potential of practitioners to see a way of ‘doing things differently’. Asking ‘what if’ helps to break away from the traditional thinking about how we deliver services. Visionary leadership can turn a good idea into something achievable. The leaders of a change programme must describe a clear vision of that future and then communicate it consistently. Where to go for more information:  Where to go for more information External references: Creating a Shared Vision : http://www.isip.nhs.uk/roadmap/initiation/PhaseI-Strategy/agreeSharedVision ISIP Care Delivery Principles http://www.isip.nhs.uk/guidance/caredelivery/index_html Strategic leadership and Decision making http://www.au.af.mil/au/awc/awcgate/ndu/strat-ldr-dm/pt4ch18.html Disney Circle of Creativity ; http://www.change-management-toolbook.com/tools/pm_02.html Named contacts: Liverpool Mental PCT Mental Health Programme: Debbie.Nixon@seftonpct.nhs.uk Central Nottingham Diabetes Network: suzanne.meredith@nottinghamshirecounty-pct.nhs.uk Wiltshire PCT: hilary.shand@wiltshire-pct.nhs.uk

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