https://www.publicsectorblogs.org.uk/2019/11/a-21st-century-approach-to-seamless-health-and-social-care-futuregov/

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For over a decade, North East Lincolnshire Council and the North East Lincolnshire Clinical Commissioning Group have worked together closely to deliver health and care services. Always looking forward, they made the bold decision to integrate organisations, structurally underpinning the ambition of bringing health and social care together as a seamless experience for residents.

Under the new Union Board, FutureGov was brought in to help design a Future Operating Model for the Union. Facing unique challenges, we’re seeking to transform two organisations to allow for the maximum integration possible whilst remaining separate entities, reconciling democratic and clinical governance and ultimately, best serving the needs of the population.

A shared lens and perspective

An organisation is like an organism, made of complex relationships between people working together to ensure evolution, sustainment and improvement. Humans interacting with other humans. But how do you bring two organisms together, each with their own unique relationships, to make one new entity?

Form follows function. Rather than looking at organisational structure, we needed to look at different categories for organisational improvement, developing the organisation first before looking at service-level improvements:

  • Is the strategy for the Union clear and directive?
  • How are data and insights used to inform the commissioning process?
  • What systems and products are used to work collaboratively and in the open?
  • What are the ways of working in place to support this?

Structuring our discovery around this, we were able to complement these questions with ones about relationships and a shared culture and mindset. The outdated, org chart assumes that people hold one role with one boss and one set of responsibilities. In a changing world, this approach doesn’t work. Behaviours, relationships and the way teams work together is what defines an organisation.

Picking our moments (and areas of focus)

Two challenges the Union faces is a large amount of unguided employee autonomy and a vision for the organisation that lacked active or directive qualities. Everyone understood the vision but didn’t know what to do with it or how to use it daily.

To help articulate behaviours and relationships, we simplified the organisational tasks into three categories:

  • strategy/governance (mainly at the top)
  • commissioning (where they meet in the middle)
  • corporate services (supporting from ‘below’)

By looking at strategic principles, commissioning & contracts and data & insights, we can understand more about where decisions are made, the tools staff have to get the job done, the skills that exist or might need to be recruited for and what capacity there is to deliver this sort of transformation.

We selected these areas to focus on because each (data and insights, contracts and prioritisation) cuts across almost all aspects of the Union. If we pull on the thread that is data and insight, we’ll likely explore and impact all corners of the organisations, which is much more meaningful than exploring singular silos.

And next…

We’ve now finished the first phase of this work with a clear sense of the opportunities for changes that could have the biggest impact, and help us to ask better questions.

This is an exciting place and opportunity to be working within. Not least because the dual Chief Executive, Rob Walsh, has set a brilliant tone that’s inspiring staff across both organisations. There’s a real sense of pride in the ambition to provide residents with seamless interactions and set the standard for a modern future of integrated health and care.

This is the first in a series of three posts that will tell the journey through discovery, prototyping and into delivery.

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