The NHS runs on committed, passionate clinicians. It relies on these deeply expert people to deliver better health outcomes for patients, despite the all but incomprehensible health system we have in the UK.
Added on 04 January 2017 by Guy Lubitsh,John Higgins
In recent times we have been working alongside those officially recognized as Clinical Champions as part of a learning and development program which is run in collaboration with Diabetes UK and Novo Nordisk. These are people who have moved mountains to help patients live with the condition and, even more importantly, help people take the steps they need to avoid it in the first place.
The dominant metaphor for these Champions is that of the standalone hero – someone able to stand out in their local area, who, through the force of their expertise and desire to make things happen on the ground, can bend the local system to the needs of patients. The challenge these Champions face is how to make their local differences happen on a larger scale – this larger scale being impossible to achieve by simply working harder (if that was possible or desirable in the first place).
The first step in trying to make a bigger difference starts by their being given the opportunity (in terms of time and resources) to come together as a collective group to several sessions at Ashridge Executive Education, so that they can pool their shared insight and learning. The unexpressed assumption is often that there is a management tool or framework that will help them crack the limits of their individual ability and understanding. If only they could pour what they each know into a shared matrix, then the answer would surely appear. Certainly there are useful models out there that make it easier to take a bigger picture, more systemic perspective, than they are used to in terms of understanding the hard science and soft sociology of the current diabetes epidemic.
Collaboration is the key to this group achieving their primary task of setting up local networks to improve the management and treatment of diabetes – and learning to collaborate well requires the Champions to take a step-up in the quality of their self-awareness. As standalone experts and heroes, collaboration is often treated as no more than the exchange of data between professionals. In local settings issues of hierarchy and trust can be overcome (or ignored) through force of personality and professional reputation – even through the imposition of collaboration by external contracts. In establishing networks that operate on a larger scale, relational skills have to be taken more seriously and taken-for-granted attitudes about self, status and authority needs have to be worked through.
The standalone hero frequently gets their kicks and their sense of who they are through their personal achievements, where their role and significance can be clearly delineated. Cause and effect can be comfortingly attributed to individual, heroic effort. Achieving larger-scale, more systemic outcomes requires a pooling of individual achievement – a loss of a sense of direct personal achievement. While this is intellectually easy enough to explain and describe, in practice it is a heartfelt and emotional jolt for many to shift from an ‘I’ based to a ‘we’ based sense of achievement.
The outcome of this process of bringing the Champions together is that insights get turned into meaningful plans. When the relational and personal side of group working is seen as peripheral to the intellectual work, plans and schedules lack the relational understanding that will make them live when they hit the messy reality of the UK health system. By starting with the so-called ‘soft stuff’, the ‘hard stuff’ has a chance to happen. Tools and frameworks become the servants of relationships, rather than the other way around.
Dr Christopher Smith, Consultant Physician in Diabetes and Endocrinology, Royal Alexandra Hospital, blogs about his first six months as a Clinical Champion and his time learning at Ashridge.
If you are interested in finding out how you could run a similar program for your organization, please contact us at firstname.lastname@example.org or call 01442 841246.