scholarly journals Creating allegiance: leading transformational change within the NHS

BMJ Leader ◽  
2018 ◽  
Vol 2 (3) ◽  
pp. 110-114 ◽  
Author(s):  
Alison Tweed ◽  
Andrew Singfield ◽  
Julia R A Taylor ◽  
Lucy Gilbert ◽  
Paul Mount

BackgroundWithin the UK National Health Service (NHS) the move to Sustainable Transformation Plans/Partnerships and Integrated Care Systems reflect the increasing need and expectation for transformational change at a system level across both health and social care boundaries. Transformational change is complex, emergent and dynamic requiring new, non-traditional forms of leadership which are highly relational and persuasive.Aim of the studyThe current study aimed to explore a small number of NHS senior leaders’ experiences of undertaking transformational change within their localities over a period of a year following participation in a national transformational change programme designed to enhance personal capabilities.MethodFour pairs of leaders working on different change programmes took part in the study and were interviewed at three time points about their approach to their change work. The data were analysed qualitatively using template analysis.ResultsA core theme of Creating Allegiance to an Emergent Future World was developed. The senior leaders created allegiance to the transformational change through a process of Connecting on three levels: relational, with purpose and vision and through practice. Allegiance creation was attempted even if the transformational change work at the year-end was deemed successful or not.ConclusionsThe study highlights the types of leadership behaviours employed by the participants reflecting the complexity and social construction of their transformational work. The findings provide further evidence to the existing system leadership literature as well as emphasising the importance of creating stakeholder, multilevel buy-in to healthcare transformation.

2020 ◽  
Vol 33 (4) ◽  
pp. 351-363
Author(s):  
John Duncan Edmonstone

Purpose This paper aims to make the case that there is a need to move beyond a focus on an approach to leadership development which is confined to health care only. It argues that, given the economic, financial, social and organisational context within which health and social care organisations in the UK operate, there is a need to develop leadership within health and social care systems, rather than within the existing “siloed” sectors. Design/methodology/approach The paper considers the context within which health and social care organisations in the UK operate; examines the nature of those organisations; makes the case for focusing on the health and social car system through systems leadership; and identifies the need for leadership, rather than leader development. Findings There is a danger of health and social care organisations “walking backwards into the future” with eyes fixed on the past. The future lies with treating health and social care as a system, rather than focusing on organisations. The current model is individual leader focused, but the emerging model is one of collective multi-agency teams. Originality/value The paper seeks to go beyond a health-care-only focus, by asserting that there is a need to regard health and social care as a single system, delivered by a multiplicity of different organisations. This has implications for the kind of leadership involved and for how this might be developed.


2020 ◽  
Vol 34 (9) ◽  
pp. 1165-1181 ◽  
Author(s):  
Emily Harrop ◽  
Mala Mann ◽  
Lenira Semedo ◽  
Davina Chao ◽  
Lucy E Selman ◽  
...  

Background: The global COVID-19 pandemic has left health and social care systems facing the challenge of supporting large numbers of bereaved people in difficult and unprecedented social conditions. Previous reviews have not comprehensively synthesised the evidence on the response of health and social care systems to mass bereavement events. Aim: To synthesise the evidence regarding system-level responses to mass bereavement events, including natural and human-made disasters as well as pandemics, to inform service provision and policy during the COVID-19 pandemic and beyond. Design: A rapid systematic review was conducted, with narrative synthesis. The review protocol was registered prospectively ( www.crd.york.ac.uk/prospero , CRD 42020180723). Data sources: MEDLINE, Global Health, PsycINFO and Scopus databases were searched for studies published between 2000 and 2020. Reference lists were screened for further relevant publications, and citation tracking was performed. Results: Six studies were included reporting on system responses to mass bereavement following human-made and natural disasters, involving a range of individual and group-based support initiatives. Positive impacts were reported, but study quality was generally low and reliant on data from retrospective evaluation designs. Key features of service delivery were identified: a proactive outreach approach, centrally organised but locally delivered interventions, event-specific professional competencies and an emphasis on psycho-educational content. Conclusion: Despite the limitations in the quantity and quality of the evidence base, consistent messages are identified for bereavement support provision during the pandemic. High quality primary studies are needed to ensure service improvement in the current crisis and to guide future disaster response efforts.


2015 ◽  
Vol 39 (4) ◽  
pp. 444 ◽  
Author(s):  
Kate Charlesworth ◽  
Maggie Jamieson ◽  
Colin D. Butler ◽  
Rachel Davey

Background Healthcare systems in Australia and around the world are failing to address the challenges of the modern world. Healthcare leaders are calling for radical, transformational change and entirely new systems of care. However it is unclear what a future, sustainable healthcare system would look like. Methods A narrative review to examine emerging trends in health and social care was conducted. Results and Conclusions Six key trends were identified. Collectively, they suggest that future systems are likely to be characterised by increasingly sophisticated technology, but at the same time greater personal and community responsibility for health and well being, innovative use of social capital, and a new approach to ageing and end-of-life care. What is known about the topic? Health care systems in Australia and around the world are failing to address the key health challenges of modern society. There are calls for radical, transformational change of our health care systems; however it is unclear what a future, sustainable system would look like. What does this paper add? In this narrative review, we identify and examine six key emerging trends in health and social care. Collectively, these trends suggest that future systems are likely to be characterised by increasingly sophisticated technology; but at the same time greater personal and community responsibility for health and well-being, innovative use of social capital, and a new approach to ageing and end-of-life-care. What are the implications for practitioners? It is becoming increasingly clear that radical change is necessary and there are emerging examples of novel and creative initiatives across many areas of practice. Practitioners need to be engaged in, contributing to and in some cases, leading, this transition to a new health and social care system.


2015 ◽  
Vol 44 (3) ◽  
pp. 549-566 ◽  
Author(s):  
BENEDICT E. SINGLETON ◽  
GARY FRY

AbstractCarers make a considerable contribution to the health and social care of sick or disabled people, reducing the strain on health and social care systems. This has been recognised through support mechanisms, including (in the UK) a payment for caring (Carer's Allowance – CA). This article draws upon data from a study of carers receiving CA. Utilising a citizenship perspective, it examines respondents’ perspectives on their role in the UK and shows how CA provides not only financial support but also contributes to normative conceptualisations of citizenship. The data highlight the primacy of paid work in UK citizenship, as well as the stigma associated with receiving welfare benefits. The article concludes by claiming that changes to the UK benefit system need to take into account a ‘recognition’ aspect, reformulating what is considered a worthwhile contribution to society.


2005 ◽  
Vol 25 (5) ◽  
pp. 769-783 ◽  
Author(s):  
IRENE HARDILL ◽  
JACQUI SPRADBERY ◽  
JUDY ARNOLD-BOAKES ◽  
MARIA LUISA MARRUGAT

In recent years, there has been a growth in academic interest in international retirement migration in Europe, particularly north-south retirement migration to destinations like Spain. In this paper we focus on those members of the British community who have lived in Spain for a considerable time and for whom familial, social and institutional ties with Britain are weak or disrupted. Age Concern España was established by members of the British community to provide information and services on healthcare, benefits and local services in Spain. Four indicative case studies of those requesting assistance and classified as being of ‘serious need’ are presented. They illustrate the ways in which happy and fulfilling lives in Spain were abruptly changed as the person's resources (bodily, economic, social and skills) for independent living diminished, and in which institutions and friendship networks played a key role in supporting life. The paper is the product of collaboration between researchers and practitioners in Spain and the UK, and brings together previous research with new qualitative case studies. Whilst policy-makers, practitioners and gerontologists have an increasing awareness of the needs of older migrants and the challenges they pose for public policy, particularly for health and social care systems in Spain, there have been little sustained analysis and cross-country debate.


2016 ◽  
Vol 80 (2) ◽  
pp. 132-138 ◽  
Author(s):  
Kate Hamblin

Introduction Telecare is increasingly part of the United Kingdom (UK)’s health and social care arrangements, and therefore occupational therapists’ practice. Understanding factors which influence telecare’s acceptance and usage is important to ensure optimal outcomes, both for service users and health and social care systems. Method This paper uses data collected by a qualitative, multi-method, longitudinal research study ( n = 60) to explore whether an American model of ‘obtrusiveness’ is applicable to the UK context by examining what factors influence older adults’ acceptance and use of telecare. Findings The obtrusiveness model is broadly applicable to the UK context, but there are also two further issues which affected the acceptance and use of telecare: the degree of control a service user feels they have and the information and support they receive in using their devices. Conclusion The obtrusiveness model, plus the two additions (control and information), highlight important issues which could assist professionals working with telecare, including occupational therapists, in ensuring telecare is both accepted and well used.


Author(s):  
Lorna Templeton ◽  
Sarah Galvani ◽  
Marian Peacock

AbstractThis paper draws on data from one strand of a six-strand, exploratory study on end of life care for adults using substances (AUS). It presents data from the key informant (KI) strand of the study that aimed to identify models of practice in the UK. Participant recruitment was purposive and used snowball sampling to recruit KIs from a range of health and social care, policy and practice backgrounds. Data were collected in 2016–2017 from 20 KIs using a semi-structured interview approach. The data were analysed using template analysis as discussed by King (2012). This paper focusses on two of seven resulting themes, namely “Definitions and perceptions of key terms” in end of life care and substance use sectors, and “Service commissioning and delivery.” The KIs demonstrated dedicated individual practice, but were critical of the systemic failure to provide adequate direction and resources to support people using substances at the end of their lives.


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e047353
Author(s):  
Henry Aughterson ◽  
Alison R McKinlay ◽  
Daisy Fancourt ◽  
Alexandra Burton

ObjectivesTo explore the psychosocial well-being of health and social care professionals working during the COVID-19 pandemic.DesignThis was a qualitative study deploying in-depth, individual interviews, which were audio-recorded and transcribed verbatim. Thematic analysis was used for coding.ParticipantsThis study involved 25 participants from a range of frontline professions in health and social care.SettingInterviews were conducted over the phone or video call, depending on participant preference.ResultsFrom the analysis, we identified 5 overarching themes: communication challenges, work-related stressors, support structures, personal growth and individual resilience. The participants expressed difficulties such as communication challenges and changing work conditions, but also positive factors such as increased team unity at work, and a greater reflection on what matters in life.ConclusionsThis study provides evidence on the support needs of health and social care professionals amid continued and future disruptions caused by the pandemic. It also elucidates some of the successful strategies (such as mindfulness, hobbies, restricting news intake, virtual socialising activities) deployed by health and social care professionals that can support their resilience and well-being and be used to guide future interventions.


Author(s):  
Syed Fahad Javaid ◽  
Aishah Al-Zahmi ◽  
Munir Abbas

Dementia represents a significant problem in the Middle East. Sociocultural and political factors that shape conceptions of health and care tend to stifle research and the dissemination of knowledge throughout the Middle East. These socio-political challenges concerning engagement with individuals living with dementia and their carers include language barriers, stigmatization, logistical constraints, lack of informal support outside of hospitals, and over-dependence on clinicians for dementia information. There is an urgent need in the Middle East to increase care and support for adults with dementia and their carers, enhance research efforts and improve the dissemination of information related to dementia in the region. One possible way to do so is to begin to promote a knowledge-based culture throughout the Middle East. This can be achieved by aligning traditional deterministic and spiritual perspectives of mental health with more Western, scientific, and evidence-based models. We suggest employing practical, multidimensional approaches to deal with the stated challenges, both at individual and societal levels. Doing so will improve knowledge of dementia and allow health and social care systems in the Middle East to begin to address a growing problem.


2016 ◽  
Vol 22 (4) ◽  
pp. 263-268 ◽  
Author(s):  
Jennifer Perry ◽  
Fiona L. Mason

SummaryThe health and social care landscape in the UK is changing, and there is now, more than ever, a real need for doctors to embrace leadership and management. Evidence shows that medical leadership is associated with better outcomes for patients. Psychiatrists are particularly well suited to such roles, given the interpersonal skills and self-awareness that they develop in their training. In this article, we examine the role of the psychiatrist in leading at a patient, team and organisational level and the impact this has. We also discuss different leadership and management styles.


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