Like many of us, I am often involved in driving forward “system wide” transformation efforts. Recently, I have found an ally in the form of a sidekick straight from the Hobbit… Gollum!
To put it in context, this is all part of Tameside & Glossop’s 100 Day Challenge (supported by Nesta). As a combined area, Tameside and Glossop are in a good position. We have an exciting programme of transformation called Care Together, we have funding from Devolution Manchester to make it happen and, more importantly, multi-disciplinary teams working together across health, social care and the voluntary sector to improve the patient, or rather people’s, experience.
Senior managers will not hesitate to say that the single most important factor in transformation is a person-centred approach. The problem comes when we all sit around the table to reshape services. Our person-centred principles fly out of the window only to be replaced with Gollum-like tendencies.
For those who aren’t avid Lord of the Rings fans, perhaps some explanation is needed… Gollum wants only one possession and he will go to any lengths to get, keep and control this possession – the One Ring. And at times we are no different as we desperately try to gain or hang on to a service or activity that has historically been ours, or that we believe should now belong to us. Often, we do this regardless of whether it is in the interests of the patient or not.
So to help with the 100 Day Challenge and other efforts aimed at convening systems and places around people - if you find yourself at an impasse, channel Gollum… and in doing so, the following questions might help.
Is the issue about control? Be brave and say if you think this is the issue. All too often we hide behind an excuse because we don’t want to let go, for example, statements like “I would let others get involved/manage this element but it is out of my control/ authority”
Is the issue about fear? Often we don’t want to let go of control or blur organisational boundaries because of fear. Fear that we could lose our own professional role or individual job, or even damage the future viability of a whole service or sector within which we work. Be honest about your fears.
Is it about trust? Or more importantly, is it about a lack of trust? Often we don’t want to let go of something because we don’t trust other services or sectors to do it as well as we feel we can. Or perhaps or we don’t trust the intentions of other services, or fear they will stop working with us if we don’t have control.
Is it about perception? One of the biggest challenges we face with integration is the perception of what each professional role does – or doesn’t do. For us in the voluntary sector, this is a big problem as often we are not seen as part of the ‘professional’ offer that makes up the integration of health and social care. This can be due to a lack of understanding, or the language we use to describe services as ‘volunteer led’ or ‘community’ and a perception that this is therefore not professional. Or perhaps it is that we judge services by what they have provided in the past, rather than what they are capable of providing in the future as the landscape of health and social care changes.
So I invite you to, as me, adopt Gollum in your efforts, and every time you start to think ‘precioussss’ thoughts about a role or a service, then challenge yourself to let go.