Sackwell and Binthorpe bulletin: Proactively working as a system

Another bulletin from the Sackwell and Binthorpe ICS, this time highlighting the importance of seamless integration at PCN, ICB and systemwide levels

It’s Penny here, from the primary care support and strategic intelligence unit (PCSSIU), with another packed edition of the newsletter.  

Sharp-eyed readers will have noticed that the PCSSIU, formerly the primary care support and strategic integration unit, has had a change of name. This important change reflects the completion of our integration journey and a new focus on intelligence in primary care commissioning.

The first action of the Sackwell & Binthorpe integrated care board (S&B ICB), when it came into statutory existence in July, was to order an immediate review of the names of directorates, operating divisions and strategic commissioning units. This work is progressively ongoing, and our expectation is that it will be culminatory towards the year-end. We’ll advise you of the final outturn in subsequent newsletters.

Linda Marshall, chair of the strategic naming review and refresh (SNRR) group, would like to thank primary care colleagues for their tireless work putting up posters and handing out questionnaires.

Meet the system leaders
Although the ICS has been running in shadow form for two years, July marked the point we started working in earnest. We celebrated with a Meet the System Leaders Day on 27 July. Patient representatives, PCN clinical directors (CDs), practice managers and the extended primary care team had the opportunity to network with deputy director of finance Selina Sayed and senior contracting manager Ken Moss. 

All the attendees who completed the feedback form agreed the event had been ‘interesting’ and/or ‘quite informative’. Delegates reported a 13% increase in their perception and knowledge of ICS aspirations and ambitions, based on surveys taken before and after the buffet lunch. 

Amanda Pritchard made a short video presentation thanking front-line colleagues for all they do and pledging full support to ICS leaders. 

The NHS England chief executive promised that NHS regional directors would be checking in with them regularly to find out where robust, targeted support was required.    

A stronger voice for primary care
As we move at pace towards fully integrated working at scale, primary care colleagues have expressed concern that their ‘voice’ could get lost. The ICS has put in place decisive steps to ensure this does not happen.

These include fulfilling the statutory obligation to have at least one primary care representative on the ICB. It is equally important that we deliver enhanced voice at the levels of neighbourhood and place and that leaders develop the active listening skills to ‘hear’ it. 

As Dr Claire Fuller memorably observed in her ground-breaking review, ‘only by collaborating can we work together effectively’. 

An important part of my team’s role will be to maximise the opportunities for collaboration, from multidisciplinary cross-fertilisation at practice level to the introduction of distributed leadership models in PCNs. As networks of PCNs evolve, we will see blended leadership models emerge, with primary care and place leads matrix-working to ensure neighbourhood workstreams are harmonised with place-based initiatives and flow seamlessly into the overarching systemwide strategy set by the ICB and/or the integrated care partnership (ICP). As you can see, questions about how and where decisions are taken or who’s in charge are much less relevant. Instead, leaders should ask themselves ‘How did that make me feel?’, ‘Which leadership behaviours should I work on?’ and ‘What have I done today to build meaningful relationships?’

Working together as a network – tips for success
The success of working together as a system will be built on the success of working together in subsystems. At every level, people, clinicians and citizens will collaborate to design new models of commissioning, care, co-production, governance and general practice.

The NHS Leadership Academy, NHS Horizons and the RCGP have teamed up to produce a series of quick guides on:

• Collaborative stances, preferences and styles.
• Thinking spaces – and how to furnish them.
• Resilient behaviours of happy teams.
• Holding productive conversations.

Are you sitting comfortably?
If you’re squirming uncomfortably as you read this, it may be because you spend too long sitting down. A recent study found the sedentary lifestyle of GPs may be putting their health at risk, causing a range of problems from lower back pain and cramp to early retirement. 

Last month, the ICS brought together primary care leads, CDs and physiotherapists to address the problem. The resulting Healthy Sitting Initiative (HSI) includes recommendations on sitting with purpose, positive posture and how to adjust swivel chairs. It will be supported by a social media campaign urging GPs and other practice staff to ‘find time to stand’ and ‘stay mobile, stay well’. Do look out for it.

The HSI action group is meeting again this month to consider how the adoption of a John Lewis model in general practice may promote the adoption of more tasteful décor and softer lighting in primary care.

Penny Stint is primary care enablement lead for the Primary Care Support and Strategic Intelligence Unit (PCSSIU) at the Sackwell & Binthorpe ICS. As told to Julian Patterson