Ohio. Famous for picking US presidents (28 out of the last 30), and the birthplace of aviation (the Wright brothers grew up here in 1870s). Less famous for being home of a number of the most advanced healthcare networks in the world. With collaboration currently flavour of the month, what can the US teach us about working together?
A decade ago I swapped north London for the American Midwest, the NHS for Cincinnati Children's Medical Centre, and management consultancy for supporting an emerging learning network for children with inflammatory bowel disease.
During the nine years I called Ohio home, ImproveCareNow grew from nine care centres in the US to 109 centres all over the world, working with tens of thousands of children and their families collaborating to improve outcomes.
“Making something a reality.” Roll the phrase around. When would you use it?
In your personal life, if you’re anything like me, not much. If so, it’s probably something which won’t actually happen. Making daily gym-going a reality. Making my-attachment-to-ebay-less-all-consuming a reality.
Professionally? A bit more regularly. But likely to be in a similar context: something that I want to happen but don’t want to fully commit to. If you know it’s going to happen, why would you feel the need to assert that it’s going to become real? Stepping back, merely existing is a fairly low bar for success.
"Let's try again." Amanda, an amateur but talented ballroom dancer, restarted the music and daintily, expertly, cha-cha-cha'd her way into a lunge and twist, neatly picking up the basic step on the return beat. We enthusiastically followed her lead as she paced out the steps in front of us. Awkwardly, I crashed into the person next to me. "Sorry!" The class ground to halt for the fourth time. "And again," said Amanda.
Outside, a group of people clustered around six pieces of paper laid out on the table in the sun. "Beautiful." Catherine, an artist, pointed to one of the pictures. "The composition here is really strong. Look how the ivy leaf has come out as heart-shaped."
The group gazed at the emerging ghostly shapes of feathers, leaves, grasses and flowers, pale white on a brilliant blue background - their first exploration of the world of cyanotypes.
Last year we kicked off our event series Change in a Cold Climate with AbbVie UK. Involving face-to-face and digital events with a host of interesting and inspiring speakers, the series has focused on the nitty gritty of how change happens.
To narrow the playing field we chose to focus on learning from long term conditions care in particular, given that around 15 million people in England have at least one long term condition and their treatment makes up about 70% of the primary care budget in England.
The NHS is fragmented, but that doesn’t mean it’s broken. It would perhaps benefit from a new type of thicker glue. Learning networks have the potential to be the stronger bond to stop the shattering, prevent new fragmentations forming, and maybe even heal damage done.
And that's the reason why we at Kaleidoscope are really passionate about networks. As part of our work, I've been looking up some definitions about what a learning network is within a healthcare context. To provide context, I am naïve to the world of learning networks.
This ask was – I thought - simple: to find a definition of what a learning network is and what a learning network does that is easy to understand. However, I found this was not the case.
Having recently returned home to England from a nine-year stint across the pond, I've spent the last few months reading articles, asking questions and drawing diagrams. Earnestly I've been trying, and more often failing, to get my head round the various NHS organisations and how their remits intertwine and overlap as they desperately strive to work together to provide and improve health and care across England.
My first observation is that it's complicated, so complicated in fact that at times I've found myself scratching my head and repeatedly muttering to myself one of President Trump's most astute and truest statements, 'Who knew healthcare could be so complicated?'
Most of us would agree that we are facing a period of great economic and political uncertainty – and at a time when the NHS is under increasing demand and pressure.
We have to work in radically different ways to meet the challenges facing the health service - as the NHS Five Year Forward View and the Next Steps on the NHS Five Year Forward View made clear - and a key part of this is breaking down organisational barriers and joining up our efforts in a multi-agency health and care economy.
Networks and their leaders are a critical vehicle for achieving the changes that are needed across health and care – they sit at the heart of great leadership and large scale change. Networks have the potential to revolutionise the way care is delivered.
There are lots of different styles of clinical leadership, for example transactional, transformational or situational. There are also lots of roles undertaken by clinical leaders, such as medical director, chief clinical information officer or chief nurse at a clinical commissioning group. Sustainability and transformation plans are gaining pace, talk of accountable care systems is rising from murmurings in policy circles to organisations outside of those circles and clinical commissioning groups are merging. These are all signs that 'places' are getting bigger but also that the definition of where 'places' are is becoming more fluid and therefore less predictable.
The joy I had in my work in the 1980s caused me to create Buurtzorg in 2007. We now employ 14,000 people in Holland, and are expanding across the world – including in the UK. The government came to play an important part in our growth in Holland, but not by accident.
In the 1980s, I was a nurse, it was my vocation, but it was also very creative and exciting. Every morning you didn't know what you could expect from the day, and every weekend we’d sit down and discuss the difficult things, learn from each other, and find solutions for the problems we met in our daily work.