#DoWith services need self-organised team work
This week’s launch of the #DoWith movement marked a significant step forward for those of us working to liberate public services so that they’re better able to enhance and support the creative power of the communities they serve.
For us in Public World it was a particularly exciting moment, following as it did our own enriching week exploring the learning from 10 years of our ‘test and learn’ projects to support the introduction of self-organised team work in Britain and Ireland.
We see the liberation of public service workers as key to achieving the goals of the #DoWith movement, and our workshop in London showed the potential of self-organised teamwork to do so.
The hybrid workshop was also part of a study visit we supported by Alfred Health, a leading Australian health care provider, whose representatives also joined us in Edinburgh to learn from the progress being made by our long-standing partner there, the Thistle Foundation.
Thistle, which supports people living with long-term conditions, is one of 40+ organisations with which we have worked over that decade of ‘test & learn’, and it was truly inspiring to hear from three of them at the London workshop.
Yesim Boe of Thistle spoke of the improvements self-organisation has brought to her Supported Living team’s relationship with the person they support and their family, and to multi-disciplinary cooperation across the system.
Sam Greenacre of Newtide Homes told how its housing officers had stepped into responsibility to take decisions and actions that would previously have been referred up the ranks, and how the service to tenants had improved and costs reduced as a result.
And Cepta Hamm, now a Public World associate but back in 2015 just starting as head of community nursing at Guy’s & St Thomas’s NHS Foundation Trust (GSTT), reminded us what a difference the Neighbourhood Nursing teams there had made to the experience and self-care of their patients.
Her account was confirmed by Prof. Fiona Ross, one of the Kingston University team that evaluated the ‘test & learn’ at GSTT, and she also spoke of their findings about the organisational and systemic obstacles to growing and normalising the approach.
The latter point was also highlighted by Dr Rose Rickford, who spoke about her analysis of the barriers and challenges revealed by the Transforming Integrated Care in the Community project in Kent, Belgium and France. Of the 250 specific obstacles identified, the large majority boiled down to the difficulty of fitting the square pegs of distributed leadership into the round holes of the prevailing bureaucratic apparatus.
Yet a fascinating presentation from Kat Deyes of Frontier Economics, drawing on data from the ‘test & learn’ project at East London NHS Foundation Trust, revealed the potential of the approach to reduce costs across the system. Perhaps that is the lesson that will have the most traction with governments seeking to improve public health within constrained budgets.
All of this provided valuable evidence for our Australian guests to take home, but we learned from them too. Dr Felice Borghmans of Alfred Health spoke of their plans to move increasingly towards ‘hospital at home’ services, and related her interest in self-organisation to her study of complex systems.
In the same spirit of international mutual learning, Dr Stephen Commins of Public World and Dr Fletcher Tembo, a recent and very welcome addition to our associates group, offered perspectives from the United States and Malawi, while while Alice Chapman-Hatchett shared learning from the Health and Europe Centre.
On top of all that, discussants Katie Kelly FRSA (chair of New Local) and Public World associate Prof Colin Talbot brought combined practical and academic experience of some 80 years into their thoughts about how the workshop evidence might (or might not!) influence the current government’s approach to public service reform.
In Edinburgh two days later, Felice, her colleague Francis Dignam benefitted hugely from the insights generously afforded by Thistle chief executive Mark Hoolahan and several of his colleagues in their coaching and support staff.
Their accounts enabled us to dig deeper into the detail of all the themes explored in the London workshop, and our Australian guests left – as Felice told us – “convinced that self-organisation is critical to positive workforce experience and health system sustainability”.
We video-recorded both the workshop and much of the Thistle study visit, so over the coming weeks and months we will be sharing more of the rich body of knowledge revealed by both.
As well as welcoming the #DoWith community into our Humanity at the Heart online community platform – we’re delighted to greet many new members this week – we believe the body of knowledge created by our continuing practical work will contribute strongly to achieving its purpose.