The RCOP programme board had several workstreams taking forward different aspects of the full programme across the partnership. Many of these workstreams identified training and learning needs to support staff at all levels across all sectors to deliver against the service outcomes the partnership identified as required for the delivery of the new model of care.
An event supported by the board illustrated the availability of 108 such sessions making it very difficult for teams and managers to know who and what to prioritise within this. Having identified these 108 sessions teams and managers were struggling to understand what were ‘must dos’ for the team and what would support staff development but not necessarily support delivery of the new model of care. There was a lack of clarity about the work of the programme board and what actual outcomes were expected or why.
It had been identified through various forums and networks that there was a lack of understanding around the ethos of co-production & partnership working. Partnership members felt that they would like the opportunity to improve relationships with other organisations, extend community connections and as most organisations are extremely busy they would like to try and achieve this all in one go. So we had to look at how this could be encapsulated within a one-day event.
Action learning (AL) is an approach that is widely recognised as having great value for leaders and managers who are working with complex issues. Participants do not simply discuss theoretical issues, but bring real challenges to the group, to first understand them better and then to find how to take skilful action. AL fits with both action research and the experimental approaches required for complex issues, as well as with PDSA (Plan, Do, Study, Act) frameworks for taking proactive improvement initiatives.
A learning set is a group of eight to ten key members who agree to meet for an agreed number of facilitated sessions to reflect on how and what they are doing in the face of complex challenges. These meetings are confidential and require a willingness to question their assumptions. The aim is learning not performance management and, facilitated by an external third party, focuses on tackling the real work issues of the participants. It involves reflection, analysis and taking specific action. Group learning involves drawing from each other’s issues and action plans for what are often similar or shared problems.
Anticipating patients that are moving towards a health transition because of emerging health issues.
In Moray we monitor daily the number of patients that are over 65yrs, who attend A&E and are subsequently discharged. We used the Change Fund to second a senior nurse practitioner to work alongside a Consultant Geriatrician to follow up the patients who were discharged. Case studies suggest that early intervention of this type has prevented further deterioration or enabled planned interventions removing the unpredictability of an unscheduled admission.