100 System Leaders programme – what it is and how it works | Sharon Adams

Sharon Adams

With North West Leadership Academy’s support, the 100 System Leaders programme became a reality. Here, Sharon Adams, head of organisational development for Fylde Coast ICP, part of the Lancashire and South Cumbria ICS, talks about the development of the programme - a course designed bottom-up to encourage system leadership behaviours among staff in a wide variety of roles.

We’re grateful to the NHS North West Leadership Academy for having the faith in our proposal and providing the original funding we needed to set this scheme up, which was co-developed and delivered by the Advancing Quality Alliance (AQuA) and Delve OD, who also carried out the evaluation.


Our first 100 leaders were selected by looking at our key priorities as an ICP, which were around urgent and emergency care, planned care, and the integration of primary and community care. On top of this we thought about specific clinical challenges we faced, as well as mapping geographically and looking to get a wide range of pay grades involved; this was never just about senior leaders. We took delegates from our clinical senate, and A&E delivery boards, as well as project leads, directors, paramedics consultants, nurses, social workers, GPs and colleagues from public and mental health.

We explained the concept of the programme to our leaders and what we were trying to achieve, explaining the scope and the time commitments. This was to help them make an informed decision about being able to commit to attending the whole programme. We did a lot of work to try to get the delegate list ‘right’ and ensure that leaders were invited to attend based on their role in the system, not on their pay grade. Getting the final list signed off was not an easy task due to the numbers and organisations involved (there were 12), but we got there in the end.

The programme ran over ten months and was launched in September 2018. We were really proud to achieve an 85 per cent attendance rate at this event. The programme was developed around the NHS North West Leadership Academy, Systems Leadership Behaviours framework. The programme started with all of the leaders attending a development centre and undertaking a ‘strengths based’ assessment to help them see what behaviours they were already demonstrating. Then we designed a series of workshops around the four overarching themes which included:

·         be resilient and authentic

·         communicating and relating

·         leading and visioning

·         delivering across a system.

The focus activity at the development centres was the development of a Fylde Coast Quality Improvement Strategy. Giving a group like this a blank page enabled them to think about quality from a number of differing perspectives including patients, carers, finance leads and clinicians all at the same time. The activity produced some really stimulating work, as well as setting a strong foundation for the ’real’ Fylde Coast Quality Improvement Strategy.

The groups also participated in multi-disciplinary action learning sets. Groups were made up of colleagues from the council, NHS and social care to encourage genuine, cross-organisational relationships to develop. Another element of the programme was the identification of community-based projects to enable our leaders to put their ‘new’ systems leadership knowledge and skills into practice. We designed ‘leadership in action’ sessions which saw us connecting with 14 voluntary and community sector organisations. Our leaders then spent a day observing the impact that lifestyle and other determinants have on people’s health and their health decisions. We had delegates working at the local soup kitchen, food banks and providing support to socially isolated older people living with dementia.

Helping our systems leaders better understand the impact of people’s diet, or homelessness, or social isolation has been a really successful exercise in generating whole system understanding of, and commitment to, what really makes people healthy. It has provided our leaders with the opportunity to take their ‘clinical’ or ‘professional’ hats off and think about population health from a public health perspective. It also helped our leaders to build relationships with our partners in the third sector.

Our first course finishes in June 2019 and we’re looking forward to reflecting, a bit of a redesign and the start of cohort two. We’d perhaps invest in some better accommodation, and increase our social care contingent, and we think we’ll probably get this group to nominate their friends and colleagues who they think can work in this way.

We’ve learned the power of bringing together people who work and live in their own communities, and how we can generate a sense of common purpose in neighbourhoods that is more than the sum of its parts. Our next course might further try to develop that sense of ‘us’ that you get from living and working in the community you are trying to improve.

Lastly, I’d reflect that you can spend £000’s sending someone on a course, or you can build your own thing, knowing that the relationships formed on our programme are almost as important for our systems transformation as the learning itself.

If you are interested in replicating the programme, please read Blackpool, Fylde and Wyre ICP’s case study in this summary produced by NHS England.

Sharon Adams is head of organisational development for Fylde Coast ICP, part of Lancashire and South Cumbria ICS.

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