►
From YouTube: CQC Connect: Sustaining Improvement
Description
In this episode of CQC Connect, the podcast from the Care Quality Commission, we talk to NHS Trusts who featured in our sustaining improvement case studies.
We hear from them about their improvement journeys and how they've sustained the improvements they've made.
You can read the full case studies here: https://www.cqc.org.uk/publications/themed-work/sustaining-improvement
Listen to more podcasts from the CQC: https://soundcloud.com/carequalitycommission
Find out more information about the CQC and how it regulates health and social care in England: https://www.cqc.org.uk/
A
B
A
A
A
So
in
this
episode
we'll
be
talking
about
our
new
sustaining
improvement
report.
This
is
part
of
our
driving
improvement
report
series
in
which
we
spoke
to
services
about
how
they
improved
their
cqc
rating.
For
this
report,
we
went
back
to
four
trusts
to
find
out
how
they
then
sustained
their
rating
or
improved
it
further.
A
Before
we
get
stuck
into
the
conversation.
Let's
should
we
learn
a
bit
a
bit
about
ourselves,
your
background
and
what
your
role
involves
so
kevin
you're
newbie
here
at
cqc
six
months,
I
think
that's
right
detected
twinge
of
a
new
zealand
accent
there
as
well.
Right,
yes,
can
you
tell
tell
us
something
about
yourself.
B
Sure
so
I'm
a
child
adolescent,
forensic
psychiatrist,
my
background,
my
training,
I
spent
some
time
working
at
national
patient
safety
agency
and
then
for
eight
years
I
was
chief
medical
officer
at
east
london
foundation.
Trust
where
I
did.
A
lot
of
work
on
quality
and
quality
improvement,
went
back
to
new
zealand,
had
a
quality
improvement
job
there
and
then
returned
to
this
exciting
role
at
cqc.
A
C
Yeah,
so
I'm
I
have
two
roles
I,
which
are
split
half
time,
I'm
a
consultant
anesthetist
with
an
interest
in
transplantation,
vascular
anesthesia,
but
also
perioptic
medicine,
and
I
led
our
perioptic
medicine
program
for
eight
years
now.
Those
roles
are
split
with
my
current
role,
which
is
the
clinical
director
for
improvement
and
transformation,
and
in
that
role
I
am
co-leading
with
a
colleague
the
move
of
our
organization
towards
a
culture
of
continuous
improvement.
D
A
B
So
I
think
there
are
some
common
features
in
the
organizations
that
do
this
really
well.
Quality
improvement
doesn't
happen
in
a
vacuum.
Okay,
you
have
to
put
energy
into
it.
You
have
to
focus
relentlessly
on
quality,
or
else
it
becomes
something
which
is
very
difficult
to
improve
the
trust
that
we
have
spoken
to
all
had
formal
quality
improvement
programs
in
place.
B
B
B
I
first
got
an
inkling,
but
this
wasn't
the
right
approach.
When
I
went
to
an
institute
for
healthcare
improvement
meeting
their
annual
meeting,
they
get
6
000
people,
there
all
devoted
to
quality
improvement,
and
it
was
lunchtime-
and
it
was
sunny
and
you
could
go
outside
yeah.
A
thousand
people
had
attended
a
program
entitled
no
more
red,
amber
green
during
their
lunch.
B
B
So
I
think
it's
about
everyone,
knowing
that
they're
going
to
look
at
the
data
in
the
same
way
and
that's
very
difficult
for
nhs
organizations.
You
have
thousands
of
people
wanting
to
do
it
their
own
way.
You
have
to
have
an
agreement
about
that
accreditation.
I
think,
was
one
thing
which
came
across
so
having
a
sort
of
internal
accreditation
process
so
that
you
could
recognize
what
was
working
in
your
own
organization
having
a
set
of
standards
that
you
had
set
yourselves
and
then
you
held
people
to
account
for.
B
Open
to
this,
yes,
so
the
organization
will
come
up
with
their
own
standards,
but
then
they
will
consistently
apply
that
across
the
whole
organization.
But
of
course
it's
the
variation
across
an
organization
which
can
cause
difficulties
with
quality,
and
then
this
sort
of
focus
on
leadership.
The
nhs
has
an
unusual
leadership
style
in
which
the
top
of
the
organization.
B
B
B
I
know
from
my
experience
at
east
london
towards
the
end.
I
really
understood
I
learned
to
understand
that.
Actually
I
achieved
far
more
than
having
one
day
a
week,
which
I
went
down
to
school
staff
and
heard
what
they
had
to
say,
rather
than
sitting
in
some
boring
governance
meetings,
sort
of
signing
off
sort
of
chart
after
chart
after
chart
which
is
sort
of
it's
a
bit
soul,
destroying
really
and
actually,
more
importantly,
it
doesn't
achieve
anything
and
the
importance
of
actually
developing
people's
leadership
skills
as
something
that
you
really
want.
B
B
B
Yes,
definitely
the
best
organizations,
the
organizations
that
we
will
showcase
in
the
report
are
ones
which
allowed
their
staff
to
get
on
with
it.
They
didn't
have
to
ask
permission
or
to
produce,
I
think,
in
the
worst
case,
organizations
which
require
everybody
to
produce
a
business
case
before
they
can
do
anything
yeah.
No,
you
don't
need
that.
That's
not
what
quality
improvement
is
about.
Yeah,
yeah.
A
B
This
is
not
simply
putting
an
advert
out
on
the
newspaper
or
on
a
website
and
then
expecting
whoever
turns
out
with
the
basic
qualifications
to
be
appointable
to
your
organization.
The
people
you
appoint
should
be
sharing
the
values
that
you
share
and
then
so.
You
therefore
have
to
be
able
to
assess
that
before
your
point.
So.
B
A
B
So
it's
very
important
that
the
your
healthcare
organization,
your
trust,
is
not
something
separate
from
the
rest
of
the
community.
You
are
there
to
serve
the
community.
You
are
there
to
support
the
sort
of
wider
health
of
the
local
population.
You
need
to
be
working
with
your
commissioners.
Schools,
education,
the
wider
system
to
make
sure
that
hey
that
they
understand
why
you're
doing
what
you're
doing,
but
also
that
you're
not
all
working
at
cross
purposes
that
you're
that
you're
all
focused
on
a
similar
goal.
B
A
You
kevin
and
kevin
kevin
minds
I'll
come
to
you
next.
I
just
want
to
pick
up
some
of
the
findings
around
this
continuing
focus
on
leadership
and,
and
it
always
seems
that
when
we
talk
about,
you
know
trophies
that
always
comes
back
to
leadership.
What
was
what's
your
view
on
this
particular
area
of
the
report?
Well,.
D
Clearly,
leadership
is
vital,
I
think
if
you,
I
normally
start
with
the
evidence,
space
and
there's
a
clear
evidence.
Space
for
leadership.
Kevin's
mentioned
the
stability
of
the
senior
team
and
the
execs
is
clearly
one
of
those
issues
that
we
need
to
concentrate
on.
And
if
you
look
at
the
you
know,
the
evidence
base
around
leadership
now
the
biggest
determinant
of
organizational
success,
whether
it's
in
within
healthcare
outside
healthcare
is
leadership
and
the
biggest
determinant
of
success
in
leadership
is
role.
Modelling
and
the
biggest
determinant
of
good
role.
D
Modelling
is
being
authentic
and
our
staff
can
see
people
that
are
not
authentic
but
from
a
thousand
miles.
So
it's
important
that
leadership
is
key
and
central
and
it's
not
about
creating
more
followers
leadership,
is
the
role
of
leaders
is
to
create
more
leaders.
I
think
sometimes
you
get
a
bit
mixed
up
with
that.
I
think
for
us.
Certainly
slangs
I
mean
there's
something
about
using
frameworks.
D
So,
for
example,
you've
heard
of
john
cutter
that
talks
about
creating
a
compelling
vision
and
he
does
the
eight
steps
to
change
and
then
the
first
one
is,
you
know,
creating
a
sense
of
urgency
and
if,
if
you
put
into
special
measures
and
that
doesn't
create
a
sense
of
urgency,
I'm
not
sure
if
there's
anything
will
to
be
honest.
So
does
that
create
an
urgency
compelling
vision
and
the
biggest
part?
Is
that
compelling?
What's
you
call
it
coalition
for
change?
You
know
getting
the
right
people
around
the
table
with
you.
D
D
So
if
we
had
a
problem
or
we
would
try
to
put
a
business
case
together,
we
could
say
things
to
each
other,
like
that
sounds
very
good,
but
I
can't
see
how
it's
safer
or
that
doesn't
sound
more
personal
or
is
that
as
effective
as
it
could
be?
So
again,
it
was
good
about
getting
the
research
around
the
evidence
base
and
getting
the
right
people
around
the
table.
It's
absolutely
key
and
we
brought
in
things
like
compassionate
compassional,
leadership
and
again,
a
key
behavior
in
leadership
is
to
be
vulnerable.
D
It
is
not
a
thing
you
should
be
ashamed
of
to
get
chief
exists
in
chairs,
saying
some
guys.
I
don't
know
what
I'm
doing
with
this,
because
I
have
some
help.
Please
it's
very,
very
great
for
staff
to
be
honest
and
be
taught
about
just
coaching
in
terms
of
fair
and
getting
the
key
execs
and
chairman
et
cetera,
back
to
the
floor,
so
they
could
actually
work
alongside
people
that
were
doing
the
business
for
us
because.
A
D
C
So
in
terms
of
them
that
using
cambridge
as
the
context
we
had
a
slightly
different
we've
had
slightly
different
experience.
We
went
into
special
some
financial
special
measures
and
requires
improvement
in
2015,
and
the
response
at
that
time
was
that
pwc
were
called
in
and
our
leadership
style
was
very
much
heading
towards
grip
and
command
and
control.
C
And
then
we
had
a
new
chief
executive
officer,
roman
sinker,
and
he
came
in
and
recognized
in
fact
that
we
didn't
have
a
lot
of
empowerment
within
the
various
layers
of
the
organization.
That
was
very
much
led,
led
from
the
top
with
arguably
a
rather
disengaged
workforce,
and
I
always
feel
that
the
the
document
delivering
people
improving
care
was
a
bit
of
his
manifesto.
It's
one
of
the
first
things
he
he
has
done
himself.
C
So
we
have
a
senior
leaders
programme
which
has
now
exposed
over
250
of
our
senior
leaders
and
that's
sort
of
band-aid
and
above
to
a
fantastic
program
led
by
the
king's
fund
and
the
dutch
business
school
from
cambridge
university,
and
it's
a
two-year
program.
Cohorts
of
20
go
through.
They
spend
several
days
together
about
four
times
a
year.
They
build
relationships.
These
are
people
from
across
the
organization
people
who,
for
example,
when
I
wanted,
went
on
it.
There
was
a
you
know.
C
Radio
radio
cry
wouldn't
normally
meet
a
radiographic
radiographer
necessarily,
and
we
began
to
build
these
networks
in
that
way.
So
we've
had
eight
cohorts
of
20
staff,
all
right,
no,
it's
more
than
that.
It's
11
cohorts
of
20
staff
go
through
that
so
far
over
the
last
three
years.
So
there's
that
there's
been
a
development
program
for
matrons
for
nurse
leaders,
we've
focused
very
heavily
on
our
equality
and
diversity
training,
so
so
to
really
begin
to
figure
out
what
sort
of
behaviors
empower
our
staff.
A
A
lot
of
investment
in
the
in
the
staff
there
a
lot
of
a
lot
of
investment
in
leadership,
and
I
suppose
this
comes
down
to
what
we
were
saying
earlier
in
terms
about
the
you
know:
the
role
model
that
you
you
brought
up
kevin
about.
Actually,
let's,
let's
put
the
investment
in
here-
let's
put
the
investment
into
the
people
where
it's
absolutely
needed
is.
Is
that
absolutely.
C
Right
I
mean
we've
been,
you
know
it's
a
lot
of
time
so
that
to
let
me
members
out
there,
I
must
my
yes,
the
senior
leaders
program
is
something
like
12
days
a
year
and
that's
not,
I
don't
have
to
take.
We
don't
have
to
take
leave
for
that
or
study
for
that.
That
is
part
of
our
job
and
they're
beginning
to
recognize
that
this
we
need
to
do
tailored
programs
for
our
new
consultants.
C
So
that's
just
started
and
that's
been
a
very
successful
sort
of
five-day
intensive
course
that
the
cohorts
of
new
consultants
come
through
we've.
We
have
leadership.
Our
divisional
leadership
consists
of
a
nurse
adopter
and
a
manager
there
we're
developing
a
triumvirate
leadership
program
for
each
for
each
division
in
in
recognition
that
really
right
now,
it's
incredibly
challenging
to
lead
within
our
context
of
the
nhs
and
that
we
need
to
ensure
that
behaviors
that
really
facilitate
an
improvement
or
a
sustainable
improvement.
Culture
are
are
being
focused
on.
I
suppose.
A
C
Absolutely
so
this
is.
This
is
part
of
the
same
story.
Really
we,
when,
after
we
went
into
special
measures,
there's
a
huge
focus
on
the
development
of
our
quality
and
safety
directorate,
and
they
worked
with
the
eastern
academic
health
science
network,
particularly
around
methodology.
You
talked
about
methodology
earlier
kevin
and
they
embraced
the
model
for
improvement.
The
super
healthcare
improvement
methodology
and
they
set
up.
They
both
looked
at
how
how
we
investigate
a
safety
incidence,
how
we
think
about
how
do
we
learn
from
them?
C
So
we
sit
outside
the
directorate
for
quality.
We
actually
effectively
sit
within
finance
with
the
with
the
program
management
office
on
the
improvement
and
transformation
team.
We
we
work
together
and
it
has
been
mine
and
my
colleague
debbie
morgan
who's,
the
director
of
service
improvement
transformation
to
actually
take
forward
how
our
organization's
approach
to
how
do
we
introduce
and
embed
continuous
improvement
in
a
sustainable
way?
So
have
we
done
that?
Well,
first
of
all,
we've
done
a
lot
of
talking
to
people.
C
C
If
you
really
wanted
to
think
about
organizational
culture
change
recognizing
that
that's
a
five
to
ten
year
journey,
we
looked
at
doing
it
ourselves
and
we
looked
at
working
with
another
organization
and
after
sort
of
21
months,
we
we
have
actually
just
signed
up
to
the
institute
for
healthcare
improvement
to
work
with
them
in
a
partnership
to
co-produce.
If
you
like
our
way
of
moving
of
moving
the
organization
to
to
a
continuous
and
sustainable
improvement
culture,
and
they
begin
with
us
in
april.
So
we're
very
excited
by
that.
A
C
Well,
the
literature
says
you
start
at
the
top.
Doesn't
it
and
that's
what
we've
done
so
there's
a
fantastic
document
by
the
health
foundation
called
the
improvement
journey,
so
anybody
who
actually
wants
to
know
how
to
do
it
just
read
that
it
does
use
east
london
foundation,
trust
as
a
as
one
of
their
examples,
but
it
also
uses
western
sussex,
which
is
you
some
of
you
may
know
and
uses
lee
lean.
It
uses
gives
an
example
of
how
leads
move
to
move
their
their
stem
cells
forward.
C
So
we've
done
that
we
didn't
feel
that
considering
the
fact
that
we
live
in
a
we
live
in
a
an
atmosphere
of
continuous
firefighting
that
we
did
not
have
the
headspace
to
be
able
to
sit
back,
hold
a
mirror
up
to
our
organization
and
say
you
know
we
can
do
this.
We
all
agreed
with
our
board
management
executive
agreed
that
that
was
not
going
to
be
possible.
So
then
it
was
right.
Okay,
who
should
we
partner
with?
C
We
wrote
a
tender
which
which
we
took
on
this
year
and,
as
I
say,
the
the
institute
for
healthcare
improvement
were
six.
Are
our
successful
partners
but
there's
been
an
enormous
amount
of
work,
first
of
all
to
try
and
work
with
that
work
with
our
senior
leaders
to
understand
what
that
feels
like,
because
everyone
had
to
support
it.
C
So
you
know
it's
an
investment,
there's
no
money
around
and
our
system
is
you're,
probably
aware
they
under
the
most
pressure
in
the
whole
of
the
uk
and
and
our
trust
that
the
second
has
the
second
largest
debt.
So
for
us
to
commit
the
the
investment,
particularly
when
we're
not
buying
equipment,
the
choice
is
not
to
buy
equipment,
etc,
etc.
These
are
really
very
challenging
decisions
to
make,
but,
thankfully
I
suppose
I
feel
thankful
anyway.
C
The
organization
looked
to
the
future
and
how
do
we
think
about
future
proofing?
Our
system
understanding
the
way
our
demographics
are
heading
which,
in
our
case
anyways,
is
an
aging
population
and
any
population
increasing
in
size
and
also
adding
books.
Three,
we,
the
government,
has
announced
that
we'll
fund
a
a
new
hospital.
C
We
know
we
can't
keep
doing
things
the
same
way
that
we
have
to
think
about
how
we
care
for
people
in
a
different
way
and
we're
also
very
conscious
of
the
evidence
that
says
if
you
use
an
improvement
approach,
which
is
rapid
cycles.
Small
tests
have
changed
iterative
changes
with
an
appreciation
that
healthcare
is
a
complex
adaptive
system,
and
you
can't
just
impose
change
on
a
complex
adaptive
system
that
we
need
to
think
about
using
improvement
and
doing
it
well
to
really
build
our
future
for
our
system
and.
D
D
It's
wonderful
to
see,
I
mean
it's
so
liberating
for
staff.
It's
if
you
look
at
organizational
development.
One
of
the
best
tools
you've
got
is
that
you
said
we
did
and
it's
part
of
that.
So
when
they're
looking
at
things,
you
know
problems
that
we
didn't
think
would
be
solved,
feared
as
outpatients
hired
to
retire
whatever
you
look
at
the
staff
really
really
want
this,
and
if
you
go
into
organizations-
and
you
say
to
them-
you
know
you
do
you
think
quality
improvements?
Important?
Oh,
yes,
can
I
speak
to
your
director
of
quality
improvement.
D
Please!
Well!
We
haven't
got
one
of
those.
We've
got
lots
of
training
going
on
then
we're
thinking
about
that.
It's
got
to
be
real
and
I'd
say
to
you
that,
in
terms
of
longevity,
if
you're
not
going
to
continue,
this
do
not
start
it
because
you'll
get
it.
It's
very
difficult
to
start
these
things
over
and
over
again,
because
I
think
you
don't
need
it
this
time
and
that's
why
the
stability
is
important.
It's
a
circular
argument.
D
A
D
C
C
Like
this,
it
matters,
but
I
I
like
you
say
for
me:
improvement
is
about
people
coming
to
work
and
being
able
to
improve
the
work
and
knowing
that
they'll
be
heard,
and
it's
recognizing
that
the
people
who
do
the
work
know
what
the
prompts
are
and
actually
have
ideas
to
solve
them.
Because
that's
where
I've
been
that's,
where
I've
been.
D
When
you
think
about
it,
you
know
people
around
this
table
the
only
thing
that
we
can
do
at
this
level,
that
most
staff
can
is
to
change
and
move
resources
and
people
and
you're
saying
to
our
staff,
tell
us
where,
to
put
it,
if
that's
sort
of
the
leader
of
a
servant,
we're
here
to
serve,
you
guys
tell
us
where
you
want
to
put
the
resources
and
our
time
and
our
effort
the
night
house
that's
the
basis
of
lanes.
If
not,
they
know
better
than
any
of
us
in
reality,.
B
So
it's
really
inspirational.
I
have
to
say
it's
always
great-
to
hear
from
leaders
working
in
nhs
trust
about
their
improvement
journey
and
being
open
and
honest
about
some
of
the
difficulties
you
face.
When
you
start
this
work
because
it
is
difficult,
you
will
end
up
having
difficult
conversations
at
the
senior
level
of
the
organization
because
you
do
have
to
have
everybody
agreed
that
you
can
take
this
approach
and
that
you
know
that
took
us.
I
think,
east
london,
about
nine
months
to
a
year
before
we
had
everyone
lined
up.
B
It
doesn't
matter
which
methodology
you
use,
but
what
is
important
is
that
the
methodology
you
choose
resonates
with
your
staff,
because
if
it
doesn't
resonate
with
your
staff
values,
then
you
gonna
find
it
very
difficult.
You
saw
a
lot
of
organizations
seizing
on
lean
as
their
approach,
because
I
think
lean
sounds
nice.
B
It
sounds
like
you're
going
to
save
money
and
be
more
efficient
and
you
are,
but
your
staff
have
to
be
really
signed
up
to
that
approach,
or
else
they're
going
to
think
here.
We
go
again,
let's
face
it,
it's
another
fad
and
it's
also
getting
staff
to
believe
that
their
job
is
to
come
to
work,
to
do
their
job
and
to
improve
the
work
that
they're
doing,
and
I
think
we
don't
always.
B
F
I've,
given
this
a
great
deal
of
serious
thought
and
actually
the
one
top
tip
I
would
give-
is
around
staff
engagement.
I
don't
think
that
can
be
underestimated.
It's
imperative
that
our
staff
feel
listened
to
it's
imperative
that
they
feel
that
they
have
the
freedom
to
act,
and
that
has
been
our
biggest
achievement.
F
That
has
been
the
biggest
change
in
leadership
partnership
foundation,
trust
you
go
on
to
any
of
our
clinical
services
and
our
corporate
services
and
staff
talk
with
pride
about
their
achievements
of
that
week
that
month
that
year
and
that
shines
through
I'm
a
nurse
and
I've
been
a
nurse
for
34
years
and
most
of
that
time.
In
fact,
all
of
that
time
has
been
a
little
chip
partnership
foundation,
trust
in
many
iterations.
F
F
We
were
very
lucky
to
be
asked
to
be
part
of
these
case
studies
and
I
think
that's
a
reflection
on
how
far
the
organization
has
come.
In
the
last
four
years
in
2015
we
had
a
report
that
was
really
not
a
very
pleasant
place
to
be,
and
as
a
board
and
as
a
team
of
staff,
we
had
to
reflect
on
what
was
being
told
to
us.
F
I
think
one
of
the
biggest
things
to
note
is
the
board,
and
I
wasn't
a
member
of
the
board
at
that
time.
But
I
was
a
member
of
staff
of
the
organization
and
one
of
the
biggest
things
was
the
feedback,
and
what
staff
was
saying
was
listened
to.
There
was
no
kind
of
well,
that's
not
right.
There
was
no
arguing
about
the
content
of
the
diagnostic.
F
F
Only
in
the
last
week,
we've
heard
that
yet
again,
we've
had
an
excellent
staff
survey,
which
goes
from
strength
to
strength
which
shows
that
this,
this
piece
of
work
that
we've
done
is
sustained
and
I
think
that's
the
critical
piece
of
work
and
certainly
for
this.
This
cqc
work
that
we're
talking
about
is
how
we've
managed
to
sustain
that
one
of
the
pieces
of
work
that
we
also
did.
F
We
spoke
about
developing
our
people
and
we
spoke
about
making
them
proud
of
what
they've
achieved
and
what
they
have
done
with
their
services
in
previous
cqc
inspections.
Up
until
the
improvements
from
2016
staff
would
wait
to
be
done
to,
they
would
wait
for
the
inspections
and
and
almost
go
into
them
in
a
victim-like
mode.
F
So
we
did
a
huge
piece
of
work
to
get
staff
to
talk
about
what
was
good
about
their
services,
the
bits
they
were
proud
of,
everything
that
they'd
achieved,
and
actually
they
opened
doors
to
the
cqc
coming
in
to
inspect
them.
They
wanted
to
talk
about
everything
that
they'd
achieved
and
actually
that
their
pride
shone
through
and
I'll
come
on
later
in
the
podcaster.
The
work
we've
done
about
kind
of
assurance
because
it's
obviously
not
all
good.
F
We
allowed
staff
to
escalate
when
there
were
concerns
that
they
were
raising
and
actually
escalate
to
a
team
that
were
prepared
to
take
action
on
their
behalf
when
they
were
feeling
frustrated
when
they
were
feeling
doors
were
closed.
It
was
imperative
that
we
allowed
those
doors
to
be
open
and
use
our
position
as
executive,
sometimes
to
unlock
some
of
those
doors
we
speak
about.
We
have
a
no
blame
culture
and
at
times
that
you
know
to
some
people
that
can
feel
just
words.
We
actually
truly
do
have
a
no
blame
culture.
F
We've
given
staff
permission
to
try,
we've
given
staff
permission
to
say,
actually
this
isn't
working
we're
going
to
stop
this
without
any
fear
of
repercussions,
without
any
fear
of
how
am
I
going
to
tell
people
this
hasn't
worked
and
the
biggest
thing
from
that
and
the
biggest
achievement
from
that
is
as
an
executive
team.
We
have
no
surprises.
We
know
where
our
areas
of
concern
are.
We
talk
quite
openly
in
board
meetings
and
with
our
council
of
governors
and
with
other
all
of
the
stakeholders
about
our
areas
of
concern.
F
E
F
F
We
have
people
externally
that
come
in
for
interviews
and
one
of
the
first
things
that
is
often
fed
back
is
the
feel
of
linkshare
partnership,
foundation,
trust
and
that's
very
hard
to
put
into
words.
But
actually
it's
a
good
place
to
work,
and
I
think
that
cannot
be
underestimated.
Our
staff
are
happy,
they
report
being
happy.
We
have
the
same
pressures
as
everybody
else.
We
have
staffing
shortages.
F
I've
spoken
about
the
vision
and
values
and
I've
spoken
about
the
diagnostic
work
that
we
did,
but
actually,
as
a
result
of
that,
we
then,
as
an
organization,
did
set
out
a
new
set
of
values
for
lpft
and
what
they
would
look
like.
That
was
too
true
co-production
with
the
staff
and
I've
spoken
about
it,
but
actually
I
cannot
underestimate
just
how
embedded
they
are
and
I
think
that's
incredibly
important.
F
Another
piece
of
work-
that's
happened
over
the
last
four
years
and
I'm
going
to
talk
about
this
a
little
bit
now
and
I
actually
cannot
underestimate.
The
importance
of
this
is
around
communications
and
engagement
with
your
staff,
our
communications
department
and
linkshare
partnership
foundation.
Trust
is
truly
outstanding
and
it's
very
difficult
here
in
lincolnshire
we're
very
rural.
We
don't
have
one
motorway,
it's
all
a
challenge
for
us.
You
don't
get
anywhere
very
fast
and
actually
being
the
face
of
a
visible
executive
team
when
you've
got
60
sites
over
an
incredibly
difficult
landscape
is
not
easy.
F
F
We
have
a
video
team
brief
that
is
kind
of
sent
out
to
the
masses,
so
they
all
get
to
see
that,
but
we
do
have
regular
executive
team
visits.
We
do
have
regular
visits
with
our
non-executive
colleagues
and
our
staff
report
that
we
are
an
incredibly
visible
team
and
sometimes
it's
just
doing
our
job,
but
doing
it
in
a
different
location.
It's
not
always
about
having
the
great
royal
visit
from
the
executive.
It's
just
about.
F
F
F
F
We
have
regular
accountability,
reviews
with
our
clinical
divisions
and
we've
done
a
huge
amount
of
work
around
our
governance
processes,
so
our
clinical
divisions
have
their
own
internal
governance
processes.
We've
made
our
reporting
structures
much
slicker.
We've
moved
away
from
a
huge
paper-driven
board
meetings.
F
Quality
improvement
is
the
heart
of
everything
that
we've
kind
of
achieved
over
the
last
four
years
at
lynchshare
partnership
foundation,
trust
it
started
with
trustwide
projects
which
were
led
by
executives
simply
so
that
the
staff
would
see
how
that
could
work
and
what
that
could
mean.
We've
now
moved
to
a
place
where
quality
improvement
is
embedded
in
all
four
of
our
large
clinical
divisions.
F
E
I've
been
at
combined
healthcare
since
april
2019
and
before
that
was
for
a
number
of
years,
finance,
director
and
deputy
chief
executive
at
a
community
foundation
trust
for
a
short
period.
I
was
also
chief
executive
of
another
mental
health
trust
within
the
midlands
region,
I'm
originally
from
stoke-on-trent,
having
spent
my
first
22
years
growing
up
in
the
city,
so
the
opportunity
to
work
back
in
the
area
that
I
grew
up
in
with
services
that
I'm
absolutely
passionate
about
was
something
that
I
really
couldn't
turn
down.
E
The
trust
works
within
the
staffordshire
health
and
social
care
system,
and
within
that
footprint
I
am
the
lead
for
the
organizational
development
and
leadership
program
and
also
oversee
the
mental
health
system
program.
Both
are
privileged
roles
to
carry
out
and
ensure
that
I
work
with
internal
and
external
partners
in
equal
measure.
E
E
E
Throughout
our
journey
we
have
embarked
on
a
number
of
in
quality
improvement
initiatives
which
have
individually
improved
our
performance
and
service
quality,
but
more
broadly,
it
is
perhaps
people's
ambition
and
desire
to
take
on
board
new
quality
initiatives
that
has
been
our
greatest
asset,
having
immersed
myself
in
the
trust
over
the
past
year.
Above
all,
it
has
reminded
me
that
a
can-do
positive
culture
is
the
biggest
asset
that
an
organization
can
have
when
embarking
on
an
improvement
journey.
A
So,
moving
on
to
a
different
topic,
and-
and
it's
it's
clear
that
being
involved
with
the
local
system
is
key
for
sustaining
improvement
as
well
and
kevin
I'll
I'll
start
giving
moines
I'll
start
with
you.
Can
you
give
us
an
idea
of
what
your
trust
does
to
to
make
sure
it's
an
active
partner
in
the
in
the
local
system
that
you
operated.
D
Yes,
this
is,
this
is
a
key
area
for
the
trust.
I
think
we've
come
to
the
conclusion
that
you
probably
can't
have
a
a
fantastic
trust
in
a
an
imperfect
system.
I
think
the
system's
got
to
work
as
one,
so
we
come
to
the
conclusion
that,
if
it's
good
for
the
trust,
it's
good
for
the
system
and
vice
versa,
so
we're
looking
at
things
like
co-production
of
most
things,
you
know
even
meetings
agendas.
D
Can
we
put
joint
research
bits
together,
joint
business
cases
together?
Can
we
put
joint
job
descriptions
where
people
can
work
across
boundary
together?
Could
we
set
up
new
roles?
For
example,
you
know
healthcare
workers,
social
workers
or
whatever
that's
good,
for
they
can
cross
boundaries
across
local
authorities
from
the
trust,
etc.
So
we're
trying
to
to
work
together
as
a
system.
It's
not
easy
it's
early
days,
but
I
think
there's
a
genuine
want
from
us
all
as
key
leaders
to
make
this
stuff
work,
and
we
clearly
want
to
be
part
of
that.
D
But
I
think
co-production
is
important.
I
think
the
key
skills
again
back
into
leadership
is
not
about
competition.
It's
about
collaboration
and
it's
about
working
together.
I
think
people
that
have
been
brought
up
in
an
era
as
I
have
in
reality
about
it's
all
about
competing
with
other
trusts
competing
with
the
partners.
D
And
it's
getting
to
know
people,
it's
true,
you
know
it's.
Sometimes
you
don't
want
to
get
into
anything.
That's
combative!
You
know
joint
race
resources,
understanding
each
other's
budgets
open
book
term
they
use.
So
for
this,
there's
no
surprises.
It's
not
clever,
to
sit
around
your
table
with
your
partners
and
surprise
them
with
anything.
You
know
it's
not
it's
a
game
here
this
you
know
we're
trying
to
try
to
improve
the
outcomes
of
patients
across
the
country.
This
is
real
stuff.
We're.
C
So
the
way
so
our
system
is
cambridge
and
peterborough
ccg.
Our
hospitals
got
very
involved
with
that.
To
the
point
that
our
chief
executive
officer
roland
is,
in
fact
the
responsible
officer
for
the
stp
and
our
chairman,
mike
moore,
is
in
fact
the
chairman
of
it
so
we're
right
in
in
the
thick
of
it.
We
have
a
direct
executive
director
of
strategy
nicola
ayton
who's
really
led
on
all
the
system.
Partnership
work
and
that's
included,
working
with
our
gp
practices,
perhaps
as
they've
evolved
into
primary
care.
E
C
We've
had
some
very
good
work
for
our
stroke
team,
stroke
and
rehab,
and
that's
been
going
on
actually
for
nearly
two
or
three
years,
also
msk
and
the
diabetes
pathway
is
that
sort
of
works
been
coming
in
fits
and
starts.
But
it's
it's
certainly
a
focus
of
how
do
we
try
and
bring
everything
together
for
the
benefit
of
patients,
in
particular,.
C
B
So
health
care
is
changing.
Our
thoughts
about
how
health
care
should
operate
is
changing.
It's
no
longer
the
case
that
there
is
an
acute
trust
here.
A
mental
health
trust
here,
there's
primary
care
over
there
and
each
of
them
are
operating
independently
of
each
other,
pointing
their
finger
at
each
other
for
sort
of
not
not
delivering
in
some
aspects
and
then
there's
the
local
authority
doing
their
thing
and
education
doing
its
thing,
and
then
criminal
justice
doing
its
thing
that
just
results
in
a
completely
fragmented
relationship
where
trust
just
gets
dissipated.
B
B
A
B
C
C
You
need
to
find
the
influencers
energize
them
sign
them
up
and
then
plan
how
your
progress
will
be
measured,
monitored,
reported
and
importantly,
celebrated
so
measurement
over
time
is
the
only
way
whether
you're
really
going
to
tell
whether
there's
an
improvement
and
if
you're
not
making
improvement,
stop
adopt
it.
If
it's
not
working,
don't
adopt
it
abandon
it,
and
if
you
will
take
your
learning,
so
you
can
adapt
it.
But
these
are
really
key
things
that
we
don't
do.
We
just
try
something
and
then
forget
to
evaluate
it.
Great.
D
Yeah
I
mean
I've
talked
about
this
all
day.
I
think
there's
something
around
find
ways
in
your
day
to
find
stuff
to
say.
Thank
you
to
you
know,
recognize
and
reward
them.
The
other
thing
is
find
more
opportunities
to
have
face
to
face
forget
the
emails.
We've
all
tried,
the
no
email,
wednesdays
and
all
that
stuff.
It
doesn't
work,
get
out
of
your
seat
out
your
office
and
go
and
see
these
guys
and
thirdly,
understand
the
context
in
which
they
work,
and
I
think
I've
written
down
here.
It
sounded
good.
This
thing
be.