Feedback from reports into integration of health and social care suggests that it is still at an early stage of development. Although integration has the potential to transform the experience of those requiring care the day to day experiences of people can be difficult to impact. The role of the Health and Social Care Academy is to help drive transformational change in Scotland’s health and social care system, led by people living with long term conditions, disabled people and unpaid carers. One of the ways the Academy does this is to inspire and share good practice and where there are gaps, support the development of new practice. To consider what could be transformational across health and social care the Academy hosted a Think Tank that brought together a cross section of Scottish society including third and independent sector leaders; leaders from across the public sector (including the NHS, Scottish Government, Police Scotland, Scottish Fire and Rescue Service and academia); and people who use health and social care services. The output from that day resulted in the development of the ‘Five Provocations for the Future of Health and Social Care’: courageous leadership, nurturing transformation, emphasising humanity, target culture and ceding power. People responded with interest to these provocations and were keen to look at how they might translate into developing strategy and changing practice. Feedback from the health and social care sector was that support was needed with how to implement the Five Provocations.
As a result of this the Academy co-designed the ‘Unfold the Future’ toolkit to support people working in health and social care to think creatively and ambitiously about transformational change and improvement in their area. The Tool includes a workbook which unfolds six stages of transformation, from the present day to ten years from now, working through key questions and barriers that may be faced along the way. The questions are clearly tied to the Academy’s Five Provocations – emphasising humanity, nurturing transformation, target culture, courageous leadership and ceding power. The Toolkit is presented in an engaging and accessible format with room for writing alongside the questions. The Toolkit will be delivered by a facilitator using coaching and appreciative enquiry skills to build staff confidence in transformation and improvement plans and their own ability to lead and deliver change. By working through questions and barriers that may be faced in the short, medium and long term, the workbook supports the user to tolerate uncertainty and difficult conversations in order to achieve long-term strategic goals. The Toolkit is designed to help teams and individuals think about what the future should look like in their area, to challenge their own assumptions about transformation and provoke deeper thinking about what change is necessary to get there.
The tool was co-produced over the course of a year with a wide number of partners from across health and social care, including Healthcare Improvement Scotland and people and carers who use services. To identify potential demand the Academy carried out a feasibility study and reached out to six Health and Social Care Partnerships to schedule research discussions. The overall reception of the toolkit was very positive with the HSCP’s expressing the hope that the toolkit could address broad cultural issues (eg. Low staff confidence and interest in co-production) and specific organisational projects.
Competitive analysis was undertaken to assess what already existed to support people with transformational change. This research discovered several programmes that overlap with the functionality and audience of Unfold the Future, however, there were no toolkits focussing on transformation or fully covering the Five Provocations – the unique selling points and key benefits of Unfold the Future. The conversations with HSCP’s revealed that they considered the Toolkit to be filling a substantial gap in the market for transformational and culture change, and believed there would be enthusiastic take up of the product in the sector, complementing the resources already provided.
The funding will allow us to recruit a Project Manager to further refine the Toolkit, test out ideas and scale up delivery. This will allow targeted engagement with IJB’s and HSCP’s to let them know about the Toolkit and discuss how they could benefit from it. Co-designed facilitated sessions will be organised and delivered, followed up and evaluated. In depth research will be carried out into accreditation.
Feedback will be solicited at the end of training sessions to allow for continual improvement of the toolkit. The Academy will also follow up with participants following the training to track and support the subsequent delivery of transformational change.
Benefits to the Q community
The Toolkit offers flexible options to all members of the Q community depending on needs and availability to support transformational change. Funding the initiative and sharing your feedback is an opportunity to shape the tool and ensure that it reaches as many people as possible.
The Academy uses the Five Provocations to enable transformational change and improvement. Particularly relevant to improvement is the need for courageous leadership. The Academy, in partnership with SSSC has been running a series of events aimed at creating a framework for how to be a courageous leader. This has involved illustrating examples of courageous leadership from across health and social care with people sharing examples and opinions; defining courageous leadership and looking at how we can enable courageous leadership. We would be delighted to share this learning and facilitate discussion with Q members using a variety of formats, including through peer learning, an improvement lab and community of interest.
How you can contribute
- Help us identify who would be interested in using the Toolkit
- Share your ideas to strengthen evaluation, measuring and sharing impact
- Express an interest in opportunities for partnership working
Five-Provocations (PDF, 3MB)
This is a great project because…
It's a good example of a more transformative approach to system change, building on progress made within Scotland that others across the UK will be keen to learn from. The toolkit format should help with thinking about sharing.
By the time of the event we encourage the project team to think more about…
Develop further the plans for sharing with the Q community. More specifically what learning is this likely to generate and how can you engage with Q to help think about the best way to do this. You may find thinking about how to share what you're doing will in turn help local implementation.