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'Our beleaguered health economies came under fire from every direction'

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From nervous start to victorious finish - via stress, debate, assessment, collaboration and, of course, fun. Jessica Streeting reports on taking part in the NT Leadership Challenge

Last month a group of six from our PCT set off, with some trepidation, to participate in the NT National Leadership Challenge in Coventry. Colleagues who attended the first challenge in November had briefed us, though their considerable success at the event left us despondent as to our own ‘fitness for purpose’.

Our team consisted of one project manger district nursing/community matron, the lead nurse from a walk-in centre, a district nurse team lead, health improvement team leader, the professional lead for children and clinical supervision and me; team leader for school health.

Were we remotely equipped to play the role of a district general hospital within a health economy? Would we be up to meeting the challenge alongside other key stakeholders, of developing the market-based system with commissioning, consumerism and competition within a potentially failing organisation?

'Remember, work collaboratively and play to your individual strengths' we were advised...

Familar territory

Travelling up on the train, I studied the Challenge Guidelines, struggling to recall where my own strengths might lie.

We had been given background information on a fictitious generic borough. Having recently completed my SCPHN training, this was a world I understood - the health issues had direct correlation to the borough’s position on the social gradient. Public health practitioners in the community address such challenges daily. The only snag was that today we were not public health practitioners at all, but the chief governing body of a general hospital. That means ‘acute’, and we felt a little rusty on this.

Once assembled at the impresesive RICOH arena, our nerves began to dissipate; we could only do our best after all, the hospitality looked to be wonderful and this was meant to be fun…

Nursing Times editor Rachel Downey introduced the day, explaining how the idea had come about (over a glass of wine, by the sound of things) and this was followed by an introductory speech by Clare Chapman, director general of workforce at the Department of Health, previously HR director at Tesco.

Clare made salient points, including her belief that nurses are at the heart of leading change and that leading really is about engaging. From user group studies she reminded us that it is important to get the basics right, such as clean hospitals, and that the NHS should fit into people’s lives, treat the person not the symptom and work with people as partners.

Regarding staff, she reinforced the importance of resources. At this point I felt an inner plea rising for serious increase in the school nursing workforce to back the rhetoric. Presumably every discipline present held a similar thought.

But she moved on swiftly, extolling us as leaders to support people to succeed , to take people to places they couldn’t have gone on their own, to look out and not up, and in turn to to see how vision in action can change the world.

Courage under fire

Perhaps her best advice was to have 'courageous conversations'. Clare specifically meant around behaviour and culture, but we liked this phrase, which might be useful in all aspects of influencing, today and beyond.

Then the Challenge began, and for the next seven hours we were swept into a maelstrom of managing. Each team elected their own chief executive and other senior roles, such as communications manager and director of nursing. I was head of operations and, with somewhat hazy understanding of this title, discovered it afforded me useful flexibility for the purposes of the game.

'Remember it is just a game', they said.

As the day sped on and our beleaguered health economies came under fire from every direction, the ‘game’ felt quite real. We had to plan sustainable strategies for the spending of millions, alongside delivering official statements at simulated press conference. We had to work collaboratively to improve infection control long term, while simultaneously defending our lamentable MRSA statistics to a hostile overview and scrutiny committee.

We had always to watch the clock and be alert for fresh ‘interventions’, while in turn, we were constantly observed by assessors with clipboards. Fun?

A problem shared

We learned quickly that success depended on pooling resources. There were teams here from health trusts nationwide, nurses expert in every thing.

This is where some of the best learning came and yes, some fun, as we gained insight into others’ worlds, shared transferable skills and sometimes just chatted.

In a cross-trust committee planning obesity strategy, I saw the need for greater understanding of the preventative health agenda in general nursing, acknowledging that we public health practitioners pass too quickly over what we may dismiss as hospital problems.

By early evening, we were winding up our endeavours over drinks and canapés and handing in final reports to the adjudicators.

Chief Nursing Officer Christine Beasley addressed us and awards were presented, with trophies for Best Media Relations, Best Innovation, Best Strategy…

To our pride, our own health economy collected an award for Best Cluster, as recognition of good collaborative working. Flushed with this success and the very nice wine, we almost missed another little award tucked on the end: Best Individual Team - our very own PCT!

More challenges of this kind please. Participating was good, learning was great and to appreciate that we could be winners was best of all.

Jessica Streeting

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