Learning from changing focus of strategies at NHS organisations

NHS organisational strategies aren’t traditionally thought of as fun reading material (unless you have a particularly niche interest). So why would we spend our time reading more than 35 different NHS strategies from a range of NHS trust organisations all over England?

Well, because at Kaleidoscope we’re fascinated by what makes a good strategy, and the challenge we have been thinking about is the changing focus of NHS trusts.

Historically, providers have just had to think about treating the people who come through the door but now their role in population health is becoming far more explicit. This changing focus got us curious about how different organisations were strategically responding to this.

We looked at a range of different organisational strategies, from organisations based in Devon to those in Northumbria. We looked at what they’re up to on the east coast of Kent, and considered what they’re thinking in West Hertfordshire.

Improving population health

And we looked at a range of different organisations (acute trusts, community trusts and one social care partnership trust) to understand how they’re approaching population health, and how partnership working is helping them to do this.

So if you’re working at an NHS trust and you want to know what you can do to move the needle in these areas, read on.

Let’s start with the changing role of providers, and the different themes that came through in the strategies we reviewed. We identified more than 200 strategic actions geared towards improving whole population health, which we grouped into five key themes.

• The first theme is making the most of anchor institution power, with providers using their purchasing power and investments to make an impact on the wider factors that shape local population health.
• Trusts are also emphasising the strategic importance of increasing carer and user voice in order to better understand the needs of their communities.
• Many providers are upskilling staff to use a Quality Improvement approach to increase the quality of clinical services.
• And they have an explicit focus on making an impact on population health.
• The final set of activities we identified were the development of coordinated and collaborative plans for reducing health inequalities.

Creating healthier communities is not something providers can do alone, so we also wanted to know how trusts are thinking strategically about building partnerships and collaboration capacity to meet this shift in ambition.

Improving partnerships

As you would expect, the range of activities being planned across different organisations is quite diverse (more than 100 different activities or actions flagged as relating to partnerships in our review).

However, we noted clear themes in the types of strategic action that providers are taking to improve partnership.

• Organisations are making explicit strategic decisions about where to focus relationships and prioritising those which have the potential for the most impact.
• They are connecting locally and nationally in order to learn and share best practice.
• Time and attention is given to clearly describe their offer – both what it is that they do, and how it is that they do it.
• Trusts are also acknowledging that successful partnership working requires both the capacity and capability to be able to collaborate well.
• And they are prioritising the creation of infrastructure to make collaboration easier – specifically thinking about things like governance structures that are designed to empower collaborative decision making.

Co-creating success

So what does this all mean for other organisations developing their own strategies for population health and partnership? Well, at Kaleidoscope, we think looking at what others are doing is a really helpful starting point.

But we also know good strategy doesn’t look like a plan that is written in isolation (or copied from somewhere else) and then put on a shelf for posterity.

The most successful strategies are those that are co-created with the people who will deliver them and those who will be impacted by them… there’s no reason though why that process should start with a blank sheet of paper!

Find out more

We have helped lots of organisations to design and implement new strategies.

If you’re interested in how we bring learning from other organisations and genuine co-design into that process, you can read about our strategy development services at Kaleidoscope.

And you can join our free digital event on Monday 10 July to discuss the merits of strategy in the NHS, and how the process of developing strategy might actually be its salvation.