I feel like I’m taking liberties writing another blog about service patterns, but last week was telling (for me) and I thought it would be useful to try and capture it — and what’s next.
At SDinGov I took two things away. The first was community, which I covered last week. The second was service patterns, and what we need to do next.
As I watched Seb Thorp talk through the work they’ve done in NHS Scotland, I kept coming back to one question: why are we finding this so hard? Seb and team took the patterns that Martin and Kirsty have done and are looking to publish, and made some new ones that fit their context, but yet here we are, months in, and we’ve only really explored a couple of patterns. Why?
My immediate thought was scale. NHS England is massive. It’s bigger than NHS Scotland and probably several government departments put together. At what point though does that start to seem like an excuse?
In both cases (x-gov and NHS Scotland) it feels like service patterns are the side hussle of one or two people, putting time into it around their jobs. I asked whether either had ever had dedicated time to work on it and the answer was no.
While we do need to be kind to ourselves about best endeavours — and we have actually done quite a lot — our position that we need dedicated time might not get us anywhere. I began to think that I need to just crack on with it. But given I’ve just moved teams, I’m not sure that’s wise
Luckily something else did occur to us: steal. At first (because their talk came earlier), I thought we could take the central gov ones and build from them. But then of course I saw that Seb had done that already, and made them health focused. So if we steal theirs, we should be somewhere towards a decent start, right?
Conversations led to another insight: while we are clear what service patterns are and where we want to get to long-term, we’re less clear on our short- to medium-term goals. We need a better vision for the next 3–6 months. And I intend to write one, starting with stealing.
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Elsewhere this week, I have started in earnest in the community health team. We had a call with Sussex, who told us some of the problems they have delivering community health services, particularly around community nursing.
In many ways it was unsurprising. Problems with connectivity, with systems talking to each other, with scheduling and forecasting, and communications.
I actually think a lot of is solvable. Our job is to uncover where the greatest possibilities and benefits might be, and surface them. With a greater focus on stuff like this, I feel confident we can have a big impact.
My goals around this are to try and understand as much as possible — so that we can deliver on our brief. We will have an intense few months, but by January we should have a reasonable sense of what the biggest problems are, and where the most value can be realised.
Both goals, more than anything, are about focus. Which feels like an increasingly slippery notion.