By Belinda Weir

HSMC has had a focus on promoting and understanding systems leadership in recent years: we recognise the importance of developing systems leaders and system leadership capability to support new models of care and new ways of working in communities to deliver better outcomes for populations. Directors of Public Health are central to this transformation in health and social care and HSMC was delighted to be awarded the contract to design and deliver a programme for aspirant Directors of Public Health earlier this year. This new programme - delivered in partnership with Public Health England, and designed in collaboration between HSMC, our ‘sister’ department at the University of Birmingham INLOGOV and the Birmingham Medical School - has been developed to support those who aspire to director-level roles focused on improving the public’s health.

High performance in these director-level roles calls for leaders capable of working in volatile, uncertain, complex, and ambiguous environments, to be skilled at building relationships across whole systems of public service provision, and able to operate effectively in a dynamic political landscape. The programme focuses on enabling aspiring senior public health leaders to find ways of working successfully in this challenging context, so that they are able to build and sustain necessary strategic partnerships, and collaborate to deliver health improvements for local communities.

Over the course of 9 months - through a series of connected workshops, intensive leadership classes, action learning sets, coaching and mentoring opportunities - participants are supported and challenged to apply the principles of systems leadership to their work, build a connected learning community, and develop the behaviours, skills and knowledge of effective systems leaders.

It is early in the programme for Cohort 1, with two further cohorts to start in 2018 and 2019 respectively, and a good time to reflect on progress so far. What are we learning about how to deliver a successful programme that doesn’t simply offer a content focus on collaboration and whole system working, but actively seeks to model such an approach in its design and development?

Unsurprisingly perhaps, our learning mirrors the lessons which are emerging from other leadership collaborations across the public sector. Leaders coming together to produce collectively a new service, new ways of working in care partnerships or a new leadership development programme are likely to experience many of the same challenges, since at heart, the focus is on how we build effective working relationships that deliver high quality and fast. 3 key lessons have emerged from our reflections:

This was easy in some ways – as a collective we were all agreed that we wanted to design a high quality programme to meet the development needs of future directors of Public Health. Nevertheless, even such a clear shared aim needed discussion to refine our vision: what size of programme, and how should we select participants when demand, inevitably, exceeded available places? What approach to learning should guide the design? Assessment centres? No, they took up too much of the available time without clear evidence for efficacy. Learning sets? Yes – the evidence is clear that they provide one of the best means of translating programme learning into application to practice. Designing the process collaboratively, with different teams who - over the years of delivering highly successful leadership programmes to the public sector – had all developed slightly different ways of doing things meant lots of meetings, discussions, emailed versions of documents and teleconferences over the months leading up to launch.

This didn’t imply that our process needed one sole leader, though it was important to know who was in charge at any point. More important was to agree who would lead on each task or function, and for each of us to be prepared to take on the mantle of leadership at different times and for different tasks. This was partly a pragmatic decision based on available time but it was also driven by expertise and knowledge and this only became apparent if we asked the right questions. For example, one member of the team was expert in designing web content but, because she was relatively junior, her role was largely reactive and it was only in the latter stages that we developed ways of allowing her to take the lead in design and tell other members of the team what copy was needed. By the same token, it is not possible in any collective endeavour in a complex system for everyone to be involved in every task – establishing a lead who would take responsibility, and, crucially, giving them the power to get on and make the decisions on behalf of the collaborative, becomes important and must be built on foundations of trust and respect.

Effective partnership is based on the sharing of rewards, resources, responsibilities and risks and respects the fundamental differences that each partner contributes. As we note above, our collaborative approach enabled everyone to share leadership and it also required us to explore the value of the different perspectives we brought to the work. These differences – in perspective, in resources, in accountability and in values – occasionally surfaced conflict. Managed well, conflict and difference enables a partnership to move beyond holding individual positions towards developing a shared sense of what is possible, and realising the synergistic benefits generated by the partnership, but it can feel uncomfortable at times. In our design and development processes we actively sought difference, recognising that this was the only way we could produce something truly innovative that captured the best of what each partner brought to the meeting table. Hence our decision to use the 21st Century Public Servant research as a model framework for development and to find new ways of making it relevant to a Public Health group.

There will be other learning points as we continue to develop and refine our approach to programme development. Nevertheless these three – having Clarity of Vision, the Courage to Lead and Curiosity about Difference – are aligned with emerging data about effective leadership in whole systems and we will continue to explore these in our collaborative conversations with PHE, with University of Birmingham partners and with the wider system.