Developing a Shared Vision This guide explains the importance of having an LHC wide strategic vision

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Developing a Shared Vision This guide explains
the importance of having an LHC wide strategic
vision, and illustrates through case studies the
role of visioning in empowering Local Health
Communities to achieve successful service
transformation
A Practical Guide for the NHS
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The Power of an LHC Wide Strategic Vision

• A good vision is not an idea, its not even an
  important idea, it is a force in peoples hearts,
  a force of impressive power.
• At its simplest level, a shared vision is the
  answer to the question - What do we want to
  create?
• An LHC wide Strategic Vision provides a picture
  of what your health and care system will look
  like in 5 to 10 years from now. It should have
• a time horizon of up to a decade or more. It
  should be ambitious and represent a dream that is
  beyond what you think is possible. It is a
• reflection of the values and beliefs of the
  people who created it. Listening to and engaging
  staff, patients and the public is therefore an
  essential
• part of creating the vision that will be the
  future health and care delivery system.

Individual health and care providers may be
successful in their particular activities, but
there is a tremendous advantage and a powerful
synergy that develops when the whole health and
care community works together to describe its
vision for the future and bring that vision to
reality. The strategic visioning process
focuses and channels the energy and the
creativity and ideas of the public and the
leaders into a powerful strategic vision and
action plan. It builds on the many good things
that are happening across the LHC, aligning them
in a common direction and creating new impetus
for their completion. The vision must be both
strategic, because it anchors plans and actions
in the context of your specific environment, and
ambitious, because it is what is needed to
inspire commitment and action. It should stretch
beyond your current state but cannot be pie in
the sky, which is merely an illusion.
Strategic thinking Thinking hard about your
particular setting and anticipated future.
Looks at LHC strengths, weaknesses,
capabilities and forces and trends that
impact. How to take advantage through
selected focussed effort.
Strategic Planning Applies strategic thinking to
a systematic process of planning for the
future. Anticipating changes, setting goals and
action plans. Often extends the present into the
future by focussing on problems or limiting plans
to current resources.
Strategic Visioning Is a strategic planning
process that includes a compelling description
of the desired future state ( a vision) and
generates a plan and resources to realise the
vision. It leads to deployment of resources and
focussed development of effort.
An LHC wide strategic vision inspires people to
deliver positive change
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Ten Reasons for a Strategic Visioning Process
10. Somebody sneezes and dusts flies off your
old plan. 9. Half of your community doesnt
know if you have a Strategic Plan. 8 The
other half doesnt care. 7 Your health economy
is under pressure, there is a general sense in
the community that the health and care system
is failing. 6. You know in your heart that the
Local Health Community is capable of great
things if you could all come together in a common
effort. 5. Your existing plan is not really a
plan, it is a list of activities that it
would be good to do, rather than a systematic
examination of your Health community, a
strategic vision for the future, an action plan
with responsibilities assigned and a timeline
for completion. 4. Your existing plan is not
really strategic. It is a template borrowed
from another community that does not build on
the strengths and capabilities or an
understanding of the emerging issues that will
affect your community. 3. Your existing
plan has no vision, it is an extension of the
status quo based on existing resources,
rather tan a compelling image of the
desired future that energises your community to
take charge of its future. 2. You dont
want to look back in ten years time and wish that
you had taken action now. 1. You realise
that a strategic vision and action plan
that is bold, compelling and embraced by the
entire community is one of the most
powerful engines to drive a Local Health
Community towards long term successful
service transformation .
Envisioning and communicating a better future
When there is a need to achieve
transformational change, and in order to achieve
such a beneficial, future state, the leaders of a
change programme must describe a clear vision of
that future and then communicate it consistently.
A clear and articulated vision is a foundation
and focus for the transformational change
programme. It is the basis for the outcomes and
delivered benefits and is a key enabler for the
buy-in, motivation, activity and alignment of
stakeholders.
Managing Successful Programmes OGC
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What Does A Good Strategic Vision Look Like?

• Use the following criteria to evaluate your own
  Strategic Vision
• Forward looking
• Does your Vision Statement provide a powerful
  and positive picture of what your
• health and care system will look like in 5 10
  years time?
• Ambition
• Is it ambitious does it represent a dream beyond
  what you think is possible now?
• Is it all about excellence ?
• Motivating
• Does it clarify the direction in which your
  provider organisations needs to move?
• Does it clarify the future commissioning
  direction?
• Does it clarify the user focus for commissioning
  decisions and service provision?
• Does it clarify the capabilities commissioners
  and providers will need to develop?
• Purpose-Driven
• Does your vision statement give staff a larger
  sense of purpose?
• Is your vision statement worded in such a way
  that staff see themselves as
• "building a cathedral" rather than cutting
  stones?
• Inspiring
• Does it create enthusiasm, inspire and engage
  people?

A story from the Middle Ages Three stone masons
were hard at work when a visitor came along and
asked them what they were doing. The first stone
mason was working hard, sweat beading his brow -
I am cutting this stone The second man though
less distraught sighed and said - Im building a
parapet. The third man replied with a radiant
face I am building a beautiful cathedral that
will glorify God for centuries to come Author
unknown
Success is about maintaining the vision even
through the most gruelling details
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A good Strategic Vision is owned by the Local
Health Community
Vision without action is merely a dream. Action
without vision just passes time. Vision with
action can change the world. Author Joel
Barker- The Power of Vision

• The more broad based involvement there is up
  front in the visioning process, the more
  likelihood of success in bringing that vision to
  reality.
• Organisations, which include independent sector,
  public sector, local authority, non profit
  organisations, voluntary sector, each have
• A collection of resources, financial, human,
  technology
• An agenda
• A vision of their desired future
• A leadership structure
• A set of allegiances to that agenda and
  leadership
• The potential to be a partner in development
  efforts in the community.
• The potential impact of these organisations being
  aligned into a common vision and action plan is a
  recipe for successful transformation.
• If the vision is not shared or supported, or if
  there are conflicting visions, the result will be
  a chaotic collision of competing priorities and
  failure to meet local needs.

Liverpool PCT say Be inclusive Following
the visioning event to develop a year of care
model for schizophrenia wider feedback
highlighted that families and carers felt
excluded, as a result a further event was held to
ensure their views were heard and responded to.
For more information and top tips read the
Stakeholder Engagement Practical Guide
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Strategic Visioning The Process
Visual exploration Explore the possibilities
Vision creation Where do you want to be? Dare to
dream
Visual communication Show before and after?
Visual awakening Where are you now ?
What if ?

• Describe an accurate
• picture of the current
• reality for the LHC
• Draw a strategic map of
• your LHC
• Use demographic and
• public health data to
• show current strengths
• and weaknesses.
• The gap between where
• you are and where you
• want to be will be the
• creative tension that
• helps pull you towards
• your vision.

• Examine the emerging
• local, national, global trends
• Be creative ask - What if?
• Make sure that your vision includes the whole
  care continuum from heath promotion and
  prevention through care and treatment to review
  and rehabilitation.

• Feedback is given in the form of a summary
• Think of different ways of communicating the
  messages
• Create a powerful case for change.

• Use language that reflect peoples values and
  beliefs to win hearts and minds
• The ISIP Care Delivery Principles may be a useful
  starting point.

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Demonstrator Experience Nottinghamshire PCT
Model of Diabetes Care
Visual exploration Explore the possibilities
Vision creation Where do you want to be? Dare to
dream
Visual communication Show before and after?
Visual awakening Where are you now ?
What if ?
What if we used policy drivers and local
incentives to change the way that services are
currently delivered, offering more choice and
services closer to home? Both primary, community
care and acute practitioners recognise and accept
that it is important to create the right
conditions to change services to increase
quality, improve access and make the best use of
the resources available (people, technology and
finance).
The aim of the Visioning event was to establish a
compelling case for change in the context of
local service provision. This event was designed
to involve and engage a wide group of local
stakeholders who commission, provide and use
current services. It was important for us that
we built on existing good practice and the
extensive work of the Central Nottinghamshire
Diabetes Network. We brainstormed all the good
things that were already in place. We wanted to
get a view of the current service provision so we
used data and we asked our users for their
experiences.
Visioning event a half day event was held with
input from local GPs, consultants, National
Diabetes Support Team and ISIP. Delegates
included users, doctors (GPs and consultants),
nurses allied health care professionals, diabetes
network members and managers.
Service that empowers and enables patients and
users to self care
Patient Experience
Communication
Workforce
Transfer of knowledge, skills and support to both
patients and health care professional
Different ways of working, competent workforce in
the community
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Demonstrator Experience Liverpool Vision for
Schizophrenia Year of Care
Visual exploration Explore the possibilities
Vision creation Where do you want to be? Dare to
dream
Visual communication Show before and after?
Visual awakening Where are you now ?
What if ?
What if ?
We spent time preparing for the event, gathering
data to really understand the current state. We
decided to use the Walt Disney Circle of
Creativity in a facilitated workshop to develop
our vision for the Year of Care. .
The critic asks what if problems occur, what
could go wrong?
The Dreamer says anything is possible - no
constraints
The Vision was taken to the Mental Health
Consortium Committee and they have made a number
of comments on it . We held a second workshop to
look at the comments and agree actions.
Walt Disney Circle
Need to place family along this whole model
The realist says How do I / we want to do that
The Circle of Creativity was developed by R.
Dilts based on the successful strategies of Walt
Disney. The approach was developed through
individual interviews with friends and colleagues
of Disney. It is a model for effective and
creative development of personal and professional
plans. It helps you to transfer an idea into the
input for a plan. http//www.change-management-o
olbook.com/tools/pm_02.htm l
If the needs of families and informal support
networks are not considered within this planning
stage the focus will be narrow and gaps will
remain.
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NHS ISI Experience Wiltshire PCT Reforming
Community Services
Visual exploration Explore the possibilities
Vision creation Where do you want to be? Dare to
dream
Visual communication Show before and after?
Visual awakening Where are you now ?
What if ?
Wiltshire Primary Care Trust has a new vision for
the future. What if people lived healthier
lives, care was delivered much closer to peoples
homes, people had greater choice over where and
how and when they receive NHS care, and we could
provide care when needed in modern facilities?
The current range of community health services in
Wiltshire did not fit with the PCTs ambitions for
modern NHS healthcare.

• People will be actively encouraged and supported
  in adopting healthy lifestyles
• Eleven new neighbourhood teams will enable more
  older people to live in their own home
• Fewer people will need emergency admission to
  hospital
• Local access to clinical assessment and
  diagnostic services in Primary Care Centres
• Reduced attendance at Accident and Emergency
  Departments and reduced non-urgent ambulance
  call-outs
• Local and integrated support from the 11 new
  neighbourhood teams will reduce Length of
  Hospital Stay
• Improved recuperation through better use of
  Community Hospital beds
• Faster access to clinical professionals and
  treatments in five new NHS Primary Care Centres
• Reduced need for patients to travel to main
  hospitals for diagnostic tests or therapy
  services such as intravenous therapy, blood
  transfusion, blood tests, and rehabilitation, as
  they will be available in the community through
  the new NHS Primary Care Centres.

• .

• 500 people attended a series of stakeholders
  assemblies to discuss the proposals
• 3,000 people attended public consultation
  meetings
• 600 staff provided their views
• 790 people completed anonymous questionnaires
• 700 other comments were received by telephone,
  letters, fax and email

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Key messages
Make sure that your vision appeals to hearts and
minds of the people affected by the change - a
benefits led approach helps to engage
stakeholders and create the case for change.
Visioning events can unlock the potential of
practitioners to see a way of doing things
differently. Asking what if helps to break
away from the traditional thinking about how we
deliver services.

• Involvement and inclusion of stakeholders is key
  if transformational change is to become a
  reality.
• Listen to stakeholders and package their thoughts
  into a vision that can be understood and embraced
  by all concerned with systems of care.

Visionary leadership can turn a good idea into
something achievable. The leaders of a change
programme must describe a clear vision of that
future and then communicate it consistently.
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Where to go for more information

• External references
• Creating a Shared Vision http//www.isip.nhs.uk/
  roadmap/initiation/PhaseI-Strategy/agreeSharedVisi
  on
• ISIP Care Delivery Principles http//www.isip.nhs
  .uk/guidance/caredelivery/index_html
• Strategic leadership and Decision making
  http//www.au.af.mil/au/awc/awcgate/ndu/strat-ldr-
  dm/pt4ch18.html
• Disney Circle of Creativity http//www.change-m
  anagement-toolbook.com/tools/pm_02.html

Named contacts Liverpool Mental PCT Mental
Health Programme Debbie.Nixon_at_seftonpct.nhs.uk Ce
ntral Nottingham Diabetes Network
suzanne.meredith_at_nottinghamshirecounty-pct.nhs.uk
Wiltshire PCT hilary.shand_at_wiltshire-pct.nhs.uk