Don made us an offer we can’t refuse

Professor Don Berwick visited the UK this week to see how vanguards across the country are working on developing new models of care and to share his insight and knowledge with them. The Chief Executive at Dudley CCG reflects on the visit:

It is a privilege to have had such a renowned leader in healthcare as Don Berwick come and impart his knowledge and thinking to our team here in Dudley.

More than 200 staff from across our organisations heard Don’s lecture giving insights on how to manage the challenge of change – and as a national vanguard for implementing a new model of care we are certainly experiencing change at pace.

One thing that stood out for me during the conversation was his remark that we have a choice – to either react to change or to be proactive in managing change – and it genuinely feels that the new care models programme affords us the opportunity to do the latter rather than the former.

After a morning’s Board development session where we spent a very productive time exploring the risks and mitigations to the key objectives of our CCG for the year, we were joined over lunch by Don and his hosts from the morning: colleagues from the Modality Multi Specialty Community Provider Vanguard (MCP).

It was an ideal opportunity to exchange ideas on challenges and opportunities in our respective MCPs and to express a common shared interest in the goals of our local Sustainability and Transformation Plan of which we are both part.

Listening to Don’s lecture to our staff, it was obvious his words struck a chord with everyone in the room.

An environment where reliance on inspection to improve merely identifies failure and seeks to remove it, does nothing to enable improvements overall. Whereas, an environment that encourages innovation, will enable genuine learning and improvement to be achieved by learning from the mistakes as well as the successes.

The analogy – that you don’t learn to ride a bike by watching others ride them, you have to get on the bike to learn for yourself and also expect to fall off the first time you try – clearly illustrates how we best learn to improve.

As a vanguard we are innovating a new model of care and learning as we go. We therefore have to create a positive learning environment, with clear review processes, to enable us to evolve the new design of care that is right for our local system.

I find Don’s insights inspiring and hugely motivating. As a local leader of healthcare here in Dudley, I am encouraged from what he says that we are on the right track. While trying to find a different system of care is both difficult and challenging, we are motivated to both empower our staff to achieve and focus on what matters most to our patients and public.

There is still much to learn and much more to do but care and outcomes come first and foremost. We will continue to strive to create the right environment so we can achieve the best possible results for our population.

  • Professor Donald Berwick is a renowned international authority on health care quality and improvement management, and International Visiting Fellow to The King’s Fund and President Emeritus and Senior Fellow to the Institute for Healthcare Improvement. In 2010, he was appointed by President Barack Obama as the Administrator of the Centers for Medicare and Medicaid Services (the federal agency overseeing Medicare and Medicaid), a position that he held until December 2011.
Paul Maubach

Paul Maubach is Chief Executive of Dudley Clinical Commissioning Group and has overall responsibility for ensuring it meet the needs of Dudley patients, CCG employees, the taxpayer, the wider CCG membership and partnerships, and the law and statute within which the CCG operates.

He has worked in the NHS for over 25 years and is a qualified accountant, with a degree in mathematics from Warwick University and a master’s degree in leadership and organisational development from Birmingham University.

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  1. Dr Rob Dalziel says:

    What stood out for me was Don’s perceptive comments on his father’s work as a doctor and his instruction to patients ‘You will get the penicillin when I say’.

    We have made progress in involving patients and the public in healthcare systems and services design and healthcare professionals entering into a dialogue with people to discover what matters to them.

    But we still have a long way to go to achieve genuinely co-productive collaboration and partnership working with patients and the public to achieve more working together than is possible working in isolation from each other

    Don emphasised the need for professionals to be less precious about their status and location in the healthcare landscape. As the US surgeon and writer Atul Gawande points out the greatest opportunity for learning and change in the way we do things to help people comes from a position of humility and a willingness to transfer power to others so that they have more influences and control of matters (he spoke about this as part of his presentation at this years Reityh Lectures and his work on breaking down barriers and improving team working in the operating theatre that has dramatically reduced mortality rates

    I was alsio impressed by Don’s remarks on the end of the visit in many instances to the surgery or the hospital – and more community-based or technology based consultations etc happening in locations and at times more convenient for people. there are great opportunities to give people more control over their healthcare and how it works for them.

    • Elsie Gayle says:

      As a Patient Leader NHS Midlands and East and carer to a young person in the CCG locality, I sought and failed to achieve co-production here. I am sad that co-production, developing truly therapeutic relationships will not be achieved here. Clinicians are too precious about their status; which after all depends on the patients submission to them and their treatments. Opportunity lost Don Berwick…. we continue to firefight vs using the ‘Escape Fire’ model.