‘Culture eats strategy for breakfast’

November 24 2017

At Thames Valley RCGP Faculty’s annual management course last week, practice groups spent 2 days thinking about what a move to more ‘GP at Scale’ might mean to them whether in merged organisations, collaborating local clusters, more formal federations or ‘super-practices’.

Having been informed by perspectives from NHS England and the RCGP GP at Scale and Quality teams participants shared their own experiences of working at scale. As they did it became clear that whilst most were already collaborating with others to develop pathways of patient care and increase access to funding, concerns remain about the mixed evidence for at scale working to improve the quality of care, how to maintain continuity of care for patients and how ‘scale’ working would impact on the autonomy of individual practices.

It was however a presentation by Neil Suggett who asked us to consider the culture of the new collaborations we are forming that has been in my mind since returning home. Neil, who spent much of his career developing a culture of coaching leadership in secondary schools, proposed to delegates that the challenge for any organisation is to develop a culture that allows leaders managers and staff to engage and develop for the benefit of all stakeholders.

He suggested that, ‘no corporation or practice can thrive in the absence of creativity, innovation and learning and the greatest threat to all three of these is disengagement’. This resonated with the finding of the recent RCGP / Nuffield Trust Report on Collaboration in General Practice which also suggested that, ‘the main challenges faced by those establishing collaborations are building trust and the engagement of member practices…’

So, with echoes in my mind of Druckers ‘culture eats strategy for breakfast’ and an anxiety about disengagement from scale organisations I left the conference wondering how as new organisations form with time and energy set aside, to develop cultures that promote improvements, rather than becoming focussed on strategies and structures to achieve scale at pace?

Please share your experiences of how you approached this in your organisations and what outcomes you’ve found both the successful and those you wish you had done differently.

I’m sure the challenges of improving the quality of care will form part of the national conference…..

GP at Scale national conference

Date: Wednesday 6th December, 2017, 9:20-16:00 Location: Prospero House, 241 Borough High Street, London, SE1 1GA (map)

This year’s national event will collate the work and themes of the programme over the last 12 months to celebrate the incredible work of at scale primary care teams.

Delegates will have the opportunity to engage with representatives and system leaders from RCGP, Nuffield, BMA, and NHSE; ask them questions in a Q&A panel and contribute to working sessions on shaping the future of improving quality through scale organisations, the opportunities of different models of care, and the importance of leadership.

Learn more and attend this free event


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