The document describes a web seminar on connecting people for innovation and collaboration through "FabTeams". It introduces the session chairs and provides an overview of three FabTeam stories: the High Intensity User project, Transfer to Assess project, and Purposeful and Productive Community Services. The stories highlight how the teams worked across boundaries, built trust, embraced different approaches, and achieved successes like improved system flow and reduced care packages. Participants were then polled on their motivation to try some of the approaches discussed in their own work.

1. FabTeams Week - Connecting
people for innovation and
collaboration -
Claire Haigh, Cath Doman, Boena Zeneli, and
Andrew Messina
3rd November,2017

2. The Team Today
Session Chair
Janet Wildman
@jwildman1
Chat Room and
Technical Support
Paul Woodley
@PaulWoodley4
Twitter Monitor
Leigh Kendall
@leighakendall
Twitter Monitor
Rosie Redstone
@RosieRedstone

3. Joining in today and beyond
• Please use the chat box to contribute
continuously during the web seminar
• Please tweet using hashtag #EdgeTalks and
the handle @HorizonsNHS

4. Creating Surprising, simple and
social spaces for public service
innovation and flourishing
Claire Haigh
Co-Founder
Collaborate Out Loud
@HaighClaire
#CollabOutLOud @CollabOutLoud #EdgeTalks

5. Three FabTeam Stories
Boena Zeneli
High Intensity User
(HIU) Project
Teams beyond
Boundaries
Andrew MessinaCath Doman
Transfer to Assess -
Connecting People
for Innovation and
Collaboration
The Harrogate
vanguard

7. #Quality2017

8. Where do you currently do most of
your team working?
A. In a traditional team reporting to one line manager
B. In project teams
C. In collaborative teams across organisations and systems
D. In teams that span formal structures and social
networks
#CollabOutLOud @CollabOutLoud #EdgeTalks

9. 0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
2/18 3/18 8/18 5/18
In a traditional team reporting
to one line manager
In project teams In collaborative teams across
organisations and systems
In teams that span formal
structures and social
networks
Where do you currently do most of your team working?
Percentages

10. Collaborate Out Loud’s Community Manifesto
Collaborate Out Loud communities are a democratic community of
innovative and generous public service collaborators who work out
loud to hack challenges, hatch new thinking, experiment with
implementation and prototype and spread impactful new ideas that
will enable the changing public services landscape to get further faster
and embracing the power of new ideas, collaboration and democracy
How we work
• In an open and free way where anyone
could follow the story
• Everything that we develop is open
source and free to be used by anyone
• We are a group of true collaborators
• In a way that successes and failures are
equally welcome opportunities to
learn
• Where the process of collaborating in
this new and free way is observed,
tested and understood
What we do
• Serve public services at all levels and places
• Work on the challenges that public services are
facing in a shared space without the constraints of
being within the formal systems and structures
• Crowdsource challenges to work on that serve
public services in a different and freer space
• Actively encourages challenge, new thinking and
learning from when things don’t work out as
expected
• Brings together the unusual suspects, thinking
and approaches and allows the magic to unfold
• Work with kindness, generosity and inclusivity
#CollabOutLOud @CollabOutLoud #EdgeTalks

11. #CollabOutLOud @CollabOutLoud #EdgeTalks
What have we learnt
about Fab Teams from
the edges
Collaborate Out Loud’s Learning So Far…..

12. Shot-term and project based – come
together for a limited time to get
something done
Borderless– span across
organisational, system, and
professional
Complex - Working on increasingly
complex challenges
Collaborative - a move towards
collaboration rather than
partnerships
Virtual – geographically spread often
over long distances
Multi-layered - Individuals are often
working across multiple teams at the
same time
Agile - Need to change shape and
direction easily to respond to changing
landscape
Democratised - they are able to access
people, ideas and skills in ways we never
could before
Technology enabled – they have a loads
of tools at their finger tips that help
them to connect and be productive
Socially powered – need to build social
rather than have positional power
Self organising - often built around the
idea of a community that learns and
shares together. Based on shared intent
and trust
Whole – they encourage people to bring
their whole self to the team
How are teams changing?
#CollabOutLOud @CollabOutLoud #EdgeTalks

13. We are all about creating
surprising, simple and social
shared spaces between the formal
and informal and this is what we
have learnt about teams in these
spaces so far……..
• They embrace and harness the energy
of difference and the crowd
• They create surprising, simple, and
social spaces between the formal
structures and informal networks
• They spend time building a
community, trust, and a shared intent
where people bring their whole selves
• They embrace the principles of
transparency, democracy,
and openness
• They are social, share with generosity
and kindness
• They work on real and often complex
challenges collaboratively
• They borrow learning and thinking
from anywhere and everywhere to
learn collectively
• They co-create novel solutions
and ideas to tackle their collective
challenge
• They are able to rapidly test their ides
and iterate them together
• They work out loud as you go —
attributing their ideas and inspirations
• They spread the best ideas (as well as
the learning from what didn’t work)
What are we learning about teams
from the edges?
#CollabOutLOud @CollabOutLoud #EdgeTalks

14. Cath Doman
Programme Director – Harrogate
Vanguard
@cathdoman
cath.doman@nhs.net
Working on behalf of:
Harrogate and Rural District Clinical Commissioning Group,
Tees Esk and Wear Valleys NHS FT,
Harrogate Borough Council,
Yorkshire Health Networak,
North Yorkshire County Council,
Harrogate and District NHS FT

15. “Being brave enough to say we haven’t got something
right, …is often quite easy to say but hard to do in
practice.”
Sam Jones

16. March 2015…

17. Creating effective teams: the beginning
The good:
 Integrated care teams
 Out of hospital care
 Working with GPs
 Involving mental health and
social care
 Skill sharing and role blurring
 Dissolving the boundaries
 Everyone working happily
together
The bad:
 “Do something different!”
 “Integrate!”
 Wifi
 Inadequate attention to OD
 Pressure to deliver too fast: “just
do it!”
The just plain ugly:
 Incontinence corner
 General grumpiness
 ‘Behaviour’

18. The journey
March ‘15: •‘hey- we’re a Vanguard!’
Feb ‘16 •Pilot starts
March ‘16 •Funding reduced
Stop and
regroup
July ’16:
new plan
Nov ‘16: roll-
out across
the District
Mar ‘17: STOP!
Unaffordable

19. March 2017…

20. Stop and regroup

21. March ‘17:
the Transformation Board’s challenge
• Test something radically different
• Create a ‘pop-up’ organisation that feels really different
• Focus on preventing avoidable admissions
• Practice population focused (3 practices)
• True integration
• Support and permission

22. Magic ingredients
 Permission
 Ground-up design
 Protected time
 Co-location and sharing the
milk
 Daily problem-solving
 Access to leadership
 Daily huddles
 Access to systems
 Parking
 Anxiety management tools

23. Quality Improvement System:
Purposeful and Productive Community Services (PPCS):
Daily
huddles
Leadership
team
Visual
controls
Caseload
management
Cell
working
Diary
manage-
ment

24. GP
Living
Well
Social
care
Pharmacist
Practice
manager
PMO
Team
leader

25. Questions for Cath

26. High Intensity User (HIU) Project
Teams beyond Boundaries
Boena Zeneli
NEE CCG
03.11.2017

27. The High Intensity Users (HIU)- Working
across boundaries
• We identify frequent users of urgent and emergency services, mainly A&E and the ambulance service but
also 111, OOH and GPs and use multi-disciplinary team (MDT) approach to agree care/intervention plans
• We work with a variety of clinicians including: ambulance
service, acute trust, mental health, community services, 111,
Out of Hours and GPs as well as non clinical partners including:
social care services, voluntary and fire services, police and
Borough Councils
• We haven't been perfect but through this work we’ve learned a
few things that we feel are worth sharing

28. So how do we work with teams across
boundaries and build the team spirit?
The Goal: Working with different professionals beyond organisational boundaries to achieve better
integration of services, reduce urgent and emergency activities and ultimately provide effective and
efficient healthcare for patients as well as enhancing working experience for our team members
The How: Understanding the culture, be that organisational or personal is crucial to building the team spirit
• Being proactive and tenacious as a leader/PM and
– Establishing common aims
– Building trust/commitment
– Doing, in the timely fashion, what you say you would do
– Putting processes in place and showing determination
• A lot of:
– Communicating
– Sharing and learning
– Reiterating
– Empowering and treating each individual fairly and equally
– Informal ambiance for MDT meetings
– Flexibility- see, analyse and readjust…
• And biscuits and cakes definitely do the trick!

29. Challenges to how we developed as a Team
and achieved our objectives?
• The main challenge was to securing meaningful engagement from all providers so that we could
work as a team without boundaries and provide integrated healthcare for our patients
• The bigger challenge, however, was not implementing the change, it was (and still is) finding and
engaging with the right players/champions in order to maintain the team’s effort to continually
engage with the process and not accept slippage…
• The process of team engagement across boundaries needs to
persevere and continuously improve, typically requiring endless
pushing/support from a leader/PM
• Keeping myself inspired whilst being faced with endless obstacles

30. How establishing meaningful connections
resulted in achieving great success?
• By introducing novel methods to communication and engagement we created a culture that has high
performance standards and accountability, along with positive relational glue keeping everyone
supported and engaged (team members willingly coming to MDTs on their days off)
• Success: we have had great engagement across the economy but
also we are starting to see engagement from new services.
Furthermore, due to the Information Governance limitations,
we have established separate non clinical HIU MDT and have an
excellent partnership with Borough Councils, Fire/Voluntary services
• Success: we have and continue to explore different avenues to
empowering patients to take ownership of their health and well-being whilst decreasing their
dependency upon unscheduled care services, i.e. home MDTs, fire services home visits
• Success: Started to helping others to set up similar way of working collaboratively and across boundaries

31. What do our team players say about the
project…
‘’Without collaborative multi-disciplinary working we cannot expect to deliver patient focused, cost
effective services that allow us to maximise resources where they are needed most…’, East of England
Regional Clinical Coordinator – Paramedic
‘’…If it stopped I would not have access to provide better quality care for my patients. There would be no
integration at all between primary and secondary care and it would be very difficult to support these
patients without the MDT approach…’’, GP Practice matron.
‘’We have made a difference to patients who are now not high intensity users due to our regular
communication… I do feel that it would negatively impact our patients if the group were to disband’’,
Deputy Clinical Director, East of England Out of Hours

32. Where do we go next?
The HIU project enhanced our understanding about managing teams beyond boundaries in achieving
common aims and shared purposes. It also showed us that in order to implement and sustain
improvement in an integrated and multidisciplinary team environment, team members must
understand the objectives and logic of the change and collaborate without boundaries.
A lot has been done but we still need to:
• Continue with partnership working which is crucial to enabling team members to engage and
withstand engagement in implementing changes across boundaries
• Continue creating and sustaining a patient focus and cost effective services as well as encouraging a
positive working experience for our team members
• Encourage and engage with more services to share our experiences, successes and lessons learned
and understand and seek to learn from the successes of other teams and organisations

33. Last thought…

34. Questions for Beona

35. Transfer to Assess
Connecting People for Innovation and Collaboration
Andrew Messina (Programme Lead)

36.  Through the Stockport Together programme, we’ve
introduced Discharge to assess pathways, which we’re
calling Transfer to Assess (T2A).
 Within the T2A pathways, identified patients are discharged
as soon as they are medically well enough to leave hospital.
What is Discharge to Assess?
 Nationally recognised as best practice for supporting patients who no
longer have care needs that can only be met in an acute hospital.
 Proven to enable a shorter discharge process of up to 2 weeks,
with care packages being put in place directly with the person
at home.
T2A pathway cuts
across multiple
organisational/
service boundaries
Lack of trust
across
teams
Period of
significant
change
Our
challenges

38. Empower staff
to make change
happen
No blame
All views equal
Patient journey
Problem solving
Plan, Do, Study,
Act
Learning
environment

39. Improvedsystemflow
Around 50 people
discharged through
T2A each month.
Care packages
reduced by
half.
Breaking down
silos & better
relationships.
Greater
level of
trust
Champions
of
change
Staff
benefits
Solution
focus

40. Any
questions?

41. Questions for Andrew

42. How energised are you to try some
of the approaches and tools you have
heard about today in your work?
A. Very motivated
B. A little bit motivated
C. Not sure yet
D. I still need some convincing
#CollabOutLOud @CollabOutLoud #EdgeTalks

43. 0%
10%
20%
30%
40%
50%
60%
70%
11/17 5/17 0/17 0/17
Very motivated A little bit motivated Not sure yet I still need some convincing
How energised are you to try some of the approaches and tools you have
heard about today in your work?
Percentages