Finally, on leadership and decision-making:

"We should be empowering ourselves. I'm a big believer in distributed leadership, but people in the chain of distributed leadership need to be able to see the big picture... It requires creating that context and then devolving that authority."

On innovation and health & life sciences:

• NI's small population provides significant opportunities for strategic industry partnerships to address some of our burning problems

• Such investment could alleviate constraints on the public purse - But will require leadership and clinical empowerment

On the role of the VCSE sector:

• VCS orgs play a vital role, connecting with people at the community level and helping manage conditions that would otherwise drive patients towards general practice: They must be seen as an equal partner

• Longer-term VCS contracts would be mutually beneficial

On primary care & the shift left:

• Shifting resources towards primary care can help manage the % increase in the overall draw on NI’s spend

• Reducing unwarranted clinical variability at the first point-of-contact and scaling initiatives like MDTs & GP Federations are important areas of focus

On staff experience:

• The quality of line management and fairness in the pay system are major factors impacting staff morale: We must communicate our efforts to improve in these areas and ensure staff feel valued

• Colleagues must not be blamed for raising concerns around unmanageable workloads

On workforce:

• Workforce planning is central to any HSC reset: It must be informed by practice to ensure staff are appropriately skilled and deployed to meet both current & future demands

📒 Our workforce report outlines opportunities to address these challenges: tinyurl.com/nicon-no-tim...

On clinical engagement & empowerment:

• "No clinician goes into work to do the wrong thing": We must move away from a culture of blame & create conditions whereby clinicians are empowered to be the best they possibly can be

• Clinical buy-in = Alignment with a shared purpose & vision for the HSC

On place-based approaches:

• Embedding a place-based approach into the HSC operating model will assist with changing the pattern of utilisation - Facilitating the implementation of Bengoa & reducing waiting times

• This may involve formal arrangements for Trust decision-making to optimise assets

On demand management:

• Demand is outstripping funding in health and care systems globally – Continuing on the current trajectory is unsustainable

• Tackling demand involves both supporting the public to stay healthy & ensuring that patients can access the right services at the right time

On prevention, outcomes and public & patient engagement:

• "Connecting to people on their own health is the solution" to implementing the shift from treatment to prevention

• Yet addressing waiting lists must also be a priority: Time spent waiting for treatment is a major determinant of outcomes

On culture and collaboration:

• “Culture eats strategy for breakfast”: Creating a culture of ‘one team’ is key to implementing NI's strategies

• True collective working entails routine collaboration across Trust boundaries, utilising estates, facilities & workforce effectively

Mike on system working:

• System working is about more than just the horizontal relationships between HSC bodies; it involves working with government departments, local authorities, primary care and the public

• It also entails ensuring that health and care spending supports a wider agenda

NICON were delighted to provide the opportunity last week for over 150 members to meet the new DoH interim Permanent Secretary, Mike Farrar @health-ni.gov.uk

🧵A short thread of insights from the session, covering a wide range of system issues:

First up - We asked Mike, "Why Northern Ireland?"