A coalition of the willing

Sarah Kilner

Sarah Kilner is programme manager for streamlining in the North East of England and also chairs the national streamlining operational group. Sarah highlights in this blog the work of the streamlining operational group and also achievements to date. 

What struck me about the first time I met with colleagues working in other regions implementing streamlining was how differently we each interpreted what streamlining was, what its priorities should be, how challenges should be addressed, and how each of our programmes operated. Some regions appointed external consultants, some had no formal infrastructure, others had large teams while I was, and remain, the only directly employed streamlining post in my region. Yet, we were all a ‘coalition of the willing’, keen to work together to achieve the same aims both within and beyond our own regions. 

The initial share and learn sessions developed over the past two years to form, what is now the national operational group, a sub-group of the national streamlining steering group. While membership of the steering group consists largely of HR director-level regional executive sponsors and directors of national partner organisations, the operational group consists of regional programme managers and deputy HR directors. 

As the group’s incoming chair, I am pleased to be part of the group’s continued evolution, positively reinforcing the success of many of our regional programmes at a national level and offering a means of support and consistency nationwide. As with anything, it’s all about give and take and recognising that what works at a local or regional level, doesn’t always transfer elsewhere or nationally.

Our physical geographical spread can be challenging – although I personally enjoy hearing so many accents during calls! Face-to-face meetings remain invaluable and a welcome opportunity (usually during coffee breaks) to make connections. We tried meeting in either Leeds or London, but acknowledge that due to transport links, there’s better attendance for London (even if that means a six to seven hour return train-trip for those of us way up here in the North East).

Ideally, in the same vein as we’re optimising functionality of digital systems, including Electronic Staff Record (ESR), we’d like to make
better use of other communication media. This is challenging in that there is variation in terms of what we can each access via our employing organisations. As has often been said ‘if it was easy, we’d have already done it by now'.

From our humble beginnings we now have in place: 

  • a streamlining resource hub, which is hosted on the NHS Employers website and can be accessed by all 
  • an informed list of streamlining contacts within each of the regions
  • membership including NHS Improvement, ESR and NHS Jobs 
  • a formal structure, standing agenda items and escalation methodology
  • connectivity with the doctors in training work led jointly by NHS Improvement and Health Education England
  • a formal means in which to escalate and resolve issues affecting streamlining on a national basis.

There’s a lot of information available as to what streamlining is, however, programme management (at least in my experience) is only a small part of the story; we’re in the business of changing culture. Some call it organisational development, whereas I view it as effective leadership best coupled with patience and a great peer network. I love a challenge!

If you have any ideas or contributions for the operations group to consider, or would like to know who represents your region on the forum, please contact streamlining@nhsemployers.org

Special thanks to NHS Employers which has been a key partner in enabling each of the national forums to succeed; providing us with meeting venues, maintaining (the ever-changing) distribution lists, communicating with us all and having the connections to introduce us all to so many useful contacts. I would like to offer my person thanks to Liz Gambrell, area head of engagement for the South with a remit for national streamlining for both her insight and listening ear.

Further information

This blog was published as part of NHS Streamlining Week, visit the streamlining resource hub to learn more about streamlining in the NHS and the efficiencies you can make.


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