The Wilderness of At Scale Working – The Basics of Success
There is much noise about collaboration and working at scale. Particularly in primary care. But do you know what the term really means? And how to deliver it? And why you should care? No? No rocket science alert. Below, I set out some basics in the first of five articles that will look at things that must be in place to deliver at scale working.
This article sets out the basics. The rest will focus on more detailed issues.
First, “at scale working”. Great term, so much conveyed in so few words. Like integrated care system or urgent care centre. As we know, these are not consistent across the country but the overall shape of them are understood. The words convey meaning. But at scale working is less understood.
At a basic level, it involves some form of collaboration, whether formal or informal. We use the term “at scale entity” to mean some form of joined-up delivery organisation. This can include practices seeking a formal merger, shared service arrangements, primary care home and networks or multidisciplinary teams seeking to work together in hubs or clusters of practices. So, there is much that qualifies as being at scale.
All are examples of organisations working together for mutual benefit. All involve collaboration. We often hear the word “collaboration” when it comes to business ventures or an agreement between two people or organisations. Collaboration can be described as being co-operation when two or more entities co-operate to complete a task. Often, they agree their strengths and weakness and develop something new that solves a problem. Or puts them in a stronger position. Working together and collaborating is one of the things humans mostly do quite well.
But of course, history is littered with examples where has not been the case. What are the issues that have been associated with success? I use the following four groups of questions as a basic test of your collaboration. Can you answer all of these?
- Your Why - What were your reasons for deciding to collaborate and create something at scale? Why did you decide to collaborate with those specific others? Are you sure you all share common aims? Why did you choose the format you did?
- Your What - Do you know what you are trying to achieve? Did you think about alternatives? How clear you are about what you are trying to achieve? Are those forming the at scale entity willing to embrace real change?
- Your People - Have you engaged with your staff and stakeholders about the collaboration? How much do they support those changes? Do they understand what those changes will mean for them?
- Your How – Do you understand how you will deliver the at scale entity? Have you got a detailed project plan with SMART objectives? Do you understand the actions and resources required to deliver your plan? Have you involved your commissioners in your planning?
There will be many more questions to answer of course. But these will give you a great starting point. And they are all fairly straight forward. Simple issues we would apply to many situations in life. And as you begin to plan delivery, other issues will present themselves to be addressed. There is often a lot of compromise and problem solving involved in successful collaboration. And to be truly successful, there must be a win-win situation.
To help GP Practices understand where they are now and to help plan for future collaboration, we have developed the At Scale Readiness Assessment. You can use this free, easy-to-use tool to test your readiness to move forward. Quick to use, you will receive a PDF assessment based on your responses. And an opportunity to talk over your assessment with one of our At Scale advisors.
Try it now at https://at-scale.co.uk/tools-and-resources/at-scale-readiness/
The next four articles will deal with each of the four key areas in more detail. These will aim to demystify what makes for successful at scale working. Try out the At Scale Readiness Assessment while you wait.