Samantha Jones, Chief of the Vanguards – that was last weeks NHS Managers chat with Roy Lilley and Samantha Jones at The Kings Fund in London.  Here’s my blog – we can learn a lot from the folk at the top and sharp end of NHS change and reform…And here is Sam herself….

But the title sounds like the sort of thing you might see in a sword and sorcery series.  I don’t think Sam would be flattered by that, but hey, Game of Thrones has been very successful for Fox…

You may have heard of Vanguards. As ever at a Health Chat at the Kings Fund with Roy Lilley, you do expect an awful lot of the background to how the person got to “today” because that informs what they are now trying to do.  And why they are well suited to it…or not.

Sam is well suited. She doesn’t do detail. So she lets the people at the sharp end make things change. She said her job is just to create the space so that can happen.  If only all the micro managers out there could see that is the only way.  Not the best way. The only way.

As ever, a health warning. This is my own views of what I experienced at The Kings Fund on  29th October.  You would have a different take. Read it as such.

So what are Vangurds for?  We’ll get to that soon.

Background? Roy’s first question was about her children when young. If you were there, you understand the context. But her answer was fab. “I wondered why I’d said yes to this interview, and I am definitely wondering that again now”. And then when Roy kept interrupting (he gets excited), she cut him dead with “I am still speaking”. Not, you notice “can I finish please” nor “I’m sorry, you are interrupting”. It was the far more assertive statement of fact, which meant Roy had to shut up, and that was mainly because there was a guffawing cheer and applause from the assembled! She must work in committee like that?

Loads of her mentors and bosses had given her space to “do stuff”. She continues that philosophy in her daily work.  I don’t know all the names she dropped into the conversation, but the CEO of the NHS? At the time was Duncan Nichol? (Sorry Sam – this got lost in translation from my notes!) Anyway, she contacted him as a management trainee to ask to shadow him for a week.  And he said yes. So there she was in meetings with Stephen Dorrel who was health sec at the time. After every meeting, what did the CEO do?  He sat her down and asked her what she had seen, and what would she do differently.

And that’s what the Vanguard programme is all about.

It is bottom up.  It asks end users and front facing and coal face people what they would do.  Here’s an example from her previous job.  The hospital was going to hell in a handcart. No panicking imposition of rules and regs from above. She cancelled all normal meetings. Got everyone involved in ‘fix it gatherings’.  Lots of front line staff came in. Senior team …not allowed to impose.  Hard for them…but hey, results and change happened.  As she said, the fish rots from the head down.  Change needs to happen from the bottom up.

A porter said that patients who had died were not being treated with dignity.  The transportation module (usually a galvanised steel coffin box) was not big enough and looked terrible, especially to the other patients and the relatives, I assume.   The porter was shaking and scared to verbalise this. Sam held his hand while he said it all again when asked why. Then she said to him “ok, you redesign it”. And that is what happened.  And that is what the Vanguard movement is all about.

It is about letting the local people sort their own stuff out.  And to get everyone who is involved In that care model, locally, to get involved.  And then to share the ideas and methods widely.

It will break down silos.  It will stop the stupidity of falsely applied budgeting getting in the way of patient care.  It will be cheaper.  It will be safer.  It will be more efficient.

And it will put patients first.

About time we had a passionate Chief Exec of the NHS who was like Samantha Jones.  Been there, done lots, got the scars, has the passion and wants to make things better for every patient in the NHS.

I loved her attitude.  And I know she will make a difference.

If you want to know more about New Care Models and how the Vanguards are indeed at the vanguard of change, then click on this report from NHS England.

https://www.england.nhs.uk/2015/07/31/vanguard-support/

It is also there in the 5 Year Forward View – Sam published her new Care Models sub set in March, looking at the Care and Quality gap:

http://www.kingsfund.org.uk/sites/files/kf/media/Sam%20Jones_5YFV%20opportunities.pdf