Meeting Summary

Introducing Dr Patricia Oakley (Helen Thomas – HEIW)

Dr Patricia Oakley has been instrumental in shaping NHS Wales’ Organisational Development (OD) approach and leadership strategies since its inception. Her extensive background in workforce policy analysis and medical politics provides a unique perspective on systems leadership, a critical component of their efforts to transform NHS Wales and the broader healthcare landscape in Wales.

Systems leadership is essential for leading across boundaries and dissolving barriers between teams and organisations. It is integral to our compassionate leadership strategy and crucial for driving the transformation of healthcare services. Pat’s involvement and insights have been invaluable in informing our approach to systems leadership and organisational development.

Pat, a retired strategic service and workforce policy analyst and workforce research fellow at King’s College London, brings over 35 years of experience in health and public services. Her extensive experience spans management organisational development and collaboration with national policymakers, trust boards, and executive directors. Pat has also worked with the government to develop strategies for delivering affordable public services. Her wealth of experience and knowledge is a tremendous asset to our session today.

The UK Science plc Strategy (Dr Patricia Oakley)

Our session focuses on systems leadership within the context of the UK Science plc strategy, initiated in 2003 during the Blair administration. This strategy, led by Lord Mandelson, has guided significant investments in healthcare, aiming to create a more integrated modernised system. Over the past 20 years, these investments have transformed healthcare infrastructure and enabled the development of advanced medical technologies and practices.

Integrated Practice Units: A New Approach

Drawing from a Harvard Business Review paper by Professors Michael Porter and Thomas Lee, Dr Oakley highlights the importance of integrated practice units (IPUs). These units represent a shift towards a more integrated approach to healthcare, breaking down silos and fostering collaboration across various healthcare organisations. The concept of IPUs aligns with the broader goal of integrating general medicine, genetic profiling, therapeutic targeting, and advancements in cancer treatment, radiology, and stem cell research.

Major Investments in Healthcare

The UK Science plc strategy has been implemented in three major phases. Multi-billion investments in general medicine, including:

1. First Wave (2003 Onwards):
   • Genetic profiling, therapeutic targeting, and advancements in cancer chemotherapy and radiology.
   • Significant investments in stem cell research, exemplified by the Crick Institute’s work in London.
   • Prosthetics, regeneration & bioengineering.
2. Second Wave:
   • Focus on genomic-based diagnostics, providing faster and more accurate diagnostic tools.
   • Development of genomic medicine service and advancements in predictive analytics, epigenomics and pharmacogenomics.
   • Developments in biosimulars, immunotherapy and stem-cell transplants.
3. Third Wave:
   • Emphasis on big data and clinical informatics strategies, with NHS Wales leading the way in contracting for data management services.
   • Implementation of artificial intelligence (AI) and machine learning (predictive analytics) to enhance clinical decision-making.
   • Investments in Centres of Excellence to develop methodology and ‘know-how’ in diagnostics and imaging.

As these new technologies emerge, sometimes taking decades to come to fruition, it’s important to plan and adapt our systems leadership processes to ensure that we can integrate them into local clinical practice successfully. Our existing systems don’t stand up to support therapeutics with this new kind of science. 

Policy makers today, having invested so much to bring these new sciences into hospital, GPs and community services, now need to ensure that the current organisational structures and processes don’t stand in the way of progress.

Addressing Challenges and Future Directions

Despite the progress, challenges such as the disruption caused by Brexit have delayed the integration of science and informatics programmes with Europe. However, efforts are underway to rebuild these connections and fully leverage the benefits of scientific research.

The Evolving Healthcare Workforce

The advancements in healthcare science and technology necessitate a dynamic approach to workforce development. New staff groups and expertise are emerging, requiring tailored training and integration into the healthcare system. This includes roles such as clinical bioinformaticians, pharmacogenomicists, and clinical engineers, among others.

With Big Science comes the world of data and informatics. Platforms that inform clinical decision making and search engines pulling in data from multiple sources all require new departments and staff groups, trained workforce and processes so that data reaches the clinicians and impacts patient outcomes.

Systems Leadership in Medical Services

Focusing on medical services, which account for a significant portion of healthcare resources, Dr Oakley emphasises the need to align generalist and specialist roles, integrate physical and mental health services, and manage personalised risk factors. The goal is to create a cohesive system that supports primary and secondary prevention, early diagnosis, prompt care, long-term care, and end-of-life support.

Conclusion

In conclusion, Dr Oakley’s insights underscore the importance of systems leadership in transforming healthcare. By fostering collaboration, integrating advanced medical technologies, and adapting to the evolving new workforce, we can create a more efficient and effective healthcare system. Today’s session was a valuable opportunity to learn from Pat’s experience and apply these principles to our ongoing efforts in NHS Wales.