1) The document describes an action learning set for clinical commissioning group doctors in London. 2) Over four sessions, the doctors gained a better understanding of their roles, developed professional networks, and enhanced their skills in areas like commissioning and procurement. 3) Participants found the opportunity to learn from peers and experts like Sir Cyril Chantler to be most useful. They hoped to continue the networking and apply what they learned to their work in clinical commissioning groups.

1. The role of action learning sets
and self-reflection in your
development
Jamie Ripman
#ccgdev

2. #ccgdev

3. What is an Action Learning Set?
• History
• Structure
• Objectives and philosophy
• My personal experience
#ccgdev

4. • The story of the London ALS for CCG
Secondary Care
• What might you create in your area?
• What tools and techniques might
individuals use for self-reflection if you
can’t get to an ALS?
#ccgdev

5. The Action Learning Sets for CCG Secondary Care Doctors in
London
Overview
• Sponsored by NHS England in London
• All Secondary Care Doctors on London
CCG Governing Bodies were invited
• A few statistics!
• Group champion – Sir Cyril Chantler
• Group facilitator – Jamie Ripman
#ccgdev

6. Our first meeting. Getting underway. Important for
success of group?
Agenda
• Welcome and introductions
• What is an ALS?
• What else is required of us?
• Assurance from sponsors vs participant led learning – expect
some tension!
• Complete initial evaluation
• Our compact – how are we going to work together?
• Understanding the context – STEEPLE
• If this is our context, what do we want this ALS to achieve?
• Group objectives
• Personal objectives
• Start Action Learning
• Set dates for future meetings
#ccgdev

7. Starting point – initial evaluations
To what extent do you have an awareness of what
your peers are doing across London CCGs?
Not at all 4 (2)*
To a little extent 2 (2)
To some extent 0
To a moderate extent 0
To a large extent 0
* Evaluations from members who didn’t attend final session are shown in
brackets
#ccgdev

8. To what extent do you have a full appreciation
and understanding of your role as a CCG
Governing Body member?
Not at all 0
To a little extent 1
To some extent 4 (1)
To a moderate extent 0 (3)
To a large extent 1
#ccgdev

9. How do you rate your current knowledge and
skills specific to your role?
Poor 0
Below average 0
Average 4 (2)
Above average 2 (2)
Excellent 0
#ccgdev

10. To what extent do you contribute to innovation
at CCG level?
Not at all 1
To a little extent 1
To some extent 2 (2)
To a moderate extent 2 (2)
To a large extent 0
#ccgdev

11. Our compact. As part of this group we
agreed to:
 Respect confidentiality. Anything taken out of the
group is agreed first.
 Share air time. No dominant voices
 Feel able and confident to give / receive positive
challenge
 Allow all questions – no stupid questions
 Be committed to this for the long term – after the four
allotted sessions
 Apply respectful behavioural rules
 Learn from everyone
 Keep revisiting our learning
#ccgdev

12. Group objectives
• Gain further clarity of role of CCG
• Create clarity of CCG roles
• Develop ability to get greater influence of
commissioning intentions
• Create / develop an informal network
• Maximise the value of our network – create a
collective force; maximise our influence
• Better understand what are the ‘givens’ / non-
negotiables
#ccgdev

13. Individual objectives – included:
• Develop clarity around 2ndry Care role
• Improve ability to influence governing body strategy
• Develop a network of CCG 2ndry care Drs
• Create learning which can be shared in my CCG
• Clarify the role of CCG in commissioning
• Role of competitive tendering
• Quality issues v finance
• Responsibility / clarity of role of CCG vs NHS England vs CSU (feels lacking power)
• Influence / power of CCG 2ndry care doctor to drive local commissioning intentions
• How to work with a CCG in debt
• Better understand influence of NHSE on General Practice and Social Care
• Understand my responsibilities to NHSE
• Specific knowledge in how to influence commissioning decisions
• How to get more effective information about trends and outcomes
• Sharing & exploring common CCG issues
• Cut and paste good service redesigns/pathways
#ccgdev

14. Some of the topics we explored. How do I:
• Work with my Governing Body to achieve high standards at the CSU
so they do what we want them to do? How do I articulate my
concerns?
• Help my Governing Body to influence the Local Authority to spend
money most effectively on health and social care (Better Care Fund)
• Have sensible input into our procurement processes from start to
finish?
• Influence commissioning decisions with integrity? (Value Based
Commissioning)
• Ensure I am being used for my full potential in this role?
• Get clarity of my responsibility for the governance of my CCG?
• Interact effectively with outside bodies (NHS England, CQC,
Monitor)?
• Ensure we run an effective competitive tendering process for a
large service provision?
• Create some collective power and start the revolution?
#ccgdev

15. Four sessions later – final evaluations
To what extent do you have an awareness of what your
peers are doing across London CCGs?
Not at all To a moderate extent
Not at all To a moderate extent
Not at all To a large extent
Not at all To a large extent
To a little extent To a moderate extent
To a little extent To a large extent
No data* To a moderate extent
* Did not attend first session
#ccgdev

16. To what extent has the Action Learning Set
helped to enhance your appreciation and
understanding of your role?
Not at all 0
To a little extent 0
To some extent 1
To a moderate extent 3
To a large extent 3
#ccgdev

17. To what extent have your knowledge and skills
(related to your role) improved or increased as a
result of attending the actions learning sets?
Not at all 0
To a little extent 0
To some extent 0
To a moderate extent 5
To a large extent 2
#ccgdev

18. To what extent do you contribute to innovation at
CCG level?
Not at all To a little extent
To a little extent To a moderate extent
To some extent To a moderate extent
To some extent To a moderate extent
To a moderate extent To a large extent
To a moderate extent To a moderate extent
No data* To some extent
#ccgdev

19. To what extent do you feel your personal
learning objectives have been achieved?
Not at all 0
To a little extent 0
To some extent 0
To a moderate extent 4
To a large extent 3
#ccgdev

20. How would you rate the programme overall?
Not at all 0
To a little extent 0
To some extent 0
To a moderate extent 1
To a large extent 6
#ccgdev

21. What have you found the most useful about the
Action Learning Sets?
• Opportunity to have others views & to have “assisted”
reflection
• Finding out about the differing roles secondary care doctor
takes
• Cyril Chantler. Great perspectives which stimulate group.
• Network with London CCG 2nd Care Doctors and building
confidence in role!!
• Discussion & learning from colleagues, learning from Sir Cyril
Chantler
• Learning from others /getting ideas from Cyril & Jamie
• Understanding the differing needs & contributions CCGs have
for 2° Care Drs. Cyril’s wisdom & perspective
#ccgdev

22. What have you found the least useful about the
Action Learning Sets?
• Other secondary care doctors ‘in my day’ anecdotes & chat.
• Can’t think of anything
• Sometimes too much emphasis on process.
• Nothing in particular!
• Need a more regular frequency (I know this is expected end
date) with ongoing funding.
• I think whatever was covered was useful. I think the ALS
should continue. Maybe once every 4 months. This will form
part of our continuing education. Would like to thank Jamie &
Cyril and all my colleagues on the group. I feel better having
attended.
• Occasional issues became too prolonged convoluted
#ccgdev

23. What next steps would you like to see and take,
as an individual and group?
• Continue facilitated Group work to develop Action Learning
• Independently apply what I’ve learned. As a group keep in
touch 2-3 times per year – ideally with continued facilitation.
• Continue contact & discussion with colleagues, talk to Sir Cyril
Chantler
• Would be helpful to maintain a network to share experiences
& developments
• To influence NHSE with a feedback session in next 6 months
• Be more involved in changing pathways & contribute to
improving patient care – meeting again.
• Learning to engage with local authorities & join up
communication paths 2° Care →Primary→Community→Local
Authority
#ccgdev

24. Any other comments?
• I am now better able to be an ambassador for clinical
commissioning.
• At the end of 1 year, my main outcome has been to understand
better what I’ve learned & how to apply it to influence change in
the service.
• On balance these sessions have been most useful & informative &
very worthwhile. Group should be reviewed. These meetings will
enable me to be much more effective on my CCG.
• Link in with other 2nd Care Dr networks across England.
• Useful
• Has helped to open horizons and ways to address common
problems
• Structure very useful
• The group as a whole feel it’s important to continue to have these
meetings as a development tool. It would be great if NHSE would
fund further development please. Much better than personal
coaching. Interaction between like-minded clinicians.
#ccgdev

25. And one participant added the following:
Outcomes from ALS:
1) Able to have a London wide perspective of the
health economy
2) The local CCG has been able to use me to develop
Value Based Commissioning for N.C London CQUINS.
3) The understanding of CPD in finances, procurement,
tendering.
4) I would have given up the CCG role, without this
ALS!!
5) The changes occurring in NW London and NC London
over the last year and on-going 2014/15
#ccgdev

26. Your thoughts, questions and
reactions?
#ccgdev

27. What might you create in your area?
What might you need?
• Sponsor?
• Champion?
• Facilitation?
• Compact?
• Skills and behaviours?
#ccgdev

28. What tools and techniques
might individuals use for
self-reflection if you can’t
get to an ALS?
#ccgdev

29. GROW – John Whitmore, Coaching for
Performance
G
W
O
R
GOAL –
exploring and
setting clear
goals
REALITY –
checking and
raising
awareness of
the situation
right now
OPTIONS – finding
alternative
strategies, solutions,
answers
WILL (and
WHAT, WHEN,
by WHOM –
testing your
commitment to
your goal,
making
concrete,
realistic plans to
reach it
#ccgdev

30. OUTCOME?
CONTRIBUTION?
ATTRIBUTES?
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31. #ccgdev

32. #ccgdev

33. Heron’s six styles of
intervention Supportive
Catalytic
Confronting Informative
Cathartic
Prescriptive
#ccgdev