At St Richard’s Hospice a multi-professional group including representation from Human Resources, Finance, Administration, Medical Teams, Nursing Teams, Psycho-social and Database Management came together to work in a collaborative manner to develop a gateway service. The gateway service aimed to be multidisciplinary, providing not only a patient helpline but also a single point of contact for all clinical services. The model of service development in place strongly echoed that described by the King’s Fund (2017). Key principles included:
• Developing a shared vision and purpose: achieved by review of comparable services, identification of key issues in the patient’s pathway through services, working together to ensure smooth and efficient flow of patients through services
• Establishing frequent face to face contact: frequent working group meetings were established, with clear agendas and time for all views to be heard
• Acknowledging and resolving conflicts: different professionals brought different challenges, teams were taken outside their comfort zones exploring services which were not normally part of their remit
• An altruistic approach; although led by two heads of department the project was very much owned by the clinicians and supporting teams. Original time scales were highly fluid to ensure clinicians’ needs were met before moving onto the next stage of the project
• Long-term commitment to this project: this is a large project which it was envisaged would take time to complete therefore the group needed to commit to this long term piece of work and to each other.
Results The service now manages all new referrals for three out of four clinical services. Planned progression to manage all referrals will take place in summer 2017. The project is very much owned by the gateway team and steering group members.
Conclusion Collaborative leadership has produced a sustainable way of working for the benefit of our patients and families.
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