System Wide Governance and Leadership: A New Governance Model to Rethink How Performance is Measured; How Integrated Services are Contracted, Funded and Co-ordinated and How Outcomes and Benefits are Assessed
Authors: Cook Ailsa , Main Gill 
Published: January 2024

This workshop shares learning from the work of Midlothian Health and Social Care Partnership to develop a strategic governance and performance framework that supports person centred practice and assesses impact on outcomes for people.
It is widely recognised that for person centred approaches to be sustained, they need to go beyond practice and be embedded within the culture, systems and processes of health and social care organisations. This poses a challenge for traditional approaches to performance management, which tend to hold services accountable for delivering on easily measurable service outputs, rather than working in the flexible and outcome focused ways required to be person centred. In this workshop we share learning from work carried out by Midlothian Health and Social Care Partnership to align strategic governance and performance systems with their commitment to person centred practice and provide space for workshop participants to explore how they could put learning into practice.
Midlothian HSCP are responsible for delivering and commissioning integrated services and supports to a local population of about 93,000 people in Scotland. The partnership has been strongly committed to embedding person centred practice for many years and have established the ‘MidWay’ approach to having ‘Good Conversations’ and building relationships with people, where services facilitate change, rather than aim to fix it.
The partnership recognised that their strategic governance and performance approach was not aligned with this focus on person centred practice and outcomes for people. In 2020 they commissioned Matter of Focus to work with them to develop an outcome focused performance framework underpinned by the Matter of Focus approach and software OutNav. Over the past 2.5 years the framework has been tested and refined by diverse services and teams and is now being rolled out across the partnership.
The Matter of Focus approach is informed by contribution analysis and evidence to action approaches and enables organisations delivering complex change that is people based to evidence contribution to desired outcomes, rather than attribution. The approach and software is being used by more than 150 organisations internationally.

The workshop will be of interest to managers, leaders, researchers and policy makers looking to embed person centred practice at scale and to improve governance and performance management approaches.
The interactive workshop will involve: 5 minutes welcome and introductions; 10 minutes table discussion; 10 minute presentation on the Matter of Focus approach; 15 minute presentation on the framework and lessons learnt from Midlothian HSCP; 10 minute table discussions; 10 minutes feedback from tables, summary of take home messages and close.
The audience will be engaged through focused discussion questions at the tables. Take home messages will be captured from each table by the presenters in the final feedback session.