The University of Manchester

Alliance Manchester Business School

MA

NC

HES

T ER

1824

Leadership responses to global health challenges and opportunities

Judit Csiszar MD MSc MBACo-Director IHL

Manchester Business School

November2017

My starting point

• Healthcare is an extremely complex field that includes science, technology, art, and – above all -the human element

• Many of its complexities are dealt with through new advances in science, technology and innovationadvances in science, technology and innovation

• Much of what we do now will be soon replaced by innovative technologies– AND IT IS NOT OUR CHOICE as professionals whether or not we like this- it is up to patients and citizens to choose/decide !

The “soft” side

• The human element

• Leaders work with and through people

• Understanding self, teams, organisations, networks and systems as well as data is key in 21st

century*

• *Frenk at al. 21st Century health professional- Lancet

Change

• All health systems- regardless of how ‘good’ or ‘bad’ they are- need improvement and change continuously

• About 70% of change projects/initiatives fail

• They do not usually fail for lack of funding or • They do not usually fail for lack of funding or management mistakes

• They fail because leaders fail to persuade people around them to support the changes (vision, values)

• Change is often messy, haphazard, difficult to “manage” but leadership can make a real difference.

Introduction

Demand side• Demographic changes

• Social changes (changes in the fabric of society)

Supply side• Capacities do not match needs

• Spiralling healthcare costs

• Growing inequalities

Health systems are in transition EVERYWHERE owing to the discrepancy between demand/supply for healthcare and the sustainability challenge

the fabric of society)

• Changing disease patterns

• Growing patient expectations

• Mass migration

• New threats to health (lifestyle, climate change, bioterrorism, AB resistance, etc.)

• Growing inequalities

• Qualitative and quantitative shortage of qualified health workers

• Fragmentation of care systems

• The economics of behaviours and lifestyle

• Integration of new technologies and solutions into existing structures, etc.

Demographics

• Life Expectancy-Hong Kong 83.7; Japan 83.3 Lesoto 46; Central African Republic 45.91

• HALE…at birth 63.1 globally (WHO) –44.4 in Sierra Leone (33.7 for male)

• At age 60 - 21 yrs in Japan, 9 yrs in • At age 60 - 21 yrs in Japan, 9 yrs in Sierra Leone

• Self reported health: Canada 89/100 USA 88/100; Russia 37/100

• Life satisfaction- Denmark, S Korea, Switzerland, Iceland 7.5/10Portugal 5.1/10; Italy, Russia 6/10

Changing disease patterns, new challenges

• NCDs

• Mental health

• AB overuse (multi-resistant pathogens)

• Resurgence of old, emergence of new communicable diseases

• Bioterrorism

• Climate related threats

• Cyber terrorism

Spiraling costs

Volume vs. capacity

• Universal healthcare- health as a human right

• Cost of workforce and technology

Cost of innovations

• Time to market from research• Time to market from research

• Lack of evidence of cost-

effectiveness

Prevention vs. cure/care

• Much of funding goes to

• disease care vs Health care

• Appr. 3% of health budgets in

the EU spent on prevention vs. cure/care

Patient expectations

• Information revolution (quality, reliability of information; inequality of access)

• Shifting the balance of power (the expert patient, data cooperatives, expert patient, data cooperatives, purchasing power, broadening choices- e.g. cross border care, medical tourism, etc.)

• Marketing (new channels and providers, easy direct access to patients and providers- highly unregulated segments of the market-dark web, etc)

• Health as a human right

Workforce issues

Quantitative shortage

• 7M HCW is missing overall

• Balance of distribution

Qualitative-shortage

• Inadequate skill mix ( generalist vs. specialist, care vs. cure, data literacy skills, public health skills, communication skills)data literacy skills, public health skills, communication skills)

• Education doesn’t keep pace with demand and doesn’t reflect needs

• Professional profiles and training needs in health/care

• Brain drain

• Where is leadership training in medical /nursing curricula?

Over 100 nationalitiesIn the NHS

Inequalities

Economics ofBehaviours & lifestyle

• Impact of behaviours and lifestyle and behaviour- on disease burden, productivity, health and social care spending

• Behavioural impact on environment (environmental literacy, planetary health)

SYSTEMIC ISSUES THAT NEED HEALTH SYSTEMIC ISSUES THAT NEED HEALTH GOVERNANCE, WHOLE of GOVERNMENT

WHOLE of SOCIETY SOLUTIONS and LEADERSHIP

(WHO)

Leadership trends

• Repeatable tasks AI

• Predictive analytics certain levels of decision making and management

• Ability to communicate with different audiences to persuade/influence audiences to persuade/influence (values and vision)

• Workforce to prepare for varied career over an extended work-life

• Working with- often remote-workforce (collaborative vs. heroic leadership) .

• “Pro-silience” vs resilience

Global health governance structures, actors

NEJM, 368:10. 2013

From MDGs to SDGs

Health: 21st century mindset

• The most exciting breakthroughs in the 21st century will not occur because of technology, but because of an expanding concept ofwhat it means to be human. ( John Naisbitt)

• Measuring success of societies in terms of the sustainable use of resources, particularly with sustainable use of resources, particularly with regard to the environment and in terms of the increased well being of citizens and their quality of life vs. narrow economic measurements

• Positioning human health and well being as an overarching societal goal as a key feature of what constitutes a successful society in the 21st

century

Systems Thinking in Health

Ageing a „wicked problem“

• Both the problems and the solutions are systemic.

• A complex system of determinants, and a plethora of actors with many different functions in society. society.

• Risk patterns are local (e.g. individual lifestyle, culture) as well as national (fragmentation of health and social support systems, lack of funding, cultural traditions) and global (changing the fabric of society, the changing concept of “distance”).(Foresight Report)

• Equity is cross cutting

GOVERNANCE FOR HEALTH IN THE 21ST CENTURYGOVERNANCE FOR HEALTH IN THE 21ST CENTURY

Health and Well Being

Social Determinants of Health

21st Century Determinants of Health – TRANSNATIONAL

WHOLE OF SOCIETYWHOLE OF SOCIETY

SMART GOVERNANCE

Whole of GovernmentHealth in All Policies

Shared Value – Corporate Social Responsibility

Community and Consumer Engagement

Government Action Business Action Citizen Action

HEALTH is created in the context of everyday life – where people live, love, work, play, shop, google, travel…

Kickbusch 2011

Innovations in public health

• Healthy cities /communities (WHO)

• Public Private Partnerships –increasing involvement of business and academia in society

• Sustainability and Transformation Partnerships (STP) and Accountable Care Systems (ACS) -UK

• Buutzoorg (NL) • Buutzoorg (NL)

• Virtual hospital, Medical homes (UK, US)

• European Innovation Partnership for Active and Healthy Ageing (EIP-AHA) Ambient assisted living (AAL); EIT Health - Europe

• Asset based approach to health (HAA)-mutual assistance communities (MAC)

• Community accountable medical curricula

• Social prescribing

Innovations -Personalisedhealth care

Personalized Medicine/ Therapeutics

• pharmaceuticals, medical devices and genomic medicine.

Personalized Nutrition & Wellness, physical activities

Personalized Medicine Diagnostics

• lab services, genetic testing, lab

Precision medicine

• lab services, genetic testing, lab tests and direct-to-consumer (DTC) diagnostics.

Personalized Care

• health information technology, prevention, disease management and telemedicine.

Innovation- AI technological and business model

innovations • Artificial Intelligence- exponentially growing computing

power, miniaturization, integration, machine learning, the internet of things

• Wearable technologies, 3d printing, -omics, internet of • Wearable technologies, 3d printing, -omics, internet of things replace traditional diagnostic and curative solutions

• m-Health to reach out to hard to reach populations

• Gamification for generation Y

• Business model innovations (health credit system, data cooperatives, crowd funding, etc)

Examples of great leadership with anIMPACT

Governance for health is not only about “governing better for results” in terms of outcome but also in normative terms of outcome but also in normative terms of

values and process.It requires

LEADERSHIP

International Health Leadership

MSc in International Health Leadership (IHL)

• Golden threads

• Blended learning that fits with full time work

• Scarcity and quality

• Renowned faculty and guest speakers sharing experiences from across the worldexperiences from across the world

• Original thinking - applied ( action learning, experiential learning)

Testimonies: “in my 20 years of education I never experienced anything like this”….“Life changing” … “You have spoken for only 30 minutes in the entire residential, yet I never learnt so much!”

Singapore Institute of Management

Presented by:

Mr. Edgar Tai

Manager, Regional Recruitment

Singapore Institute of Management (SIM) GroupFounded in1964. Largest and most comprehensive private education and training

solutions provider in Singapore

• Provides in-company

• Offers high quality

• Renamed as SUSS –Singapore University

• Offers International Secondary School company

training & consultancy services

• Organises 600 seminars, workshops & conferences annually

• 11,000 professionals

quality academic programmethrough partnerships with established international universities from UK, US, and Australia

• 20,000 students

Singapore University of Social Sciences

• Established in 2005• Officially 6th local

university in Singapore to award full-time and part-time degrees for Singapore/ SPR students

• 14,000 students

Secondary School program and prepares students for the Cambridge International General Certificate of Secondary Education (IGCSE ‘O’ levels)

• Integrated boarding programme

55. Campus Life. Campus Life

To study hard and play hard

20,000STUDENTS 4,000

INTERNATIONAL STUDENTS

80STUDENT CLUBS

And many others

To study hard and play hardDevelop Network for future contacts

55. Campus Life. Campus Life

Career Guidance, Career Fair,

Professional Trainings

Summer Schools, Exchange & Holiday

programmes

80 student Clubs, by Nationalities,

Universities and Interest

Learning Support

Student Development and Support

Faculties and MajorsFaculties and Majors

Psychology, Social Sciences CommunicationComputing and IT

From Undergraduate to Postgraduate LevelFrom Undergraduate to Postgraduate Level

Economics and FinanceLogistics Management Business, Management, Marketing

SIM was voted by AsiaOne.com readers as the

Top 3 Private School in SingaporeTop 3 Private School in Singaporein “AsiaOne People's Choice Awards” for

8 consecutive years (2008 8 consecutive years (2008 –– 2016) 2016)

SIM Global Education - US SIM Global Education - UKSIM Global Education -

Australia

DurationDuration Course FeeCourse Fee LocationLocation Same QualificationSame Qualification

MSc International Healthcare Leadership

The University of Manchester UKUK

International Healthcare Leadership

“The FOUR Golden Threads”

International Healthcare Leadership

Leading throughNetworks

International Perspectives

The FOUR Golden Threadsof Healthcare Leadership

Creativity & InnovationPutting Patients at the Heart of Delivery

• Focus on challenges presented to healthcare leaders

• Learn how innovative ways transform healthcare system

• Focus on international healthcare systems & policies

Programme Objectives

• Focus on international healthcare systems & policies

• Problem-based learning and practical case studies

• The FOUR Golden Threads of Healthcare Leadership

• Cutting edge blended e-learning approach

• Evidence and action-based learning

• Face-to-Face Residential Workshops

Learning Pedagogy

• Face-to-Face Residential Workshops

• Interactive online contact

• Fully taught by the faculty from Manchester

• 30% theory / 70% Applied-Based Learning

• 2 Years Part Time

• 8 healthcare CORE modules

• Work-based case study

Programme Structure

• Work-based case study

• Online learning of 6 hours per week

• 6 Interactive Action Learning weeks

• 100% assignment-based

Interactive Learning

Video Conferencing with AMBS

Action-Based Learning

Industry Guest Speaker

• Bachelor’s degree (Upper 2nd Class Honours degree or itsequivalent) with minimum two years of management experience

• Candidates with other qualifications or extensive relevant workingexperience can be assessed on individual merit

Admission Criteria

experience can be assessed on individual merit

A minimum of C6 pass in English as 1st Language at GCE ‘O’ level; OR

IELTS 7.0 (with speaking and writing 6.5 and no other element below 6.0)

• Allied healthcare professionals, including social workers, medical andnursing researchers, scientists, pharmacists, nutritionists and counsellors

• Directors, Managers and Administrators in the comprehensive and

Who Can Apply?

• Directors, Managers and Administrators in the comprehensive andcommunity hospitals, nursing homes, health economists and various otherpractitioners in the healthcare industry

• Clinicians who aspire to assume greater leadership positions, includingphysicians, nurses, psychologists and therapists

March 2018 IntakeMarch 2018 IntakeApplication closes on 08 December 2017

“The distinguishing factor in this program has been the emphasis on aninternational perspective on healthcare. The evidence-based teachingapproach used by University of Manchester is also laudable in addingcredibility to their course.”

Dr Ramasamy Chockalingam JnrDr Ramasamy Chockalingam JnrMedical DoctorNational Heart Centre SingaporeMSc International Healthcare Leadership

“This programme equips me with the fundamental contexts of currentinternational leading health systems and policies; health economics andits impact on current leaders’ decision-making process; and mostimportantly to acquire an in-depth knowledge and techniques in theapplication of the “soft” side of leadership to meet up with theapplication of the “soft” side of leadership to meet up with theexpectation of our global healthcare challenges in leading collectively.”

Chong C.Y.Nurse ClinicianTan Tock Seng HospitalMSc International Healthcare Leadership

“It was overall, a good experience thus far! A good foundation and allrounded curriculum for any healthcare professional who already has vastexperience in clinical settings and wishes to develop and learn moreabout leadership skills.”

Mae GayMae GayRegistered Diagnostic Cardiac Sonographer (RDCS)Paediatric Cardiac SonographerNational University HospitalMSc International Healthcare Leadership

“Throughout the workshop, we have the opportunities to interact withpeers of other healthcare institutions and other industries. Knowledgesharing, team bonding and rapport building were evidence in the activelearning sessions. I am confident that the knowledge acquired and skillsdeveloped from this master programme will remain relevant to thedeveloped from this master programme will remain relevant to thechanging needs of the healthcare industry.”

Anthony LimDeputy DirectorOperational Support ServicesPublic HospitalMSc International Healthcare Leadership

“Combined work in small teams encouraged dialogue with one anotherand added to the fun factor in the training. It was an efficient and highlyencouraging programme for all. I’ve come across a lot of leadershipmodels, and I find this master programme to be the most practical anduseful tool that builds truly good leaders.”useful tool that builds truly good leaders.”

Amamio RenalynNurse ClinicianNursing HomeMSc International Healthcare Leadership