NEWS FOCUS: Working together to drive the modernisation agenda. . .Was it a dream come true when management, finance and nurse trainees got together at HSJ's Future Leaders management challenge? Paul Stephenson reports

The managers, finance staff and nurses had settled down quickly and team-building was coming on apace. Trusts, health authorities and social services departments seemed to be working together in partnership.

Then, suddenly, it all started to look very shaky.

The acute trust's breast screening service was being investigated by the Commission for Health Improvement, and the media were about to report that thousands of women could not now be sure if their results were accurate.

Women calling the hotline speedily set up to deal with the crisis might have to wait weeks until they were reassured.

Despite developing a joint media strategy with the HA, the trust seemed to be in utter chaos about the facts of the case. And the HA spokesperson promised the media that heads would roll at the trust once the investigation was completed.

The second HSJ Future Leaders management challenge, run by Birmingham University's health services management centre, was under way at Aston Villa football club, bringing together people on the NHS management training scheme with those on finance management and nurse leader training schemes.

This year's scenarios, also played out by the more senior managers a couple of months ago, may have seemed worryingly true to real life and were tackled by the trainees with enough vigour and enthusiasm to suggest that they thought real lives - and their careers - were at stake.

While the teams playing the role of the acute trust were getting hot under the collar, things were not a lot better over at the mental health trust, where the human resources director described a major review of services as 'tweaking', but then had to admit there would be 'no guarantee about redundancies or service disruption'.

The council wasn't too pleased about that. It didn't want redundancies or service cuts, and social services were muttering darkly about poor consultation. By now the media was having a field day.

Around 150 people took part in this year's challenge, one of the crucial aspects being to assess how teams playing acute mental health and primary care trusts as well as HAs and local councils would work together to drive the modernisation agenda. The answer was, in some cases, not very well - with a few teams simply forgetting all about those they were working with.Others, though, had a vibrant health and social services economy up and running in no time.

Across the clusters there were varied requests to meet outside organisations. Some teams set up a meeting with the dean of the local university to discuss how nurse and doctor training could be improved. They were more successful than the stunned council which was told, on meeting the education action zone leader, that she had just handed in her resignation because she hadn't had any support for six months.

The enthusiasm of the participants was evident, but so was their honesty. One of the HA teams noticed their briefing told them they were 'lacking in innovation', and proceeded to stick to that brief all day, overlooking the possibility that things might change.

So what did those taking part and watching proceedings make of it? Practice development nurse Marie Jones from Birmingham Heartlands & Solihull trust said:

'It has been an opportunity to work with other organisations critical to providing healthcare, that I would not normally encounter. The diversity of people here has certainly stimulated more new discussion.'

Observer Alex Roberts, divisional manager for medicine at North Manchester Healthcare trust, says: 'The mix of the groups made the discussions really interesting.What they will have taken away is the capacity to work together. The nurses said they didn't realise how it was for managers.

They have learned a lot about communication.'

Richard Wells, an NHS trainee based at the Three Centres Cancer Network in Cheltenham, said: 'It was interesting to see issues at that sort of level.You get a reflection of how people work under pressure.'

He said the challenge was important in showing him 'what I am capable of in terms of leading, and giving me more confidence'.

Financial management training scheme trainee Caroline Dunn, who works at Barts and the London trust, said it was interesting 'to sit with management and nurses, and see how they approach a strategic problem'.

She added: 'It was well-organised and the model was accurate and considered and up-to-date.'

Prizes were presented to the most joined-up and modern at the end of the day by NHS modernisation agency director David Fillingham. He reminded the trainees that 'the heart of it has got to be delivering really effective services for patients'.