What Healthcare Leaders Get Wrong About Coordinating Patient Care with Matthew Winn

So you've got that dimension of kind of merger and creating this larger organisation with all those possibilities.

At the same time, I'm very aware that your organisation will work in multiple localities.

I think all of whom I have at various stages worked in and I can testify they're different.

in terms of geography, in terms of demography, in terms of how local people think, in terms of politics, in terms of services.

So how do you have community integrated care organisations working in different local contexts and you still get a consistency of standards, governance, and yet you can be flexible to the needs of the local population if you're the service director or the... your place lead so it's that it's how do you get that consistency and local flexibility really working

yeah and that's that's a good balance to get right and it is a balance because it it's never static i think that delegated leadership helps that approach so our leaders are their jurisdictions map on to current local authority boundaries and one of our challenges is in Norfolk in Suffolk in Cambridgeshire and Peterborough local government reviews are going to fairly fundamentally change those local government boundaries and lots of our work whether it's in children's world SEND health visiting sexual health and adults and older people services all are kind of key partners with local government and indeed in Norfolk we have a very mature section 75 where we have integrated approaches around the adult social care workforce so You have to have that local leadership and those relationships.

And therefore, you have to go back to that point, support leaders to be able to do that.

I think, though, within that, there is something very hard and non-negotiable about standards of care.

So if I'm talking to our health visitors, we have health visitors across the whole of that patch, enormous set of, I think it's probably one of our biggest

single

professional groups, fabulous crew.

I will always say to them, as we always say to them is, look, we expect your professionalism, your standards of care, your adherence to the Healthy Child Programme and the evidence base underneath that, the local safeguarding policies, the interaction with midwifery and into primary care and early years in social care and into the councils.

To be absolutely clear, we expect that to be the same wherever we do it because that's non-negotiable.

But we expect you to bend and change your approach according to your demography, according to the needs of the population, whether that's faith, whether that's ethnicity, whatever it is.

If you're Luton, over 100 languages spoken.

If you're in rural Norfolk, you may be dealing with a higher proportion of traveller communities or Lithuanian communities because of historic economic kind of migration because of food processing in the east of the area, etc., etc., But you need to be very observant of that because that's good, inclusive, non-discriminatory NHS care.

And those two positions are a balance and they're not in opposition with each other and they work.

And that's the same approach we take with everything is that there's a absolute solid spine here, folks, of standards, great professionalism, leadership.

adhering to guidance, really making sure you are professionally sound in everything that you do, the trust supporting you to do that, but change and adapt according to your local circumstances.

And again, that's easy to say, quite hard to eke out so you don't have people going off in other directions.

And then I guess as to then above that, that's the whole essence of integrated care for neighbourhoods.

So we will do the same with neighbourhood care.

Most neighbourhoods, integrated neighbourhoods, are likely to be on the footprint of existing primary care networks.

Not all of them, but most of them will.

Where there's local authority boundary changes, that will challenge that slightly.

So you've got that dimension of kind of merger and creating this larger organisation with all those possibilities.

At the same time, I'm very aware that your organisation will work in multiple localities.

I think all of whom I have at various stages worked in and I can testify they're different.

in terms of geography, in terms of demography, in terms of how local people think, in terms of politics, in terms of services.

So how do you have community integrated care organisations working in different local contexts and you still get a consistency of standards, governance, and yet you can be flexible to the needs of the local population if you're the service director or the... your place lead so it's that it's how do you get that consistency and local flexibility really working

yeah and that's that's a good balance to get right and it is a balance because it it's never static i think that delegated leadership helps that approach so our leaders are their jurisdictions map on to current local authority boundaries and one of our challenges is in Norfolk in Suffolk in Cambridgeshire and Peterborough local government reviews are going to fairly fundamentally change those local government boundaries and lots of our work whether it's in children's world SEND health visiting sexual health and adults and older people services all are kind of key partners with local government and indeed in Norfolk we have a very mature section 75 where we have integrated approaches around the adult social care workforce so You have to have that local leadership and those relationships.

And therefore, you have to go back to that point, support leaders to be able to do that.

I think, though, within that, there is something very hard and non-negotiable about standards of care.

So if I'm talking to our health visitors, we have health visitors across the whole of that patch, enormous set of, I think it's probably one of our biggest

single

professional groups, fabulous crew.

I will always say to them, as we always say to them is, look, we expect your professionalism, your standards of care, your adherence to the Healthy Child Programme and the evidence base underneath that, the local safeguarding policies, the interaction with midwifery and into primary care and early years in social care and into the councils.

To be absolutely clear, we expect that to be the same wherever we do it because that's non-negotiable.

But we expect you to bend and change your approach according to your demography, according to the needs of the population, whether that's faith, whether that's ethnicity, whatever it is.

If you're Luton, over 100 languages spoken.

If you're in rural Norfolk, you may be dealing with a higher proportion of traveller communities or Lithuanian communities because of historic economic kind of migration because of food processing in the east of the area, etc., etc., But you need to be very observant of that because that's good, inclusive, non-discriminatory NHS care.

And those two positions are a balance and they're not in opposition with each other and they work.

And that's the same approach we take with everything is that there's a absolute solid spine here, folks, of standards, great professionalism, leadership.

adhering to guidance, really making sure you are professionally sound in everything that you do, the trust supporting you to do that, but change and adapt according to your local circumstances.

And again, that's easy to say, quite hard to eke out so you don't have people going off in other directions.

And then I guess as to then above that, that's the whole essence of integrated care for neighbourhoods.

So we will do the same with neighbourhood care.

Most neighbourhoods, integrated neighbourhoods, are likely to be on the footprint of existing primary care networks.

Not all of them, but most of them will.

Where there's local authority boundary changes, that will challenge that slightly.