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Chief Executive’s Message – Friday 26 February

February 26, 2021

My thanks to all the teams working hard to progress the new Midland Metropolitan University Hospital. It is encouraging that the construction work has continued despite Covid and 2022 remains the opening timeframe. Many clinical teams will begin to be re-oriented to the plans for clinical services in coming weeks.

The vaccination programme remains mission critical for teams in Sandwell and West Birmingham and great progress has been made. It is vital that people take up the offer of a vaccine. We know that there are attempts by anti-vaccination campaigners to thwart high uptake levels. My message to you is this – make your decision based on information you have from people who are trusted. Many of our clinicians have shared information about the vaccines and their effectiveness and will continue to do so. If you have heard stories about bad side-effects such as infertility, they are untested myth. If you have concerns talk to your line manager, or any of our clinical leaders. Our fabulous R&D team will happily talk to you about the rigorous process these vaccines had to go through before they were deemed safe to use.

I wanted to reflect here on integrated care.  It is a couple of words that has been banded about rather too loosely in NHS and social care circles for decades, often without a clear definition of what is meant by it or what it is intended to achieve.  As a result, clinicians and practitioners are left somewhat unclear about what is expected of them in this context and all too often, nothing happens and the status quo continues.

For what it’s worth, I have two definitions of integrated care which are applicable to our short, medium and long term future work in Sandwell & West Birmingham:

  1. The simple, more prosaic definition of integrated care for me is the efficiency and effectiveness of a service user or patient journey, being so smooth and well-coordinated, that the service user “doesn’t see the join”.  The virtual walls in policy or process between staff in different agencies or even, rather worryingly, between departments in the same organisation, do not disadvantage the user of the service.  The end result is a journey, from referral to treatment or receipt of a service, in which the service user is kept well informed as to the next stage in their journey and the hand offs between services are seamless.  This may seem, to long time sufferers of the inefficiencies of our services, a nirvana which we may never reach.  But we must deliver it, because this is the simpler, more short-term definition of integrated care.  The harder, longer term integrated care dream is described in my next point below.  For now, try to think of it this way – ask yourselves the question “How do I stop REFERRING one of my service users to another service and instead COMMUNICATE with the receiving service or department to invite the individual to the next stage of their care?”  In Walsall, where I have come from, one of the ambitions we set ourselves in this space was to eradicate referrals and hand offs from one service to another, within five years.  We must think differently if we are to do differently.
  2. The longer term definition of integrated care for me, relates to the effective improvement of population health and to reduce health inequalities in our populations.  You don’t need me to tell you that we serve a hugely diverse and often, very deprived population.  There are inbuilt inequalities in service access, digital exclusion, in clinical outcome.  There is a 10 year gap in healthy life expectancy between the wealthiest wards of our two populations and the poorest.  Let’s be frank with each other – COVID-19 and the probable economic problems associated with exit from the EU will compound that.  If we don’t change how we impact upon what determines better health, then the demand on our services will increase beyond that which we can service.  We have set up Integrated Care Partnerships (ICPs) in each borough or place, all over England, to try to tackle this.  A functioning and successful ICP will have council, Trust, mental health Trust, GPs, housing and voluntary sector agencies all around the table.  Their aim?  To improve the social circumstances and life choices of people to add life to years and years to life.  To avoid chronic disease where we can and reduce the burden on society of poor health and mental health.  To achieve this, it takes investment, good planning and practical hard work.  We need to increasingly treat each ICP as an organisation in its own right and therefore break down the traditional walls between the different agencies.  We are only at the start of that journey in our part of the world, but the needs of our population, as well as the success of our new hospital care model, depend on it maturing quickly.

I will put integrated care for our populations locally, at the centre of what I prioritise and at the centre of our actions as a Trust.  Our vision is to be the best integrated care organisation in the country.  That’s a great vision.  But we have not yet begun to deliver it.  You can help us achieve it.

Richard Beeken