16 July - NHS non-executive directors webinar

16 July 2021

This week’s session opened in conversation with Mark Yates, Chair, Herefordshire and Worcestershire Health and Care NHS Trust.

The theme of the discussion was primary care and framed by a number of key questions including:

  • How should Trust Boards seek to support integrated care?

  • Can the ICS system deliver integrated care?

  • What are the main gaps in integrated care being identified at a Trust level?

  • Have gains in integrated care resulting from the Covid pandemic been mainstreamed?

  • How might the White Paper impact on delivering integrated care?

Addressing the theme, Mark said: “Many casual observers from outside the United Kingdom would think, we’ve got a national health service which surely must be integrated - so why are we talking about having to integrate care?"

“The truth is in this country we are fragmented into various different things, whether it be providers, CCGs, primary care and all the different governance that wraps around it."

“To me, integrated care is a simple thing that when you are a patient, wherever you enter the system, you should feel you are going place to place within the same provider of your healthcare. You don’t notice there are different providers dealing with your needs.”

“Unfortunately at the moment I believe there are too many different gaps between the divisions and providers. So for me integrated care is about the experience of the patient more than anything else.”

“Within the fire service there are national standards. I could wander into any fire service across the country and I’d see the same equipment, the same compatibility of equipment, the same training for staff.”

“In the NHS… you find a raft of differences. To understand the complexity of the NHS - the complexities of the NHS sets it aside from any other public service.”

Also overheard during today’s webinar:

“Surely integrated care is more than the NHS - care should reflect how we address the social determinants of health”

“Yesterday I heard that at the center the inequalities agenda is very much focused on health inequalities only and not all inequalities i.e. social determinants. My humble view is by narrowing it we are going to miss the boat, yet again.”

“As anchor institutions we can do much to help address such social determinants as employment and even housing and so on”

“Access to information is a fundamental problem faced by the NHS between and amongst all partners. What is NHSX doing about it? Most organisations have a digital strategy and solution being built but no consideration to pull other data sources such as inequalities data from the local authorities and linking it to the provision of care by a health provider.”

“Local authorities/police/fire are well advanced in local population data, so much of what the ICSs believe they need for public health management is already held and known - this is another reason why Local Government is so important to what ICSs should be about.”

“Local authorities - we’ll bring them to the party then shut them in the cloakroom. The NHS can’t disappoint local authorities on this.”

“Sadly local authorities are becoming disillusioned by the dominance of the NHS in the ICS structures.”

“Information exchange efforts still feel quite fractured and quite NHS primary and secondary care focussed. MH and Social Care are still a few steps behind in terms of standards and content exchange. Just another example of what feels like an NHS centric approach.”

“If systems are NHS focused is it not for us to open the door from the inside and invite colleagues in rather than wait for them to break down the door?”