26 April 2021
Most of us will have read this week’s glaring headlines that 4.7 million people are now waiting for routine operations in England because of the pandemic. The reports also suggest substantial numbers are waiting more than a year and there is a 12-year high for the number of people on NHS waiting lists.
The effect of COVID-19 has consequences for us all and we’ve seen its effects in widening inequalities and increasing population health needs. At Mersey Care, the demands we face puts pressure on our existing models of care, as well as exacerbating the national shortages of trained staff in mental health, learning disabilities and community services.
That said, our own staff and the system’s response to COVID-19 has given us a head start in putting in place some of the strategic solutions to these challenges. I wrote last week about our newly published strategic and operational plans and how we’ve strengthened our partnerships within the health and care system and with councils. This includes new work with Sefton Council, on their preparations for integrated care across their population following the Government white paper on the future of health and care. They’ve established a strategic task and finish group to steer integrated care development across the area, which will report into Sefton’s Health and Wellbeing Board and I’ve been invited to join them.
This invitation arrives as my work with the Cheshire and Merseyside out of hospital cell ends. I’ve now stood down as chair, handing over to Jackie Bene, chief officer of the Cheshire and Merseyside Health and Care Partnership. Given the current COVID-19 position and in the light of the proposed white paper on integrated care system, both the timing and my replacement make sense in doing this now. Mersey Care remains committed to supporting this important work and as chief executive, I’m sure it will never be far from my task list.
Our new strategy documents make it clear our Trust – all of us - are committed to realising the full benefit of population health management. This means reducing acuity of needs and achieving equity of access for disadvantaged groups. We’re laying the groundwork for this by understanding the link between expenditure and value and looking at needs not met in our communities. Once we’ve got all the data, we intend to embed population health management across our organisation.
This kind of planning ahead comes from our strong position. We’ve built into our plans that much of 2021 will involve COVID-19 incident management and recovery. By the third quarter of the year – from September – we anticipate a greater focus on delivering our strategic intentions and the clinical divisions’ own developmental priorities.
This phased approach also aligns with the national planning and financial framework, the publication of which has been delayed due to the impact of the pandemic. As we emerge from COVID-19, a phrase we’ll hear a lot, Mersey Care will embed the quality and safety accreditation framework, developing strategies for learning disabilities and children and young people’s services, while also working with partners to implement the urgent treatment centre model.
One of our long term ambitions as a Trust is to demonstrate that we realise the benefits of mental and physical health integration for vulnerable groups by 2023. This focus on integration in community physical and mental health services makes sense because patients receiving care in community settings often have multiple, complex health needs.
They depend on a range of health and social care services to meet these needs and although integration often sounds like a process we can’t quite grasp, treating mind and body equally is simply the right thing to do. We aim to meet the needs of those we serve by using intelligence to drive our integration plans.
In practice, this means things like pushing ahead with our one neighbourhood team programme, building on the work of our integrated care teams. We know tailored interventions are needed at neighbourhood level to manage the particular health and care needs of the community and tackle the root causes of health inequalities.
Similarly, we’ll develop our integrated palliative care team, known as IMPaCT. This provides a consultant-led, integrated, multi-professional palliative care service for people with a life-limiting, progressive condition. It brings all palliative care services across primary, secondary, and tertiary care into a single integrated service. I’ll keep you informed as the detail on these inevitably sharpens. As ever, we’ll be listening to staff and stakeholders and consolidating our COVID-19 learning.
Frankly, this should be business as usual, but by putting it front and centre, we’re making a firm statement. It’s a logical progression of our Restorative Just and Learning Culture and we intend to change staff job descriptions to build this into our daily duties, which I think you’ll agree is quite radical.
From this year, and with the approval of staff side, we’re asking everyone to take the training so all staff are ambassadors for civility and respect. Just as we adhere to the rules and expectations of all the other legislation and policies we have in our work, being an advocate for civility and respect is now part of who we are and what we do.
Aside from the training, this isn't an ask of people's time. We’re busier than ever and we’re aware of the pressures. We want to develop everyone’s psychological safety so staff know they can call out inappropriate behaviours. In fact, I hope it will make a difference to some of those pressures.
Mersey Care has developed tools to help, but this is a simple ask. Let’s all become confident supporters and implementers of the Trust CARES values, which include civility and respect.
I’ve met and worked with many of our original ambassadors and they have played a pivotal role in our success to date, supporting the cascade of messages and role modelling. Looking ahead they’ll become lead ambassadors, bringing their additional experience to continue to influence the future of this work.
Finally, after my brush with podcast stardom last month, can I recommend the work of one of our prominent and tireless service users, Waffa Nasser.
Her ongoing personal podcast initiative is always worth keeping an ear open for, and her latest episode, called ‘Mental Health and COVID-19 Vaccine’ is of particular resonance.
Waffa highlights that some harder to reach people are still not confident in getting the vaccine. She rightly says that telling her story of getting it may help reassure some people. Have a listen and of course – have that jab.
Prof Joe Rafferty CBE