Care must be designed and delivered with the patient at centre

Tosca Fairchild is Chief of Staff for the South East London Integrated Care System (ICS), a role that holds a large amount of responsibility and oversees many functions. Here she tells us about her role.

Tosca FairchildChief of Staff, South East London Integrated Care Board
22 Mar 2023
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The Chief of Staff role holds a large amount of responsibility and oversees many functions across NHS South East London Integrated Care System (ICS), including HR, equality, diversity and inclusion, sustainability, operations, emergency planning and corporate IT.

The combination of these roles ensures that we meet our statutory and legal obligations, as well as maintain a dedicated and happy workforce that is equipped, supported and feels listened to, so they can look after the health and care needs of our diverse communities.

We asked Tosca Fairchild, our Chief of Staff, to tell us a bit more about these aspects of her role.

Equality, diversity and inclusion

“Our workforce is largely representative of the diverse communities that make up south east London, but we still have work to do in terms of seeing more diversity across senior roles. A lot of our work is about tackling health inequalities, and we need to make sure that we recruit, develop and look after staff in a way that positively impacts patients and the wider community. For example, we know that health inequalities are linked to the wider determinants of health, of which poverty is one.  Therefore, from a workforce perspective, we should ensure staff are appropriately remunerated and have access to support if needed.  When staff are looked after well, they will look after patients well.

“My goal is to have a truly equitable workforce and make sure that as an organisation we truly value equality, diversity and inclusion.”


“We are working towards the national NHS goal to reach net zero by 2045. Part of my role as Chief of Staff is to ensure we are doing all we can to reach this target, alongside all our NHS colleagues. As an ICS we will meet this new duty through the delivery of a localised Green Plan, which sets out our aims, objectives and delivery plans for carbon reduction and includes, for example, driving the efforts to recycle masks and introduce car charging points to help reduce emissions.”

Corporate responsibility

Corporate responsibility is our impact as an organisation on the world around us.

“The pandemic introduced new ways of working for many people in the NHS, and ensuring we were equipped to continue business as usual in our ‘new normal’ was extremely important – and continues to be.  In my role I make sure the workforce have the right equipment to do their jobs, as well as equipping GP practices in south east London with the necessary systems, and making sure we adhere strictly to data protection regulations.”

My hopes for the ICS

“The change from a Clinical Commissioning Group (CCG) to an ICS was a great moment of change for our staff, as it involved coming together with multiple organisations to plan and pay for health and care services to improve the lives of people who live and work in our local community. I was truly impressed by the resilience of staff through the change process, and this was a testament to the organisational development and health and wellbeing support we commissioned, and equipping people with the right tools to do their jobs.”

“My biggest hope for the ICS is to eliminate health inequalities and provide seamless care utilising partnerships across health and social care, and the voluntary sector, regardless of organisational boundaries, eliminating breaks in care and providing people with access to the right support.  For this to happen, care must be designed and delivered with the patient at centre – taking into account patient and carer views and feedback. The partnerships we hold with local councils and the voluntary and community sector work to support the needs of patients throughout their whole journey to getting better and staying well. I am hopeful the ICS will succeed in this.”