The role of Chief Medical Officer exists to ensure there is a strong clinical and care professional voice at the heart of all of the decisions that we make as a system. This is particularly important when it comes to thinking about the quality of care that people receive, ensuring that access to care is equitable, and there isn’t unnecessary variation in care outcomes for people across south east London depending on care provider.
We also want to work with partners and communities to tackle some of those wider determinants that we know contribute to inequalities, targeting more resources to those who are most deprived and disadvantaged in our communities.
We have identified a number of strategic priorities as a system with a strong focus on prevention and giving young people the best start in life, improving early intervention for people with mental health needs, and ensuring that people with complex needs have more accessible and integrated support in the community.
The digital element of our role focuses on how we create the capability in our system to use insights about our population to help us better understand people’s needs and translate this into service delivery through processes of innovation and improvement. It often surprises people that currently the health and care data we have on our population is not well joined up, which means that care professionals in one setting won’t necessarily have access to all the information they need regarding the person they’re looking after. All of this negatively impacts care.
We’re looking at how we join up care records, but we’re also looking at how we then use that data to start being much more proactive – predicting and anticipating people’s needs and offering more personalised and targeted support to those people who might be currently disadvantaged by the system.
Thanks to Clinical Effectiveness teams across south east London we are already having some success in reducing the variation in care that sometimes exists across general practice, particularly with regard to patients with long term conditions. This is an important initiative and has taught us a lot about how to work at both a south east London and local level effectively. The challenge for us as an ICS is to ensure the necessary capacity and capability to improve and integrate care pathways exists at every level of our system.
To enable this we are focusing very strongly on developing system leadership which helps us to think beyond our individual organisational boundaries and work collectively as a system to transform care for people receiving local services.
We have already developed a diverse leadership community of nearly 400 people who have defined our five system leadership characteristics in south east London, and led the establishment of our SEL System Leadership Academy, including a new and unique system leadership programme – Collaborate, to develop and connect leaders across the system, and Connect – our Spread and Scale programme work to encourage innovation.
One of the things that we have consistently heard from people is that because we work within our individual organisations, we often don’t provide a truly seamless experience of care. People fall through the cracks and get frustrated by the administrative boundaries that we create between our partner organisations that don’t reflect individual needs, which often extend beyond a single institution or place.
All of this impacts on people’s experience of care. It also effects the fulfilment of the paid and unpaid carers who provide care and support to some of our most vulnerable residents. They tell us that they find it equally frustrating and demoralising to have to overcome artificial boundaries to ensure people receive more holistic care.
Currently, a lot of effort is being made to help people connect, understand each other’s perspectives and to reach across organisational boundaries. This requires a different kind of leadership in our system and in many ways is going to require those of us who worked in organisations for a long time to unlearn some of the sort of leadership habits that we have developed, which are often much more based on hierarchy, role and status – rather than relationship, networks and empowerment.
Culturally we must shift away from only thinking about the part of a care pathway that we deliver in our particular organisation and focus on the end-to-end experience for a person living in south east London.
We have to create a culture of collaboration as a system where we can genuinely integrate care, ensure that people have a seamless experience, and feel supported by a range of professionals from different organisations who are communicating with each other.
This change will not be the result of the current organisational reconfiguration we are undertaking, it will need to be much more bottom-up. I am passionate about the potential for care professionals in our system, working hand-in-hand with local communities, to really drive forward improvements in care and outcomes for people in south east London.
We need to nurture and cultivate the fantastic assets that we have in our community and voluntary sector, and in our workforce. There are still people who are who are not being listened to, who are feeling unable to contribute to the work that we want to do as a system. We must make sure their voices are heard, and they can contribute to the improvements we need to make – for me this is the key.