Dr Kathy McLean – Independent Chair of Nottingham and Nottinghamshire Integrated Care System (ICS)

I can hardly believe the end of my third month as Independent Chair for Nottingham and Nottinghamshire Integrated Care System is so near. Over the last few weeks I have had conversations and meetings with many of you as leaders and partners and together we know more about the national guidance and expectations for system working. This feels like a good time to reflect on what I have learnt and what I believe are some of the challenges and opportunities ahead.

I have been struck by the high level of enthusiasm and engagement everyone has expressed about making a difference for our population. This has been evident in conversations with colleagues in both the NHS and Local Authorities. I will also be spending time engaging with partners in other organisations and anticipate a similar commitment. I see many positive examples being driven forward by talented people, the most recent, perhaps, being the way the Covid-19 vaccination programme has been rolled out. This has involved hundreds of people from leaders at the whole system level to vaccinators in communities and neighbourhoods.

I’m delighted to see how successful this has been, really demonstrating a data-led approach to service delivery and strong partnership working – it’s great to hear about how the Councils are calling vulnerable residents to encourage them to come forward and also fielding incoming enquiries using their customer service expertise.   Primary and secondary care are working closely together to support vulnerable and potentially excluded groups to get their vaccination, including those with Learning Disabilities, Serious Mental Illness or who might be housebound. Our Integrated Care Partnerships have led on the work to target areas of lower uptake, using all their knowledge of community and voluntary assets. These are models for the future and will provide learning for wider areas of improvement.

One of the first things I have done is to discuss how we can build on the good foundations by developing a ‘Leadership Compact’ to guide the way we work together. Once agreed by all partners I hope we will use this to influence our discussions and decision making. One challenge for us all will be embedding this into our teams and bringing this to life. Whatever the organisational forms, the key to bringing about improvements and transformation is great relationships.

However, we know there is a lot of practical work ahead to implement some of the changes necessary to deliver the expectations of us. We have seen the Government’s White Paper for health and care, the NHS’s Long Term Plan and the 2021/22 Planning Guidance for the NHS. Whilst we are waiting for any legislative changes, there is a great deal we can be progressing.

Leadership through this period will be critical and I am delighted that Amanda Sullivan and Stuart Poynor will be our interim Executive Lead and Finance Director respectively, alongside their current NHS CCG roles. Supporting them on one of our important work programmes, Andrew Fearn will be taking up the Data, Analytics, Information and Technology (DAIT) lead role, again on an interim basis.   One of the early things for us to do is to integrate the CCG leadership team into the new ICS and these appointments will facilitate this integration.

Whilst there is a great deal to be done to set up our ICS, establishing the right support to our Places (ICPs) and establishing our Provider Collaboratives at Place and scale. I want to emphasise the importance of continuing to make significant progress on implementing the expectations of our residents for both a return to some kind of normality of access to health and care services, but also improvements to their lives with a focus on reducing inequalities. The number of patients with Covid-19 continues to decline and treating people who have been waiting a long time for important healthcare interventions is now a priority. Working across the system to achieve this and taking the opportunity to focus on reducing the gap in healthy life expectancy will be a test of our progress to date.

We all know our citizens are less concerned with which organisation provides their services or care than being treated as an individual in a seamless pathway. The benefits for our population will be made real through local partnership working, which is why I am keen to think about how the ICS at system level supports delivery at Place and Neighbourhood. We will talk more about this over the next few weeks and months.

So, there is a lot to do. But my first impressions are positive. I know that we have the people in Nottingham and Nottinghamshire who can make a difference, but only if we all work together with a focus on the people we serve and not our own organisations.

I hope that you are as excited as I am about what the future holds. It will not always be easy but I know that by working together we can deliver better health for our residents, higher quality care for all patients and make progress on living within our means in terms of our finances.

In amongst all the work, we are all people with other lives and as we implement our plans and transform care for our citizens, we will have the care of our people at the centre of our plans. This last year has been phenomenally hard for everyone and rest and recuperation are vital. Personally, I enjoy my allotment and hill walking. Mercifully the former has been possible throughout and I am planting potatoes at the moment, but I am really looking forward to returning to my favourite hills in the Lake District.

I plan to do a regular update so do share with others. I am keen to get to know as many of you as possible through the usual briefings and meetings but please do get in touch directly on kathymclean@nhs.net if you want to discuss something with me or have a question or an idea.

Best wishes,

Kathy Mclean

A bit of background about me if you’re interested: I’ve worked in the NHS for nearly 40 years including as a senior registrar and consultant specialising in geriatrics and stroke medicine, Medical Director of Derby Hospitals NHS Foundation Trust and then as Medical Director at East Midlands Strategic Health Authority.   I was then Medical Director of NHS Trust Development Authority and subsequently Executive Medical Director and Chief operating Officer of NHS Improvement.   Since leaving NHSI I’ve been Chair of University Hospitals of Derby and Burton NHS Foundation Trust and a Non-Executive Director at Barts Health NHS Trust.   I live in Derbyshire with my wife and have two grown-up children.   When I’m not working I like to spend time on my allotment and walking in the hills and along our coasts where I can also enjoy birdwatching. I’m looking forward to doing more of this in the coming weeks as society slowly opens back up and I’m sure that you are similarly ready to take advantage of our newly returned freedoms.