Dr Kathy McLean
Racheal Millband August 13, 2021

Kathy’s Blog – making the weather and creating opportunities for our population

When I last wrote to you, it happened to be a glorious sunny day and I am sure we all hoped for a period of good weather.  Well, that hope came good, and I certainly made the most of opportunities to walk up a few hills, with rewarding views. Thinking about the weather I was struck by the reference made by Lord Simon Stevens, outgoing Chief Executive of NHS England/Improvement, in his valedictory interview.

He was reflecting on the challenge ‘of piloting the NHS supertanker’.  One lesson he has learnt is that there will be crunch points “when you have to decide that you’re not just going to take your external environment as a given, but instead you’ve got to make the weather”.

I believe that  here in Nottingham and Nottinghamshire we are pretty good at ‘making the weather’ – creating opportunities to make the changes for our population where there might otherwise be ambiguity.  But alongside this, we are receiving some important external inputs which should help us to accelerate progress.

The first I wanted to share is that I am delighted to have been confirmed in role as chair designate for the Integrated Care Board (the body that will replace the CCG and assume its responsibilities).  Whilst the Health and Care Bill still has to go through the Committee stage of its approval process, in parliament, you will see that many of the major elements of the future are starting to be agreed nationally and locally.

Another of these relates to ICS boundaries and the Government have recently confirmed that the boundary of our ICS will expand to include Bassetlaw.  This means that the ICS has the same boundary as Nottinghamshire County Council – making it easier to deliver joined up health and care.  For residents in Bassetlaw there will be no change in the access to health care, for example they will continue to see by the same local GP practices and will carry on receiving other health and care services in the same way.  I recognise that some partners may not initially welcome this change but my commitment is that we will work carefully to understand any concerns and seek to resolve them as straightforwardly as possible.

Alongside this progress in confirming the foundations of our system ready for April 2022, I am pleased that we are continuing to deliver in the here and now on the services that our citizens expect.  The vaccination programme is coming towards the end of this first phase and I’m delighted that 84% of our adult population has had their first vaccination, with 67% of people already fully vaccinated with their second.  As we prepare for an autumn phase of boosters and also provision of vaccinations for younger people I want to say thank you to colleagues from all across the system for their contributions to this work.  This time last year it was almost inconceivable that those levels of vaccination would have been achieved – well done to all involved.

The work to refocus on non-Covid treatments is progressing well, even with the additional challenges of the current pressures impacting on bed availability.  Using the Elective Accelerator funding from NHSE/I and working together across commissioner and providers, we have been able to ensure that more than 2000 additional people have had their operations and nearly 5000 have had their diagnostic test sooner than expected.

And, despite it being August, planning for winter is well under way.  We are taking all the learnings about joint working across the NHS and Local Authorities from the pandemic and applying them to ensure that we are as prepared as possible for the coming winter – using all our efforts to support care homes and wider social care, enabling colleagues in the hospitals to treat and discharge as quickly as possible and aiming to persuade as many citizens as possible to choose wisely for their health needs.

Supporting the most vulnerable in our society with their health needs is a key focus for us so I’m pleased that Nottingham has been awarded £3.5m from the Changing Futures programme.  This funding will ensure that much of the work of Opportunity Nottingham will be able to continue, including support for people facing homelessness, those suffering with mental health issues, people with a history of alcohol or substance abuse and victims of domestic abuse.  This is another example of excellent joint working between Nottinghamshire Healthcare NHS Foundation Trust and Nottingham City Council along with other partners within the Nottingham City Place.

I opened this blog with a quotation from the outgoing Chief Executive of NHSE/I so it seems fitting to close it with something from the new incumbent: Amanda Pritchard.  The first woman to lead the NHS, Amanda is a fantastic leader who I know will drive forward the delivery of plans for integrated care.  This short thread on Twitter sets out some of her early thoughts and in particular I would note her commitment to innovation in order to tackle the big challenges around access to care and preventative interventions as well as on the major killers like cancer and stroke.  Whilst I’m mentioning Twitter do check out the ICS’s feed here which every Friday includes a round-up of the latest news and information from across our system.

I hope that when you read this update you will have had a refreshing summer break or that it is on the horizon and that you will be ready to take up these challenges in the autumn.  In the next few weeks we have a great deal of work to do, including agreeing the membership of our Integrated Care Board as well as the Integrated Care Partnership, along with confirming how these bodies will interact with our four Places and the new Provider Collaboratives.  This will all need careful thought but once we have it right these will be the key building blocks for our System.  I am confident we can achieve all this by working together and look forward to continuing to work with you all to progress this exciting work.

Best wishes,

Kathy.