Posts Tagged ‘Health and Care’

Moving into recovery, and Test and Trace

Monday, June 8th, 2020

As we pivot our efforts into recovery, while remaining engaged in the response against Covid-19, Staffordshire County Council has launched a number of practical measures intended to help businesses to restart and for the economy to get going again.  It is notable that the central government response has yet to get beyond discussions, but then, in their defence, they are looking at very big programmes that will involve huge sums of money for capital projects.  Our job is to roll up our sleeves and get on with the practical things that will make the difference between success and failure for many thousands of small and medium enterprises in Staffordshire.  While we will continue to be engaged in the conversations and the big ideas, concepts as the Small Business Grant Scheme and the Staffordshire Start-Up Programme, launched last week, are where we can really make a difference. 

All of this has to take place while we are still responding to Covid-19.  As the infection rate reduces, there are some very finely-balanced decisions to be made, the most important of which is how to deal with isolated outbreaks.  The national Test and Trace has gone live, and in Staffordshire we have an Initial Operating Capability, which we will develop into a Full Operating Capability through June.  While it is easy to criticise aspects of this strategy, the truth is that nobody has done this before and we will be learning by doing, and from other countries which are ahead of us in the progress of the disease.  The key will be containing outbreaks with rapid testing, importantly with results getting to the individuals and decision-makers in a timely manner.  The really difficult part will come when localised lockdowns or quarantine are required, which will get harder as people get used to their new-found freedoms after long-term lockdown.  We will continue to refine this policy as we learn and as new techniques and technology become available.   

Dealing with the present, and planning for the future

Monday, April 20th, 2020

It is a couple of weeks since I wrote a blog entry, mostly because I have been doing a number of video messages for The Knot, but in the spirit of planning for getting back to normal, here goes. Experts believe we are in the peak of the Coronavirus outbreak, and it is clear, that although the statistics of Covid-19 deaths are shocking, the NHS and Social Care Services are holding up well. Having done a brilliant job of constructing the temporary Nightingale Hospitals in London and Birmingham so quickly, it looks like they might now be used for other purposes, as the rate of illness has been kept within the Health and Care system’s ability to admit and treat. That is the strategy, and it seems to be working. The shielding operation whereby up to 1.5 million of the UK’s most vulnerable people are being supported as they self-isolate for 12 weeks, is, in my opinion, a piece of genius, and makes the most of the “N” in our NHS. To my knowledge, no other country is attempting this, as no other country has the level of personal health data at a national level to be able to achieve it. If it works, and I believe it will, it will reduce the death toll from this disease considerably. 

In Staffordshire, the care sector, in which we count Care and Nursing Homes as well as domiciliary care in people’s own homes, is holding up well so far. Starting our efforts to procure and supply Personal Protection Equipment (PPE) early in the emergency has paid huge dividends; we now have a stable and resilient supply chain with trusted suppliers, which has maintained the confidence of the users. That is absolutely key in a contingency operation where demand surges and ebbs, sometimes unpredictably. Having a reliable supply of PPE is a key factor in maintaining and bolstering the morale and effectiveness of the care workforce, and I would ascribe a good portion of the success to those efforts. Recruitment and training for our I Count and I Care volunteers continues, to create an emergency workforce that is able to fill-in where necessary in Care and Nursing Homes where staff are off work, self-isolating for Covid-19. 

Looking ahead, we are already planning to play a leading role in the recovery of Staffordshire’s economy and society. There will be a huge amount to do, and we will have to adopt a pragmatic approach. That said, there is much that come out of this terrible outbreak that is good; I would cite community spirit, the value of public service and a willingness to look at different ways of working to name but three. At Staffordshire County Council, we have cemented into practice the 4 years of cultural and digital changes that we achieved through our Smart Working programme; over 3,000 colleagues are successfully working from home, and we held our first Cabinet meeting over Skype last week. Many commentators are pointing out that things will never be the same again – we need to make sure that we choose the ones that we want.       

Storm Dennis, and the Integration of Health and Care

Monday, February 24th, 2020

Having written last week’s blog entry during a lull in Storm Dennis, I probably should update readers on what happened next.  In short, it continued to rain.  By Monday afternoon, the River Trent in Burton was causing concern, and we activated the Incident Management Team, led by Becky Lee, our Health, Safety and Wellbeing Manager.  Burton had suffered from serious flooding in 2007, and significant barriers have been built since.  It shows the unprecedented times in which we are living that the river level peaked at 11.00pm only 4cm below the tops of the barriers.  The team, with John Tradewell, who was our duty director this week, worked through the night, planning a response to the flooding, taking in such diverse considerations as notifying householders, planning for the potential evacuation of care homes, moving sandbags to shore up defences, and assisting the Environment Agency and Fire and Rescue Service.  Becky Lee is in effect our Operations Officer, and it may surprise you to read that the IMT has been mobilised 4 times since the start of 2019: the collapse of Allied Healthcare; the wildfires on the Staffordshire Moorlands; a building response in Newcastle; and now Storm Dennis.  They are 4 very different scenarios, but the core team are up and running in an hour in Staffordshire Place 1, providing the communications and control that allows the subject matter experts to work effectively.  It’s a seriously impressive organisation. 

On a completely different tack this week, it might interest you to read about the integration of health and care that is progressing in Stoke and Staffordshire.  I had a very useful session with Dale Bywater, the Director of the National Health Service England and Improvement for the Midlands (known as NHS E and I in the vernacular).  This is a relatively newly combination of the commissioners (the CCGs) and the providers (the hospital and community trusts) which has provided some welcome clarity to the system.  Dale is very happy with our Long Term Plan, one of 5 out of the 11 in his region to be passed as good to go.  He is clear that the time has come for implementation, and I made it clear that the county council is very supportive of getting on with it.  It reminds me of 2 old military adages; no plan survives first contact with the enemy, and plans are useful, but planning is invaluable.  In short, the plan is not perfect, because it can never be perfect, but it is good enough to start us in the right direction.  The planning that we have done over the past months will give us the knowledge and confidence to adapt our thinking and actions as the situation develops.  The role of the county council is many-faceted; we are the single biggest commissioner of social care and therefore must align what we do with the plan, and we are also the largest democratic body in the county, with a role in ensuring that people of Staffordshire get the healthcare and social care that they need in the future. 

Graduations and planning for the future

Monday, July 22nd, 2019

Philip Atkins, the Council Leader, and I visited the New Beacon Group in Stafford this week to find out their plans for developing the Beaconside site to the east of the county town.  We met Richard Li-Hua, the President of the organisation, and his staff, and received a set of formal briefings, followed by a wide-ranging discussion.  They have great ambitions to link with Chinese universities in a business school and a School of China Studies, as well as with Staffordshire University.  We briefed them on the various plans for the county and the region, including HS2 and Midlands Engine.  It certainly feels like there is something in this that will benefit Stafford in the long term, and we will be working with them closely to achieve it.      

Elsewhere, the end of the academic year means graduations at our colleges and universities.  A few weeks ago, I attended the Newcastle and Stafford College Group graduation at the County Showground; last week it was Staffordshire University and this week it was Keele University.  It was a great pleasure to see so many people receive their diplomas and degrees after so much hard work – we are very fortunate to have such good colleges and universities in Staffordshire which take such a full part in the wider community as well as in academia.  It reminded me that I missed my own graduation because I was under training at Sandhurst – on the morning that I was supposed to be collecting my degree, I was soaking wet through, breathless and aching on an assault course.  There was, as I remember, no sympathy from the instructors!

This week has also seen a range of evening meetings in the many organisations in which we work with partners across the private and public sectors.  The Health and Care Sustainability and Transformation Partnership held a workshop with a wide range of partners on the progress of implementation as we look towards an Integrated Care System, and the Local Enterprise Partnership met to discuss how they are going to strengthen their planning ability as we approach Brexit.  In this latter instance, we will see the end of the EU funding that we have enjoyed for many years, and the start of the UK Shared Prosperity Fund, which will use as its basis the Local Industrial Strategy.  It will come as no surprise therefore. that we are working hard to ensure that this is as good as it can be, so we can attract the businesses and good-quality jobs that we need to continue Staffordshire’s progress.     

Health and social care integration, and our Industrial Strategy

Monday, December 3rd, 2018

It was a delight to get out of the office on Tuesday and visit an exemplar of integration in health and care at the Samuel Johnson Hospital in Lichfield.  Claire Wood, the matron, was our host as we listened to NHS employees and adult social care workers operating together in a highly effective manner.  In essence, they had heeded the advice of somebody whom I worked for many years ago, namely sometimes it is easier to ask for forgiveness than to ask for permission.  They had just got with working together, without worrying whether they worked for the NHS or the local authority.  Of course, there is no reason why they would have to ask for forgiveness, as they were doing the right things, but sometimes I think we worry about organisational structures too much.  The lesson for me is obvious; we all just need to concentrate on doing the right thing for our residents.

On a completely different track, I spent Thursday morning with members of the Local Enterprise Partnership – business people, academics, politicians and civil servants as well as local government officers –  working out what Staffordshire and Stoke’s Local Industrial Strategy will look like.  This is not merely an academic exercise; after Brexit, the EU funding to the county will stop and will be replaced by our proportion of the UK Shared Prosperity Fund.  Although the details are yet to be confirmed, it is almost certain that our share will be at least partly dictated by how compelling our strategy is.  It’s therefore worth us taking a lot of interest in it.

Making healthy progress

Friday, August 24th, 2018

The Health and Care Sustainability and Transformation Partnership (STP) has really come on leaps and bounds in the past couple of years. I spent time working with Health and Care colleagues last week, and it struck me that we have become a single cohesive system for the first time in my experience in Staffordshire.

That’s not to say that everything is fixed and there’s nothing to do – far from it. But we have got a shared narrative and we – NHS commissioners and providers, healthcare professionals and local authorities – have a clear idea of what lies ahead of us. Given Staffordshire’s unenviable reputation in Health circles after Mid-Staffs a decade ago, that is progress indeed.

On substantive measures, Delayed Transfers of Care (DTOCs) are coming down, although not as quickly or consistently as we would like, and Royal Stoke Hospital recently achieved the 4 hour target for A&E for the first time in a long period. We are also making progress with joint commissioning with the CCGs.

Looking forward, we now have a plan to make integrated primary, community and social care a reality in 23 localities across Stoke and Staffordshire. Buildings in and of themselves will not make the outcomes happen, but with the right leadership and efforts, they will make integrated care and digital health a reality with the accompanying benefits to workforce and patients.

Dignity in Care Awards

Monday, July 30th, 2018

I didn’t manage to get to this year’s Dignity in Care Awards which took place in Newcastle College last week, but I wanted to mention it, because it is such an important event.  I very much regret missing it, because it is one of the most uplifting experiences.  The idea is simple – to recognise the many thousands of professional and volunteer carers across Staffordshire – and it works brilliantly.

Without wishing to be negative, the mainstream media tend to concentrate on care when things go wrong, either in a system as a result of poor organisation, or individually when somebody commits a crime, usually against the person for whom they are caring.  That is inevitable, and it is right that such events are highlighted, but we must not allow them to drown out the many thousands of people in Staffordshire alone who give of their time so generously.  The very clever thing, in my opinion, with the Dignity in Care Awards, is that they have categories for those who are professional, paid carers and their companies, as well as the volunteers.  With an ageing population, and the expectation that people deserve an enjoyable and comfortable life, we have to make caring a more attractive profession.  I will not attempt to cover all of the awards, but if you want to know more about them, you can find out here.

Thank you to everybody involved both in the awards, and more broadly in caring for others.

SLT Away Day; Providing a better health and care system

Monday, July 31st, 2017

The Cabinet and the Senior Leadership Team had our long-awaited Away Day last Monday to consider the direction of Staffordshire County Council over the coming 4 years.  It is probably just as well that we did not have it in the weeks following the county council elections in May, as so much has changed in the intervening time.  Saving any other shocks and upsets, we hopefully have as clear a view of the way ahead as we’re going to get.

The themes were all familiar to us: the future of Health and Care in Staffordshire; how we grow the economy and provide adequate housing for those people whom we hope to attract to the county; how we continue the improvement in Staffordshire’s schools in an environment where our direct influence is waning; and, of course, the future of local government finance to look after the most vulnerable and needy in our society.  We did not aim to get into detail, but rather to sketch out our aims and to make objective judgements on the relative importance of each area, and on relationships with organisations and people.  It was probably one of the most useful days that I have spent since coming to this role over 2 years ago.

On Health and Care, it is clear that we need to do something different.  Staffordshire and Stoke’s Sustainability and Transformation Partnership (STP) has just been graded in the bottom 5 of the 44 STPs nationally – needing the most improvement.  All but one of the measures are in the health arena, with the Delayed Transfers of Care (DTOCs) being the only one with a local authority flavour.  It is often said as a joke that the definition of madness is doing the same thing repeatedly and expecting different results, but in this case, as there so often is, there is a germ of truth in the witticism; the national structures and directives are clearly not achieving the results that anybody seeks.  I felt very proud of our politicians at the full Council meeting the week before last, when all members put party interests aside to vote unanimously for a motion to work with the NHS and the people of Staffordshire to provide the health and care system that meets our needs in the future.  Unlike so many other parts of the country, we are engaged closely with our health colleagues locally, but we do need to align responsibility, accountability and authority locally if we are to make the system work as it should.