Amy's Monthly Briefing - May 2020

Firstly I hope you’re all keeping as safe and well as possible in these challenging times. I know that’s harder still for those of you on the frontline of this crisis and I’m in awe of your dedication and personal sacrifice. It sounds trite I’m sure, but a huge thank you from me and my family to you all.

There was no monthly briefing in April as we rightly suspended the THT Board and other usual activities once the lockdown began. But I’ve been keeping in touch with the local Covidresponse and heard how partners across the system came together incredibly quickly and effectively to protect and support local people. “THT in action” as a Board member reflected last week. Some long-held goals for joined up care have been achieved in a matter of days or weeks -with previously knotty hurdles overcome and impressive innovation taking place. THT isn’t really about the Board or the governance or the various meetings (though it might well feel like that sometimes), but about exactly what you’re doing right now, together, on the frontline.
We were keen to learn the lessons of what’s worked well during the crisis -and what aspects of the partnership are no longer needed, or may have been holding us back. What enabled the system and our staff to work so effectively and at pace to join up care and implement new models of support in hospital and across the community? This was the key question we grappled with at our short, virtual Board meeting in May.

First, we shared highlights of joint working in the past few months. Flexibility and commitment was a strong theme: from the hundreds of NHS staff who relearned critical care skills, from colleagues at the Royal London who rapidly increased bed capacity and from partners who established the integrated discharge hub within a week. Digital solutions have been embraced by staff and patients for everything from community engagement to GP appointments to virtual hospital clinics. Innovation among teams has been impressive, such as the Improving Access to Psychological Services moving online in 24 hours.We’ve seen an amazing community response with charities, mutual aid groups and volunteers stepping up to help. A new home monitoring service was set up in two weeks with kits to monitor covidsymptoms distributed by the voluntary sector and GPs, with great patient feedback. The shielding programme has been a major cross-partner effort, with over 150 staff involved in a rapid call out operation to contact over 3,000 extremely clinically vulnerable people so far. I’ve no doubt there are many more examples of exceptional joint working at this time.

We then reflected on emerging lessons for THT going forward, as we move towards the ‘new normal’. Key themes were a clear and urgent common purpose, relaxing usual rules around money and contracts, stripping back governance and, crucially, enabling the frontline to lead the change. We will be thinking hard over the coming weeks about how THT can evolve to maintain this pace, focus, flexibility and operational freedom. We don’t want to automatically step back up all the old ways of working. We want a system that is ‘safe’ in terms of assurance and accountability but ‘permissive’ in terms of enabling staff to collaborate and innovate. We also need to keep population health at the heart of our work, given the new health inequalities that will arise post-covidand the areas where we will have slipped back due to current suppressed need.

We’ll be making proposals at the next Board to address some of these challenges and make sure THT is fit for purpose, capturing the very best of partnership working we’ve seen this year. I’m always open to ideas about what could work better.

Thank you once again for everything you’re doing.