Opinions

Right support, right time, right place – North Lanarkshire’s integration journey

Written by: Janice Hewitt, Chief Accountable Officer, North Lanarkshire Health and Social Care Partnership

Published: 03/11/2015

Janice writes for us on the challenges of setting up an integrated joint board and the integration of health and social care.

Janice writes for us on the challenges and opportunities that come with setting up an integrated joint board and the integration of health and social care.

As we sit a few months out from the formal implementation date of Health and Social Care Integration I ask, what will change on 1 April 2016? Well, at midnight that evening I may not think much changed that day. Foresight may tell me it may be a day of progress, challenge, frustration or joy for me personally, who knows . . .

But, more importantly, I will ask what kind of day has it been for those most vulnerable who need our support and care? Who knows what that day may bring but some people in North Lanarkshire will have planned to use our services while others may have had an emergency and need us to there for them at a time of ‘trauma’. They may be in distress, pain or may simply be lonely but the services I will oversee need to support the whole spectrum of people who may have needed me (and the thousands of health, social work and social care staff) to be AMAZING LEADERS that day. Now that’s perspective!

So, having reflected on what that means for me as Chief Accountable Officer (I use the Accountable word in my title because that reminds me that it is me who is ultimately accountable for the implementation of our plan in North Lanarkshire) I realised I need way more resource over and above those specifically been given to the Joint Integration Board to plan.

I may need my police colleagues, housing colleagues, hospital colleagues, colleagues who run NHS 24, the Ambulance Service. But it’s not just about obvious service responses. I also know I need politicians to make courageous decisions about where to put precious resources. I need professionals and their professional bodies to come and go a bit on their fiefdoms. I need those responsible for setting performance targets to be sensible and not drive behaviours that rub up  against sensible decisions that mean performance is affected. I need inspection and scrutiny bodies to realise we are on a journey at a point in time when we need them to be logical and pragmatic at times of huge transition and transformation. And we need the general public to step up both personally and within their own communities and call on us only when they really need us.

Believe me, this is not a plea from one of a privileged number of Chief Accountable Officers who have been asked to lead on integration and I (we) are not asking for special pleading but I (we) do ask for:

1. Time

2. Cooperation around a common purpose

3. Understanding – of the complexity of all the things that require to be changed within all the systems to make integration be all it aspires to be.

As an aside, I’ve become fascinated by the word ‘interesting’. When I talk to a vast array of professionals, politicians, services users and staff about the expectations or understanding of the Integration Reform the most popular reply has been…. ‘Mmmm, that’s interesting’. The complexity is not lost on anyone. However, if I have learned anything since taking up post it is how to draw on resilience . . . why? . . . because health, support and care matter.

As far as progress goes in North Lanarkshire, I am exceptionally fortunate to have a Chair and Vice Chair of my Joint Integration Board who are fully committed to being the best, hence my blog picture comes as a ‘pack of three’ leaders.

We’ve been continually listening, talking and engaging with those who will ultimately make integration work, including local clinicians, GPs and professionals from across health and social care.  Unpaid carers along with staff from the third sector and the independent sector, are vital partners too and we hope to reflect the diversity of views in our forthcoming Strategic Commissioning Plan. However, our shared sense of purpose is simple ‘to provide the best support, at the right time and in the right place’.

I can relate to this directly. I often look to my own mum (77) and dad’s (82) experience of the health and social care system. Most of the time it has worked exceptionally well with great professional care but sometimes the system has seemed disjointed, so improvement is critical.

We are set to publish a compelling narrative that puts people at its very heart of the journey and sets down our Mission, Vision and Values.

Our mission statement is simple: Right support, right time, right place.

Our vision is that citizens of North Lanarkshire will achieve their full potential through:

  • Living safe, healthy and independent lives in their communities
  • Receiving the information, advice support or care they need, at the right time, every time, efficiently and effectively.

Our values are clear too. We will lead the seamless integration of health and social care services by being:

  • Strategic, practical and engaged
  • Informed, challenging and resilient
  • Respectful, credible and valued
  • Prudent, open and accountable.

We’ve also set out our needs and drivers for reform, our priorities, what success will look like, and, most importantly, how all that will improve outcomes for the people of North Lanarkshire.

Finally, one of my overall reflections since coming into post in August 2014 is that everyone involved in integration in North Lanarkshire recognises that creating a better future and meeting the national outcomes will require continued hard work and innovation . . . and resilience.

The JIB Chair, Vice Chair and I also recognise everyone pulling in the same direction is crucial so our compelling narrative will be the guide we’ll continually refer back to, giving us that sense of direction, now – and as long as our integration journey progresses.

Finally, one of the Chief Accountable Officers said recently – ‘Integration – Be part of it and be Proud of it’.

I’ll happily steal that from her.

And with that, it’s back to work . . . and many more ‘interesting conversations’.

Janice Hewitt

Chief Accountable Officer 

North Lanarkshire Health and Social Care Partnership

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