I well remember managers, in days gone by, pleased to have shunted responsibility and cost elsewhere. For some, there were a lot of brownie points from bosses in that, and more forward-looking advocates of collaboration were not in favour.
Even now, although the integration of health and social care is being embraced more, we would probably all accept there is a long way to go. But we can be positive about the current mindset of why we do what we do: promoting better lives. That mindset is a major step forward.
It’s important to learn the newer skills of system leadership rather than merely stewarding an organisation, especially amid financial pressures across that system. At its core it is focused on people and their experiences and outcomes.
I was told only recently by someone with a long-term condition that he still finds himself constantly asking for a personalised response. That one person’s cry for help in isolation won’t move an organisation towards doing things differently.
The pressure is thus on to act in a ‘co-productive’ way, working in partnership with people who use services, carers and citizens to provide personalised care and support across systems. That in mind it’s encouraging that the much-heralded NHS long-term plan talks about personalisation.
The plan in general is far-reaching and ambitious, with its focus on genomics, cutting-edge surgery and artificial intelligence aimed at improving and saving huge numbers of lives. All this is welcome and will attract the headlines and razzmatazz.
But high-profile initiatives can risk being swallowed if resources aren’t directed at the basics. Headline-generating investment must be accompanied by a focus on initiatives, often small-scale and often unheralded. This means learning to identify, share and disseminate good things happening in pockets, contributing to better lives and reducing pressure on traditional service-based solutions.
Our challenge is to proactively seek out those low-key innovations and new ways of working which are making a difference, and then work together to better understand the ingredients of success and what needs to happen to expand it.
Getting some of those issues back onto the desk will mean that the NHS long-term plan and the upcoming social care green paper are seen as great opportunities to provide co-produced, personalised, innovative and integrated care and support – improving people’s lives.
Tony Hunter, chief executive, Social Care Institute for Excellence