Lots done, more to do!

By Catherine Wilton, Founder and Programme Director

Anniversaries are a time for celebration but also reflection and as we continue to mark the 10th anniversary of our programme we can take pride in our achievement of nurturing a new breed of leaders but remain firmly focused on the challenges that confront us in the health and social care sector.

It's no exaggeration to state that the health and social care sector is facing its toughest ever challenge right now, with increasing needs and a workforce crisis, exacerbated by the aftershocks of the Covid pandemic that has left many demoralised and exhausted.

Throw into the mix a cost-of-living crisis with people struggling to meet their basic needs and it is easy to see how health inequality, impacting most severely on the most deprived communities, remains a scar on our society.

Against this backdrop, the case for personalisation and unleashing community assets through co-productive approaches is ever more relevant but will require leaders with the knowledge and skills to make this a reality.

Our programmes, using the NHS Leadership for Personalised Care framework as their basis, can play a significant role in achieving this positive change and I was delighted to see that independent evaluation of our courses, featured elsewhere in this newsletter, shows we are making a real difference.

But we will not be resting on our laurels because to embed systemic change, moving away from traditional ‘top-down’ approaches of doing things ‘to’ and ‘for’ people towards a new model of doing things ‘with’ people and their communities, takes leaders with vision, focus, energy, and the bravery to challenge the staus quo. We need do do more.

It's easy to talk about working 'with' communities, but what do we mean by it? It means trusting that people who live in local neighbourhoods, who live with long-term conditions, people who face challenges of discrimination and exclusion every day, are the best judges of what needs to change in the system. Every single leader in the public sector needs to start talking to people and asking them what matters to them.

When we do ask people what matters, and genuinely hear what people have to say, a shift occurs. We start to see the challenges we face in the context of what's important. We start to understand the stories behind the 'data' and spreadsheets that we are required to produce. We start to consider if we would be happy for our family member or friend to experience care and support in the way we provide it. We start to see people and communities as assets, co-creators of their own health. We start to hear about different ways of doing things, to see the possibilities beyond old-style forms of service provision. We start to see the future.

Then of course the difficult work begins. How do we move from a system founded as part of the post-war settlement and shaped by the damaging 'new public management' of the 1980s and 90s, towards a more mutual, reciprocal, trusting, human version of public services?

Well, we don't get there by doing nothing. As the poet Antonio Machado wrote:

"Caminante, no hay camino. Se hace camino al andar"

"Traveller, there is no path. The path is made by walking."

We just need to start listening and taking small steps. Do we really have a choice?

Catherine Wilton

Catherine Wilton

Director - Leadership for Personalised Care programmes and Deputy Director - Personalised Care, NHS England