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An Interview with Charlotte Williams

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In our latest blog we interview Charlotte Williams, Director of Strategy in the Mid and South Essex NHS Foundation Trust.

Could you tell us a little bit about your background and how you came to be in your current role?

After studying biochemistry, I joined the NHS Graduate Management Training Scheme and spent 10 years as an operational manager in hospitals, before joining UCLPartners Academic Health Science Partnership and was seconded to NHS England to launch the New Care Models programme, and support the Next Steps on the Forward View.

Whilst at UCLPartners and NHSE I also began supporting the primary care and out of hospital planning within the Mid and South Essex Success Regime part-time, and in August 2017, joined the Mid and South Essex University Hospitals Group as a Group Director for Strategy and New Care Models – largely supporting our acute reconfiguration programme, adoption of innovation and growing improvement in our system.

In 2018 I launched the MSE Innovation Fellowship and in 2019 the QI Leaders programme for our area. I also led development of the patient benefits case for the merger of our three Trusts which took place in April 2020. I am now Director of Strategy across the merged Trust. We are very pleased that Adam Ali from Care Compare joined the MSE Innovation Fellowship in 2019.

In your opinion, what are the main ways that Covid will change the way we deliver healthcare in the future?

I think the implications for the pandemic will be far-reaching in how we organise care in future, and also how our systems and processes might enable and incentivise us. Survival and recovery in this pandemic has required collaboration – to be open about data, to share staff and facilities, and collectively prioritise action and resources. As we will be having to catch up on planned care and support the additional burden of COVID’s impacts in the future, I think we will see more consolidation of services for economies of scale (such as in surgery or diagnostic tests), an acceleration of new roles and more virtual care delivery (such as virtual wards, remote consultation and monitoring).

I believe COVID will have a large impact on how we consider risk – given there is a new, significant public health threat all around us, which will cast a long shadow, even once the immediate threat is contained. We have seen faster adoption of technology and shared care which previously were often struggling to gain traction; accelerated employment schemes and a consideration of inequality which before perhaps weren’t always seen as a core priority. I hope we will also consider the wider social impact of our plans and investments – the health and care sector has seen a stability other industries have not and we can help through our day-to-day work by adopting social value principles, such as the NHS Anchor model.

We have seen a shift in thinking about who can become involved in delivering health and social care, formal and informal support (such as community volunteers, new businesses manufacturing equipment). In the analysis and prediction of COVID demand and in our vaccination response, we have seen the power of combining local knowledge and local assets.

For us and our people, I hope and expect there to be a significant shift in how we support our colleagues’ health and wellbeing – this has (for obvious reasons) rocketed up the agenda, and it needs to stay there. I really hope this changes the behaviour of individuals and organisations permanently, as we have never seen anything like this pandemic before and cannot underestimate the human toll it will take. We also need to do more to realise our ambitions for the NHS to be a more compassionate organisation in our leadership and management practices.

It has been fantastic working with the Mid and South Essex NHS Foundation Trust and we are very grateful for your support- in your view, where do you think Care Compare adds the most value to the healthcare system in Essex?

Increasingly in Trusts like ours, as we do more and more to help keep our local population independent and closer to home, we are finding that people whom we admit to our wards are frequently older in age and often living with several long-term conditions, such as dementia or heart disease. When people and their families or other loved ones find that they may be in need of additional care and support, as may be the case after an admission and change in condition, it can be bewildering even to those familiar with social care. Being able to offer our residents a free tool which helps them access information they need and has a trusted foundation, is very satisfying for us, and we are keen to encourage adoption and raise awareness of the service.

We have shown during the COVID-19 pandemic and before, through partnership working and compassion the Trust, community partners, fantastic discharge teams and social care, a sustained commitment to helping all Mid and South Essex residents find the best outcome after admission to our hospitals. CareCompare can help us achieve this. I know our Local Authority and Voluntary Sector colleagues have also welcomed the introduction of CareCompare and seen how it can benefit local people and their families.

What do you think is the biggest challenge facing social care in the next decade?

I think social care has been in a very tricky place – and we really need to see a shift in mind-set in the priority and approach from government for this to change as we need it to. Yes there needs to be the right financial settlement and eligibility etc. and we need to create a stable provider market, but I think there is a bigger challenge and it may take a decade to address.

On most measures, care – social care, personal care, and support for those at risk, adults or children – seems to lose out against health care. In public awareness and opinion, it has a lower profile, certainly there is poorer relative prioritisation from the DHSC, lower pay and status. Today the average hourly pay for care workers is below the basic rate paid in most UK supermarkets. This is not true for roles in the NHS. There is compassion, skill and dignity in caring and I hope that COVID-19 has helped show this not the exclusive domain of the NHS.

As several relevant think tank commentaries have noted, there seems a reluctance from national leaders to embrace key questions about social care – who pays, who provides; perhaps because we avoid examining and really understanding these vital, personal care services. Care perhaps raises visions of dependence on others, where we are disabled or disempowered. Perhaps we avoid thinking about these weaknesses and implications of helplessness that might come with receiving care, so we value them less, and overlook the very real threats to their sustainability which are apparent at a mere glance, and so deserving of parity of esteem.

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