Can Do Health & Care - NHS Uncomfortable Truths Report

Part 1: WHY as system leaders we need to address culture to improve outcomes | 11 Comments Shane Gordon, Director of Strategy, Research and Innovation, East Suffolk and North Essex NHS Foundation Trust: We are fighting against structural inequity in funding formulas and priorities, for example NHS’s primary focus being on elective care and reactive emergency care, and less on prevention. It is hard for us as an isolated part of a national system to deviate from that narrative. “There are little acts of rebellion that we can muster amongst us. I wonder if we could be more systematic in that rebellion, how could we address inequality in the ways we report our progress, our performance and our achievements, and in how we make our investment decisions?” I chair the capital investment group in ESNEFT, and my little act of rebellion is to require each business case to tell us how it is making a difference to inequalities. Cath Byford, Deputy Chief Executive, Norfolk and Suffolk NHS Foundation Trust: There is a lot of evidence nationally to show people with serious mental illness die 15-20 years sooner than people without serious mental illness, and many of those causes of death are preventable. In O’ level English I learned from George Orwell that all animals are equal, but some are more equal than others. Some people in our population are treated significantly differently by services not being available, accessible and provided equitably. People die sooner in some cases for physiological reasons, but also due to inaccessible services, poor housing, higher risk of drug and alcohol misuse to mask symptoms, the risk of vulnerability associated with exploitation. My uncomfortable truth is that we have all the evidence but we are not taking accountability and responsibility as a whole system across health, social care, voluntary sectors etc. “What are we going to do about all the evidence we have that demonstrates how we are failing members of our population? When is this going to translate into a commitment to take ownership and deal with this?” We won’t fix it immediately, but the problems for our populations are getting worse not better, and mental health is just one example of that. Andy Yacoub, Chief Executive, Healthwatch Suffolk: Inequality is the biggest and the most damaging and enduring illness that we have, for our workforce and amongst our public. “We need to be aware that as a system we are shutting down the voices of people who want to be heard.”

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