Can Do Health & Care - NHS Uncomfortable Truths Report

2 | ICS System Learning: Uncomfortable Truths Ed Garratt OBE, Chief Executive, NHS Suffolk and North East Essex Integrated Care Board Event hosts normally express the hope that people are sitting comfortably, but today I want people to sit uncomfortably. At a recent conference I attended one of the speakers commented that culture is defined as the behaviours that we tolerate as leaders. What are we tolerating in Suffolk and North East Essex, either explicitly, the behaviours that we are aware of, or implicitly, the inequalities and unfairness that we are not paying attention to in our system? “What is the culture that we as health and care leaders in Suffolk and North East Essex are willing to tolerate?” We are a respected system, thanks to all the work that the people in our system do, but the truth is we are unsustainable, we deliver performance that we can’t and shouldn’t tolerate. We should accept there are good things in our system, but there are so many other challenges we need to start exploring. Today is about establishing the ‘why?’ as we talk about outcomes and accountability. Our accompanying data pack has been put together to stimulate your thoughts and provoke your ideas. For example, half of our looked after children locally have a mental health disorder, half have not been able to access an NHS dental appointment, and there is a strong relationship between looked after status and the criminal justice system. I recently visited a young offenders’ institution and saw that many were Black, many had been looked after children, and many had been drawn into county lines, because of their vulnerabilities. We need to think about a left shift in terms of early intervention and prevention. The first 2,000 days of life are vital; being in the education system makes a significant difference to children’s prospects and aspirations. We also need to shift resources, and we have started to do that but we now need a radical shift into community-based integrated care. This means a shift in culture, and today starts this process. Introduction