Can Do Health & Care - NHS Uncomfortable Truths Report

Part 1: WHY as system leaders we need to address culture to improve outcomes | 9 care and assess individuals holistically and how we look at the whole person as partners with the people who we have the privilege to care for. We have made great strides in some areas of healthcare, but I also believe we have become siloed in our thinking. By opening up our thinking we can help reduce avoidable deaths, but this requires a fundamental cultural shift. Dean: Strategists talk about this story: “If one fish in the aquarium becomes ill, you treat the fish. If most of the fish are sick, you treat the water.” The water is strategy, it is culture. If the water is pressured, or toxic, the fish become sick. If we make things more difficult for clinicians, requiring significantly more effort with some groups to achieve the same result as for others, clinicians tend to become unconsciously biased, non-listening. At some point a strategic financial decision is needed about where we invest. “The uncomfortable truth is that in practice our leaders are making financial decisions that in effect make inequalities worse.” As leaders we need to hold a mirror up to ourselves, as something we are doing is enabling the culture we have now. Do we want to change badly enough? Uncomfortable Truth 4: Not every patient experiences the care they should: recent learning from mental health and maternity. Care Quality Commission, Healthwatch, Channel 4 Dispatches Joyce: Partnering with communities is essential, and there will need to be differences in the way money should be invested in an area. “Communities just want to be listened to, to be heard.” Coming into our communities makes a real difference, we have seen clinicians coming into our safe spaces, listening to our mothers, taking them seriously and making changes by investing in the communities. Sharon: When people experience real stress they don’t want to speak, don’t want advice, they just want to hide in a corner. In CVST our cost of living action group identified issues with poor housing and poor health, one teacher telling us 50% of the children in their primary school were living in temporary accommodation. The action group dropped leaflets in the poor housing inviting families to come for breakfast. Tammy came and as a result the family is registered with a GP, Tammy obtained her medication, registered her child in school, and was found a new house and furniture. The family is now stable because of this very local community partnership.