In mind: Chief Executive Joe Rafferty talks about Covid, new buildings and more

I have been spending some time thinking about lessons from Covid. When you consider the big changes that Government has put in place, such as social distancing, we see the extent to which it only actually works if we all decide to collaborate in that particular process change. When we don’t collaborate, the objective falls apart – it is only as good as the small changes each of us has made.

This is a phenomenon that I’ve talked with staff about in the collaborative leadership forums of the past couple of years. In those sessions we discuss the big changes we need to deliver and we work out the smaller, incremental changes that need to take place. These smaller changes can be talked about by senior leaders, but with the best will in the world, the actual delivery relies on everyone. That mindset and behavioural change leads to a wider process change. We need to use this to continue to develop our organisation as we come through Covid.

If you think about Zoom parties, virtual pubs and fitness sessions we see online, they all have three things in common. The first is the mindset change: the user and supplier of services have both had to alter how they approach something familiar and recognisable - a social gathering - but now requiring technology to take part. We need to think as a Trust how we use technology to form the future shape of our organisation and there is something wholly essential about that being a co-produced activity. The second thing is leadership – for someone to take on the management of setting up that virtual pub, they need to be adept and even entrepreneurial but they need their customers to support them. And then thirdly there needs to be people willing to adapt and embrace this new approach for it to be a success. All this is underpinned by reliable technology to hold it all together.

In the case of that example, without those three things we would have a great idea – a social meeting – but no one actually there. In the case of our Trust – we would have potential but no tangible take up to deliver that positive change. Moreover, there is a danger that in establishing ‘online services’ we do exactly that – make it a transaction rather than a new type of ‘community experience’. If you actually think about the virtual pub, the transaction is community, conversation, connection – not the supply of drinks. In the same way, we need to model the digital shift in what we offer our users, with a big emphasis on the intangibles as much as the tangible aspects of what we do.

I’m pleased to see that the mindset for new ways is present in Mersey Care. A good example for us was the first virtual birthday breakfast. It was a great success and the medium worked very well, making the best of the new ways of working, although I don’t think I could actually see anyone having their breakfast at the time! We are thinking hard about how we do this for our clinical services, where we’re perhaps more conservative about what our technology does than we ask of it in our social spaces away from work. Digital is a fantastic medium for education. Work has begun on developing this and for example I am enthusiastic about the prospect of virtual reality in our training.

Digital is one excellent channel which we can use to help improve how people interact with us, but digital poverty is a significant issue in the wider population too and we take it very seriously. I saw this only last week when our Executive Director of Nursing and Operations, Trish Bennett and I were trying to talk to a patient and their broadband couldn’t hold up to running a Zoom meeting. When I consider digital deprivation, I think about provision for those who are most vulnerable. Can we give some of those in our communities with mental health and physical health needs some more choices in their lives? If you are physically or mentally frail, sometimes those choices disappear. So often that those without agency don’t have those choices to take a drive rather than take a bus, or shop online. We are talking about how the Trust can support ways through this, using some of our sites as digital hubs. These would be available to staff of course and potentially to our service users, with appropriate training, and play a part in reducing digital deprivation. This can often be related to real poverty and real deprivation. 

The process of collaboration and the spirit of it are two different things, but we are already collaborating externally on this. We had already developed stronger relationships with agencies in our area and this means we have routes and linkages ready as we need them. Liverpool City Council has been developing upgrades to broadband in some of the most deprived parts of the city which enables better access to services such as telecare. We’re in touch with them on this and have access to some valuable population health data. Already we are able to see how people’s experience of Covid interacts with their mental health, and how this links to factors such as their housing status and critically, data on the relationship between the virus and BAME communities. Understanding the challenges our population faces, now, is critical and it’s fair to say the healthcare system has not historically been quick to mine the data on this and use it fully. 

As the Cheshire and Mersey lead for out of hospital care I welcome the renewed focus on social care. The news that a dedicated director general for adult social care has been appointed by Government for the first time since 2016 is a positive step forward. It recognises the need for specific attention there and for it to be a system-wide approach. It’s fair to say that perhaps people in the centre have tried to push at levers to control areas of social care, only to find those levers sadly unattached to anything. Rosamond Roughton, who was previously the director of adult social care at the Department of Health, has become the director general for adult social care. This appointment will doubtless heighten calls for funding and service reform to address issues highlighted during the pandemic. It’s a good move.

Finally, it was good to see, during Learning Disability week, clinicians visiting Rowan View. Specialists in both learning disability and mental illness from Scott Clinic and Whalley had an opportunity to don their masks and take in the medium secure unit just a month before we formally receive the keys to the finished building.

Rowan View forms the centrepiece of the centre of excellence that is Maghull Health Park. Here, the new buildings are just the backdrop to new models of care and truly innovative pathways which will help some of the most vulnerable people in society to recover and progress. You can watch a short film here.