This week’s leadership message comes from Richard Parry, Strategic Director Adults and Health at Kirklees Council

Hello, my name is Richard.

It is 18 months since I contracted COVID for the first time in early March 2020…..whilst I can’t be sure that I had COVID as LFTs and PCRs were not yet part of day-to-day language, it did feel very similar to when I had it (courtesy of my 11 year old) for a second time. Second time round, having described the theory of the Test and Trace system many times to people, it was fascinating to experience it in practice first hand. The “detached observer” bit of me wanted to get out a roll of paper and some post its and process map it!  What we also experienced was the power of informal support from friends, neighbours and the local support group that we had been volunteers at.

When I have had the time/thinking space to step back over the last 18 months and observe, I have been fascinated by the combination of planning and pragmatism that I have seen in the system. There are things that we would have spent a long time planning, turning into specifications and worrying about that, instead, we just got on and did.  Relationships have flourished at a local community level…..I had always been optimistic about how PCNs and the broader community capacity would come together to start to develop different solutions to the health and wellbeing of local communities and that has happened in spades. There has, I would suggest, been a more proportionate approach to “governance” and an understanding of measured risks necessary to achieve a better outcome.

As we all tried to get to grips with PPE (or rather the sporadic supply of it) we had council colleagues who normally service gas boilers and manage building materials instead setting up PPE warehouses and delivering stock across the local system, library colleagues who stopped checking out books and started running testing centres, making welfare calls and delivering support to the clinically vulnerable and a community support worker who spent the weekend cleaning a care home because that was what needing doing.  Many many people across the whole health and care system stepped outside the constraints of their job description or the organisation that was on their lanyard and worked for people and for place.

In the summer of last year in Kirklees, we developed “Community Protection Plans” which were about practical, on the ground activity, in areas where infection rates were highest to understand what was driving these higher rates and how and who might best help to address this.  The answers sometimes lay in the health and care system, but more often lay outside the system, relying on a range of community leaders and broader community/universal services to take a leadership role on behalf of the health and care system.

Fast forwarding 6 months and the conversation was about mobilising the community vaccination programme.  I would suggest that we have come to understand that the large scale system approaches to inviting people for their vaccination have worked well for many people but that these approaches left other people behind….very often the same people who experience greatest health inequalities and have, historically, had less good and timely access to the health and care system.  In response, we have seen real creativity and thought go into understanding who, at a local level, can best encourage take up and where best to run a vaccination clinic in a way that really is accessible.

Delivering a community vaccination programme has hugely accelerated that sense of an integrated team delivering for a local community and broadened an understanding of who, in a local neighbourhood, needs to be part of that “team”. 

The level of operational pressure at the moment means that it will be easy to put to one side what we have learned over the last 18 months.  As we grapple with the processes needed to establish a new formal operating model for the West Yorkshire Health and Care system, we could forget about how we felt comfortable bending process if that delivered better outcomes for people and communities.

My big hope is that we really do embed the learning and broaden its application…..if we found a model that helped local communities address high infection rates in their local area, can we replicate that approach to addressing diabetes or other long term conditions where that localised community leadership is far more effective than a bland set of messages?  If we developed a model that ensured that people with a learning disability, or who are living with autism or whose first language is not English received the vaccination in a way that worked for them, can we not do that for their outpatient appointment?  We need processes that work for most people but we also need to keep doing as we have done and recognise when these processes exclude people and find a creative alternative instead.  We will need to continue to do as we have done and harness a wider group of allies to assist us by creating a joint endeavour with our local communities.  This is absolutely in the spirit of how we have worked as a local and West Yorkshire system in the last few years, so let’s just step it up a gear.

I’d like to finish though with a question….. “would it be reasonable to stop my 11 year old daughter’s pocket money for the rest of the year as a response to giving me COVID?” and a share….some photos of some great colleagues doing their bit for local communities.  A huge thanks to them and to everyone else who has been part of Team Kirklees and Team West Yorkshire.

Thanks for reading. I hope you have a nice weekend.
Richard