6 May - Non-executive directors - community engagement with Paul Gilluley

This week’s session opened in conversation with Paul Gilluley, consultant forensic psychiatrist at East London Foundation Trust and CMO designate at North East London ICS.

Paul said: “We’ve just appointed our ICB. Normally, if you’re building anything you’d start by building the ICB and build the culture of what the board’s going to do because once you’ve built that culture you can then build structures above that. But already we’re starting to build a framework for leadership without that culture underneath it and I find that quite challenging.

“Our use of language is important. We talk about the opportunity for health and social care working together. I see it as something larger than that. We mustn’t forget the voluntary sector, which is a real powerhouse of ability to engage us with our communities. That’s where we have to start our work. We must start with our communities and how we engage them. If we don’t ask, right at the start, what matters to our communities, we’re losing the plot. If we really mean co-production, we must co-produce right from the start. Engaging communities, making sure we think about where residents fit into our structures and processes. We must be challenged the whole time about whether what we’re providing is what our communities need.

“We have to think about what we really learned in the pandemic. In East London, I was asked by a clinical advisory group to take a lead in covid testing and how testing was spread across our patch. I learned so much about testing and about how the system can work together to benefit the community as a whole. Then I was clinical lead for vaccination rollout, which taught me a huge amount about how primary healthcare, secondary healthcare, acute trusts, mental health trusts, community trusts… all had to work together to make sure our community had access to the vaccines at a time when the vaccines were quite limited. It gave me a chance to work with leaders across the system to work towards a common aim.

“After that, I worked on vaccine inequalities. East London is incredibly diverse. We used different ideas and different plans to improve compliance with vaccinations in different parts of the community and it was interesting how powerful it was to provide a space to share good practice. So, it might be that there was a good project going on in Barking and Dagenham to improve the compliance of Afro-Caribbean men with vaccinations, but if you tweaked that just slightly, you could bring that project into Tower Hamlets and use it with Bengali women. We have to take that learning and bring it into ICSs and ask ourselves ‘how can we build around common aims in the future? How can we use those relationships that we built up during Covid, and take the good learning we got into ICSs to use it in a positive way?’

“The other thing I found very powerful was the role of the voluntary sector – and the way they engage with their communities. It was amazing. It taught me what an asset we already have there.

“Communities and our staff are battered and worn out. They’ve really been taken to the edge over the past two years. We must start listening to people and asking what matters to them. We must ensure people have a voice. We must start listening to what people need and build services around communities rather than building services and making people fit into them.

“If we build a strategy for NE London ICS, then we have to listen to all voices because we have to hear what matters to our residents and to our staff, because if we don’t, we’ll build something that’s actually meaningless.

“We must ring-fence some of our budget to address preventative measures or we’ll be dealing with the backlog forever.

“Be kind. Kindness is really important to keep in mind. Do the right thing. And shut up and listen to what people are saying and take space and time to give communities a voice.”

Also overheard:

“I completely agree with the approach of listening to communities and concentrating on what they need but I wonder whether the added dimension for the ICS is to convince that this new ‘ear’ will then deliver something different. For that to be achieved there is then perhaps a brokering role to work across the system to design and deliver that difference.”

“You must have the staff that reflects your community. If you’re employing them you already have access to the community.”

These meetings are by invitation and are open to all NHS non-executives directors, chairs and associate non-executive directors of NHS providers. Others may attend by special invitation.

If you have any comments, questions or suggestions about these webinars, please contact: events@good-governance.org.uk