9 September - Mental health network - governance during the COVID-19 pandemic

This week’s mental health chairs network webinar opened with a discussion about place, and how we can balance the visionary aspects of this concept with the realities of where systems are – and how place could transform communities. GGI is working on a new maturity matrix about place, designed to help systems at different stages of maturity.

Overheard during this week’s webinar:

“I have a concern around the appointment process for CEOs and the impact analysis of the process and the candidates who will be appointed. I’m also concerned about the pay gap between trust and ICS leaders, and the potential lack of diversity in ICS leader roles.”

“It is the role of the chair is to make the appointment of a CEO, and the complexity around this isn’t integrated into the chair’s role. Understanding this isn’t included in the chair’s job description, which means the person appointed may appoint a CEO who isn’t appropriate for the job. The skills and attributes they are looking for are difficult, as well as the complexities around sign-off, timescales and ratification processes. There is also no clarity on whether you can be both a chair of a trust and a system.”

[During a discussion about the CQC] “We recently had an unannounced trust-wide inspection, which took place a week after signing off an inspection that took place in January. There were no advance information requirements, so we had three to five teams requesting information simultaneously. We were already in a difficult situation due to staff shortages relating to COVID so we requested that the review was delayed, but that was refused.”

“It depends so much on the team and its leadership because the process for us was constructive and conducted well and professionally, focusing on the important issues. There was a clear focus on access, which he can see being a significant theme for all trusts, and what is being done about waiting lists.”

[On place within systems] “It looks like place is either a tier within an ICS, or almost a mini-ICS within the overall system. The documents make it difficult to pin down exactly what it does, and it risks being another tier where decisions need to be discussed, with the other challenge that it doesn’t seem to have a vision for changing the communities themselves so that you reduce inequalities through targeting resources to the determinants of ill health.”

“We have a fundamental problem with the ICS legislation, as it feels like local government is being left behind and forgotten. Local government are key experts on communities and the health of communities, but the guidance doesn’t read like this. There are risks if they don’t feel like full and meaningful partners, and this risks old difficulties arising given differences and lack of understanding between the two.”

“Perceptions and relationships between councils does need to be strengthened nationally, especially given their role in prevention and the cuts they have faced. This has an enormous impact on the future of the NHS, and working in partnership will be critically important, and it needs to be about having a voice not just a seat at the table. Also, patients don’t have a strong voice in the ICS, and this needs to be addressed. There needs to be a focus on function rather than form, and a focus on clear outcomes and deliverables.”

These meetings are by invitation only. For further details, visit our events page.

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