Stockport is a borough with an ageing population, and ten years’ life expectancy difference between the wealthiest and poorest neighbourhoods. These were key challenges even before the pandemic hit, requiring services to work together at pace.
The COVID crisis changed the way organisations in the borough joined forces to provide more tailored and personal care. One crucial example is the vaccine programme, when teams united on the common cause of increasing vaccine take-up.
Stockport MBC, Stockport NHS Foundation Trust (FT) and NHS Stockport Clinical Commissioning Group (CCG) quickly developed a collaborative planning approach. This is ensuring everyone in the borough has a say, through the Borough Plan – a ten-year vision for Stockport – and the borough’s One Health and Care Plan.
A shared vision and the strength of the relationship between the three leaders of the organisations have been key to the progress made locally. All three came together last month to talk to The MJ.
What shines through is that their trust in each other and the respect they share has provided the strongest of foundations – and given an irresistible momentum to progress in shaping and delivering services.
Karen James is the chief executive of the FT. On the vaccination rollout, she tells The MJ: ‘I think without coming together and agreeing an overarching plan it would have been very fragmented and we wouldn’t have achieved the outcomes we did.’
The One Health and Care Plan ‘sets out our vision and ambitions and what we want our health and wellbeing outcomes to be, and I think by working together collectively on that we’ve provided that vision for the future for our Stockport residents’.
Asked about their core goals for making Stockport an age-friendly place, chief executive of Stockport MBC Pam Smith says: ‘For us it’s to make it inter-generational, and have the best access to healthcare when people need it, but not have everything in terms of a medical model. This is more of a social model.’
This is the approach being taken at the St Thomas’s site – formerly an old workhouse, and an old hospital. ‘We’re turning the land there into an inter-generational mixed tenure affordable housing area, but also with intermediate care facilities. I think that goes to our ambitions and we want it to be an exemplar for sustainability. We want a vibrancy about ageing. It’s about ageing well.’
Chief accountable officer at Stockport NHS CCG Andrea Green says: ‘It’s about starting well, living well and ageing well – that whole ethos.’ She highlights Stockport Family, an innovative way of working and integrated culture that has improved outcomes for families and children. It includes the No Wrong Door programme – an integrated approach to children’s social care.
She calls it ‘a really good model for the future for us in terms of building from that very integrated way of working – holding ourselves to accountability in the partnership board for all our decisions’.
Ms Smith, who is expected to be confirmed as the new chief executive of Newcastle City Council this week, says that all three ‘have that shared passion for residents, but we also have a respect for each other – high challenge high support I’d call it’.
She adds: ‘I would in a heartbeat have Karen or Andrea come into my organisation and say: “I’ve seen this, it’s good. You need to do this.” And I think it’s born out of that respect.’
What other examples of cross-organisational working is she most proud of? Among a number that she mentions is the One Stockport borough plan, launched this year. ‘We’ve come together as system leaders to bring that forward. That was really rooted in what our residents wanted.’
Local people’s priorities are at the centre of the approach. Ms Smith also chaired the Discharge to Assess Board, which involved colleagues in all three organisations coming together to look at improving discharge out of hospital services. ‘I happened to chair it, but we collectively came together. Whatever we do, we want to improve things for residents.’
She adds: ‘We reduced our overall average discharge delay from 12.4 days to four days in quite a short space of time. When you bring all that talent together and it’s led as a system, it has a huge impact on residents, which is what we’re all here for.’
The hospital needs to be replaced and is currently on a landlocked site. The three have worked together to create a vision for new hospital services which improves transport links, addresses the carbon footprint, and creates the sustainability of the town centre.
To do this, Ms James says: ‘You have to have that trust and those relationships there, and if you haven’t got that, then it doesn’t work’.
She adds: ‘We’ve spent a lot of time developing our relationships. We share the risks and we share our thought processes and that is so important. You’ve got to understand each other’s world.’
Ms Smith says: ‘The reason for doing it this way is that it’s about levelling up. It’s about coming together to say we need to have new facilities for our residents and what we are going to do is work collectively to see where the best opportunity is for us to do that. We’re making it part of our improving workforce, levelling up, and regeneration [strategies].’
They refuse to let traditional organisational boundaries get in the way of what they are doing. Ms Smith says in conclusion: ‘For us, we said the first thing to do is to forget reorganisation, let’s look at what are the priorities for the population. What do we need to be doing? That gives us a great starting place.’
Pam Smith is chief executive of Stockport MBC. Karen James OBE is chief executive of Tameside and Glossop Integrated Care NHS Foundation Trust and Stockport NHS Foundation Trust. Andrea Green is accountable officer for NHS Stockport Clinical Commissioning Group