Publish date: 24 May 2021

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Regular readers of my blog will recall I’ve promised to keep you updated regarding the proposed acquisition of North West Boroughs Healthcare NHS Foundation Trust (NWBH). I’m delighted to report the respective Councils of Governors for both trusts have given their approvals for the acquisition to proceed. We’re now formally asking NHS England and Improvement (NHSE/I) to sign off the acquisition from 1 June.

This marks a significant advance for Mersey Care and for staff of both trusts. We’ve always been a leading organisation, but this development gives us a level of scale that will benefit patients and our new workforce and will also allow us to work innovatively with local partners.

Many of our existing staff will have been through other acquisitions and I’m sure you’ll make our new colleagues from NWBH welcome. Every time we’ve added to the Mersey Care family it’s been important and enriching. I’m keen we really do all benefit from the skills and the wider scope of services our new footprint and service portfolio will bring. It makes us stronger as a provider of very significant services that really do matter to the health, wellbeing and integrity of communities, families, and employers. It allows us to share what we’ve developed, as well as learning from others. The pandemic has shown how integrated health care makes a difference to, and benefits patients.

This is a new stage in our journey as a trust. It coincides with other planned changes as the Cheshire and Merseyside Integrated Care Partnership (ICS) evolves. The opportunity to play a very significant role in reducing health inequalities, alongside the ICS, is one of the big wins from us coming together. Our ability to care co-ordinate is greatly enhanced in the new arrangement and therefore our ability to see people socially and psychologically, not just medically, is a real chance for us to ‘add years to life and life to years’.

We often overuse the word “pride” but seeing two organisations come together, linking physical and mental health and working closely in the Mersey region, gives me a source of great pride. We learned during the pandemic that we were stronger together and on 1 June we’ll take that learning and embed it for our population’s future and not just current benefit.

What we’re all about

I’ve used recent blogs to remind everyone of ‘the story so far’ and how our new operational plan and clinical strategy relate to the day job. One area of our clinical strategy that I’d like to highlight is that of prevention. We should be working to prevent problems from arising and reducing the impact of ill health by dealing with the causes and risk factors.

It’s no longer good enough to only treat the symptoms of illness once they occur although as a universal service that must always be an available and necessary service. By working with people from birth to end of life and by identifying children, young people and adults who are most at risk from deteriorating health and wellbeing, we can target earlier interventions and provide preventative and proactive care to minimise rising levels of ill health.

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We should think of our services like school health, sexual health and Life Rooms as primary prevention channels. Secondary prevention, working to stop conditions from getting worse and tertiary prevention to support long-term condition management, are provided by our community and inpatient physical health, mental health and learning disability teams, our integrated care teams, community therapies and secure services along with our other specialist services.

Our clinical strategy notes that one in three children in Merseyside live in poverty. There’s a gap in life expectancy of more than two decades in the city and also sadly the city’s dependence on food banks is regularly reported. It makes for uncomfortable reading and devastating consequences.

We all have a role in prevention and ensuring a holistic approach to physical and mental health with the knowledge to signpost and direct the people who use our services to support their health and wellbeing. As a wider organisation, we have the presence – indeed the clout – to do this. We can treat more people in the community by working collaboratively, keeping care close to home and avoiding hospital admissions and demand on crisis and urgent care where appropriate.

What we do right now matters, and we’ll continue to deliver the range and quality of services currently offered. By looking ahead, we can do so much more and in a much more integrated way when collaborating with our partners.

This collaboration, as we grow our workforce, combined with a process of safe staffing reviews, accreditation and quality reviews, will all provide our clinical colleagues with an increased level of support to enhance their professional skills, capability and clinical practice. This helps to create a psychologically safe working environment with effective team-working to support us all to innovate, conduct research and deliver safe and outstanding care, which is consistent and equitable.

Psychological safety

I’m impressed when a bit of jargon – one of those phrases we may smile at amid the verbiage of NHS-speak – starts to get real traction. Being safe to think and act without fear of humiliation or condemnation, trusting and respecting each other is a theme I often return to in this blog. Embedding practices that enable people to voice concerns, share ideas, debrief and reflect safely are harder than we think. Yet, from them, all our workstreams and innovations can spring and flourish.

Last week I mentioned that Amanda Oates, our Executive Director of Workforce, had been speaking to several hundred NHS leads about our restorative just culture. This week, I’ve done the same, with Chairman, Beatrice Fraenkel, at a major conference on governance and quality in NHS Provider Organisations.

Senior leaders and academics were in attendance and I spoke about “healing after harm”. It’s not an easy topic to share with peers. How leadership affects learning from adverse events requires a shift in mindset, behaviour and practice. To do this means we must be honest and own the issue. Mersey Care can do this now as we’re committed to the agenda, but it’s not always the case. By saying a trust board must bear responsibility and accountability for effective incident management in its organisation, should mean that it is definitely happening in practice. Too few healthcare organisations are investing in this thinking.

I’ll continue to advocate why this must be the new normal, and not just because it saves money and reduces workforce pressures – it’s more transformative than that. It’s a golden thread through all our people, systems and processes providing a compassionate environment that supports Perfect Care and high quality, safe services.

COVID continues

A reminder that the existing guidance on masks and PPE continues. There are no changes and we need to remain vigilant. The pressures in services are real and divisions are working hard to manage them. We can all do our part by continuing to protect ourselves. Lateral flow testing remains essential and remember you can report it on your own device if that’s easier for you.

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Can I also remind those that haven’t done so already, to get vaccinated? Here at Mersey Care we have a high percentage of staff under 40 and more than a third of them are front facing clinically. We'll be encouraging them all to get their vaccine because it's effectively your PPE - protecting you and others. There’s a lot of post-COVID talk of ‘relaxing’ out there, but the NHS can’t do that.

Prof Joe Rafferty CBE

Chief Executive