Integration Summit: Interaction prompts questions about trust

You know you have been to a worthwhile conference when you come back with new questions arising from the quality of discussion.

This conference was worthwhile. It asked: how can health and wellbeing boards be effective in driving integration and coordination of care?

The Integration Summit attracted a wide variety of board members. Councillors, the NHS and local authorities were there in force, with a sprinkling from Healthwatch and the voluntary sector, just like real boards.

The clarion call

It was a facilitated interactive event, we were expected to actively listen to each other and think hard about how to achieve goals.

Are we, as individuals, sectors or boards, using the right levers to get the results we say we want for our local residents? Do we understand each other sufficiently or are we busily talking in different languages and doing little systematic listening to our residents and patients?

‘The government needs to be really clear about the authority, power and priorities of HWBs’

There was one definite clarion call from the whole group: for the government to be really clear about the authority, power and priorities of HWBs.

Many delegates felt the government expected that every significant committee or board had to have its annual report or new initiative signed off by the HWB – children’s trust boards, adult and children’s safeguarding boards, local safer community committees, clinical commissioning group five-year strategies and trust reconfiguration plans.

There was a widely held view that this dissipated energy and focus.

Systematically taking steps

A second strong theme was the importance of taking systematic steps to understand how other partners, professionals, patients and the public in general respond to new ways of working and care pathways that require them to behave differently.

‘When I do understand customer insight and user engagement, how can I apply it to integration plans?’

A pathway that is ignored or circumvented by the very people for whom it is designed, or undermined by the very professionals employed to provide it results in patients and service users being regarded as the problem and a financial liability because they “won’t comply”.

I asked myself: do I fully understand the difference between customer insight and user engagement and consultation? And, when I do fully understand it, how can I apply it to integration plans?

Also, what conversations will I have with my own HWB partners about this so that we make the most of our customer insight tools and skills?

Positive perception

iMPOWER, which ran one session, shared research results about the levels of trust between professional groups. Perception is as important as reality and a strong basis for distrust.

Don’t assume the individuals you work with on the board and clinical commissioning group are typical of their peers. In fact don’t assume that “peer” means “will behave/react the same way”.

Success in behavioural change means paying attention to the positive and negative stance and power of the individual as well as the group.

‘Perception is as important as reality and a strong basis for distrust’

I ask myself what assumptions my board partners make about me, my council and our intentions.

Do they trust us in relation to board and integrated care? Do I trust them? If not, what will I do about it in the interests of the people we all serve in Somerset?

Clare Steel is lead commissioner for adults and health of Somerset County Council