Building Trust - colleagues interview our CEO Matthew Winn

Colleagues Ash from CCS, and Sam from NCH&C, talk to our Chief Exec, Matthew Winn, about any further questions they have following the recent announcement that CCS and NCH&C will be creating an NHS Group together.

Transcript

Hi, everyone, welcome to this special Building Trust podcast episode.

My name is Tom and I'm part of the NCHC Communications Team.

I'm here with Matthew Winn, CCS and NCHC Joint CEO, as well as Sam and Ash from NCHC and CCS respectively.

My name's Ash.

I'm one of the Physiotherapists here at CCS.

I'm also Network Advocate, previously Network Chair to the Cultural Diversity Network here at CCS.

And I'm Sam.

I'm an MSK Physio as well, FCP Clinical Lead and also the Joint Staff Side Secretary for NCH&C.

So we're here to talk about the plan announced six weeks ago or thereabouts to bring NCHC and CCS together, initially under the NHS Group model as independent organisations, but with a single board and executive team who will lead the organisations into alignment from April 2025.

Today's an opportunity to dive a little bit deeper with Matthew and give Sam and Ash a chance to ask him their questions, having had a bit of time now to reflect on the announcement and speak with colleagues about how they're feeling about the upcoming change.

So to start us off, Sam, if I could come to you first for your general reflections, thoughts, observations six weeks on from the announcement.

So I think thinking the announcements, it kind of for probably quite a few people came out of the slight blue of the thought of it.

But then I think when looking back, they've also thought, oh, OK, well, Matthew was the joint chief exec.

It kind of made sense that we might be going down this model.

I think a lot of potential thoughts and concerns are, is it a merger?

What is a group model?

I don't know what those two things mean.

So I think that would be really nice to chat to Matthew about.

I think also a lot of people will be going, oh, what does that mean for me?

And what does that mean for my job?

And I know the statements have been very much clinical, won't be affected.

But a lot of our support services will now be working closely alongside our colleagues at CCS.

And that becoming a bit of a challenge, or what challenges do we perceive in the future?

So it would be really nice to hear Matthew's thoughts on those.

Thanks, Matthew.

Did you want to pick up on any of those points?

Yeah, let's do that.

And for those I haven't met, I haven't met everybody in both organisations.

So I'll Matthew lead both organisations, as Tom said.

Sometimes these things appear to come out the blue.

They clearly haven't.

We've done lots of thought behind this.

Both boards have been non-executives.

Those are people that are appointed to advise our organisations at board level and our directors on both sides have been working quite hard in their sessions since about March, April.

So it's been relatively quick and focused.

And the purpose, which I hope people have had a chance to look at the case for change, is to say, we want fabulous community health services.

We need fabulous community health services.

I mean, Ash, you and Sam both work in musculoskeletal elements, and those should be done as close to where people live, GP surgeries as you do, Sam, and expert help allowing people to get into hospitals as quickly as possible for orthopaedic care without going through loads of outpatient work.

All of those things revolve around great community health services.

And today we were recording this on a day that someone called Lord Darcy has reported a date of care.

And again, it's reiterated, we need to invest in non-acute services to ensure that we are sustainable within the health service and care services to support more of the population.

So that was our real driver to say, well, if that's the prize, how do we do it?

Both organizations are actually relatively small in NHS terms.

They're not small in kind of global terms.

Bringing it together, bringing our joint expertise, the good things that we both do into a more sustainable size, single board oversight, I think was the real imperative.

So we can support frontline staff even better than happens at the moment.

And on the specific, Sam, a group model is just an interim step to us becoming one organization.

And then we would really bring everything together.

Everybody would be paid from the same bank account.

Everybody would be one electronic system.

We would all work for one organization as employees.

The group model then is a kind of hybrid.

It says, well, both organizations need to continue and be continued to be managed well.

And we're keeping that hat in place until we get to the end point.

But in the meantime, we're going to bring together the functions at board level and directors initially.

And that will hope happen over September, October, November, December, January time.

And then we'll start to align things in a sensible way over the coming year.

So a group is just two organizations existing, but with one guide in mind in terms of executive and board approach.

It's as simple as that, really.

That makes sense.

Thank you.

Thanks, Matthew.

Ash, from your perspective at CCS, initial thoughts and feelings and have they changed in the period since the announcement?

Well, I think I wanted to start off by following up on some of Sam's comments in terms of what's happening to Matthew.

Quite clearly lined out what's happening.

Management board level, as well as services, streamlining, finances, resources, those are all going to be kind of coming together.

But the question around those on the staff on the shop floor, can they expect any changes?

And if so, what are those changes?

I think over time, and I think it will be different for different parts of the organisation, Ash.

I mean, again, let's pick your expertise areas, both of you, which kind of helps, because you're both in your musculoskeletal world.

Both organisations run big musculoskeletal services.

I am not, and we will not be, then saying, well, Sam, you, I know you don't, but if you're in North Walsh, suddenly, actually, we want you to be in Huntingdon tomorrow to do a clinic.

That's just daft and is not going to happen.

And here's the but, though, if you're working in King's Lynn or some of those down in Market or some of those GP surgeries on the west side, and Ash, we have a very good MSK centre in Whizbeach, and the line between Cambridge and Norfolk is, as we know, right through the edge of Whizbeach.

Where can we then maybe say, well, that team can operate in a bit more flexible way?

And if there's space in the MSK centre in Whizbeach, why can't Norfolk residents who live very close to there go to there and cut down some of those barriers?

So that's just a practical thing.

I think the second thing service-orientated is that we can really begin to look at standardizing protocols, practice, training, research potentially, and saying, wow, we now have a double the workforce across the organisations in MSK.

So what can we do together to really push forward clinical leadership, research, standards of care, and improve and learn from each other?

That's the sensible way to do integrated across both organisations, not to start doing the DARF things, which is suddenly deploying people in different directions.

And hopefully you will know me well enough.

The stupid things we just won't do.

Staff are employed to work in their local areas, and that should continue how we learn from each other and develop a service together.

Well, that's kind of exciting and gives opportunities, doesn't it?

Absolutely.

Thank you.

I suppose it's around kind of sharing resources, isn't it?

So as you're right, and I know we're taking it on a bit of a clinical level, but if we have two clinics that are quite nearby, but because of a county line, actually can we use that shared resources and both being community trusts, where CCS, you guys have people all the way down Luton Dunstable, all the way up to Whist Beach, we're the same.

And actually, could we use estates more effectively?

I presume that's one of the thoughts that has gone into this idea.

Yeah.

And CCS already have Children's Services in Norfolk and Waveney, Sexual Health and HIV, and there are premises which are a stone's throw from the HCHC site.

Well, when those leases come up, actually, why don't we have a conversation about, have we got spare estates?

What can we do?

How can we co-locate all Children's Services together?

Because NCHC run a set of Children's Services and bring them together.

I think the other aspect, which we've already started to do, Sam, is I was out visiting both CCS and NCHC start up in Kingslyn a few weeks ago, and the CCS world is recruiting a new team of mental health support teams into schools.

They're extending the service as is planned.

And they were thinking of having to buy space in premises for a holiday time when schools aren't open to see children.

And five minutes down the road is St.

James's Centre, where we have got space that we could use in NCHC.

We'll still pay NCHC for the time being to actually use that space.

But, and actually if you can start doing those things, we can start doing the hard things as well.

Okay, in terms of the harder things and some of the practicalities and some of the changes that colleagues, clinical and non-clinical might start to see, the time table for that, if we take April 2025 as the group model coming into effect, when would you expect that colleagues at both trusts could begin to start working together on coming into closer alignment?

I think we take things tactically.

There are already staff from NCHC doing things in CCS and people in CCS doing things in NCHC, both in a full-time or a part-time or a kind of subject matter expert role.

We'll see more of that where we have gaps, because we'll look to each other to say, have you got the support?

I think then from January, as directors are in post, and then formally take up post between January and April, people will start looking at their portfolios and say, right, this is where we can easily bring things together.

So Sam, you co-chair StarSide.

I imagine you'll be working with Heather Bennett, the StarSide chair in CCS, and saying at what point with Anita and Liz, do we start saying, well, let's have one meeting or let's have an alternate meeting.

Let's have them separate.

And then we do them together so we can share and learn.

Ash, you chair, one of our great networks in CCS.

There is another network in NCHC.

When do we start doing those things as well?

When do we become, Tom, I think, a judgment call about what's right?

I don't think I'm going to prescribe that.

I think it's up to those directors to be working with people to say when's the right time, when does it make sense?

And then I guess it's also, and Sam, this goes to your StarSide kind of responsibilities, we won't change harmonising things to where in one trust.

But in advance of that, let's take the opportunity if we're developing things together, or reviewing things to say, actually, let's make sure they are harmonised.

But actually, there will be a formal process of harmonising things that will involve StarSide.

But if policies are coming up, or there's new policies, let's take the opportunity to do the same things together.

And just imagine those will start happening.

So actually, terms and conditions, pay, your management arrangement.

So it's really important.

Those are the things that really reflect your employment.

And we need to keep those really solid.

And Ash, you and Sam, I'm sure, will be advocating some solidity and sense, rather than just kind of going off.

And Sam, I'm sure you'll have a view on that.

Yeah, I think we've already started to have those conversations in StarSide, is how could we work alongside our colleagues in CCS, and what might that look like?

So I think it's a really good opportunity to start to have those conversations probably now, rather than later and it being not put on us, but that going ahead, so actually being a bit more forward thinking and proactive about how things might work.

I think also probably the underlying question is, Matthew, do you see potentially in the future?

And I know without a crystal ball, you don't know what the future is going to hold.

But for our support service colleagues, are we going to suddenly be merging one HR team?

Are we suddenly merging one staff experience, one EDI team?

And they're now up for grabs of their job as a competition with potentially a colleague that they might be working alongside at the moment.

So there won't be any, suddenly, it will be planned and it will be for an engaged process.

And undoubtedly, the answer will be, yes, we will have one workforce team, one finance team, one clinical governance team.

Does that mean I am looking, well, we'll just apply a rule and have less headcount?

Well, no, it's got to be planned and it's got to be understood, because if there's work today in both organizations, there will be work tomorrow, even though we're one organization.

If we got six people and there's complete duplication and we need four going forward and we're okay with that, then there will have to be a process to look at that.

But, and here's the big but, we don't want to lose talent and people are talented, can put their eyes and ears and approaches to other things.

And we already have a change management process, don't we, in both organizations where we will go through it.

It is not in our psyche in either organizations to move to try and make redundancy.

That's the very, very last thing we want to do.

We want to make sure we can redeploy, use people into other talents.

So we will take that approach, but it won't be a sudden and it won't be a surprise.

It will be a working through and what makes sense.

Ash, you want to kind of say comment on that maybe?

Yeah, comment as well as follow on from that.

You've talked already about the positives and the mergings of the two community trusts.

But I wanted to ask, are there any challenges?

And to follow on from that, is there any other suggestions that you can suggest to aid in our transition?

Yeah, I mean, it's good points.

The best thing people can do is to keep talking and talk about when they're worried about something, because the worst thing to happen is for people to make decisions about their future, based on a misapprehension or a myth.

And actually, Sam, your point of, will there be changes?

Well, yeah, there will be changes, but I don't honestly know what they might be.

There is not some great master plan sitting somewhere with everything plotted out.

I mean, we'd have to be really Machiavellian and bizarre if we had that done.

And that's just not the way things were.

So I think people need to talk.

I'd love also people to be thinking about what they want to change.

So the good thing about coming together is it gives the chance to reset things.

If we do things that just are really annoying or they're custom on practice.

And you know that point where everybody goes, why do we do it?

And everybody goes, oh, well, we've always done it that way.

That's always a bad reason to carry on doing it, unless there's a real great rationale for doing it, especially if it's annoying.

I think, Ash and Sam, we need to get conversations and we will do this in a purposeful way next financial year, is start saying, actually, if we want to create something new together, that allows us to stop and start and refresh and do things together.

And Ash, I think that's about engaging with everybody to give their views around that.

Because again, that's not corporate gobbledygook.

That's about how we support people to be great employees and be good and support in their teams.

Just as a complete aside, if you could embellish me for a second, I was recording a new podcast, my podcast series and more.

Just a plug there.

But I was talking to a private sector chief exec about there and listening and thinking, wow, that's great how they supported their staff in a different way, how to be healthy.

And it's that kind of stuff of saying, well, actually, can we do better than that?

I bet we can, than we do at the moment.

So that's some of the stuff I think Ash would be really helpful to see in Teams.

And challenges, so you talked about how staff can...

Yeah.

Any challenges that we can expect?

So, look, I think things that I worry about as your leader is that this stuff takes us off course on delivering great care and we have enough pressure just to deliver great care as it stands and also continue improving care.

And in both organisations, there's loads of work going on to make sure what we do can improve and improve and change.

The challenge is making sure we do that all the time.

The second challenge is that therefore we make all of these changes proportionate and the third challenge I think we have is to ensure that this culturally is a helpful process.

It doesn't become divisive, it doesn't become them and us, and it doesn't become about creating something good, and it just gets wrapped into worry and tribalism.

That challenge, it always is the challenge of bringing things together, and we've all got to do our part to make sure that doesn't happen, I think.

To Ivar, if you have any other burning questions that you wanted to put to Matthew today.

I had a light-hearted question, that's why I was asking if everyone has to answer this question.

What was the name?

It's not going to be called, I imagine, NCHCCS.

No, and I do not think that's a light-hearted question.

I think that, let's use that as an opportunity to get views and talk to people.

I think geography is really important, but also what we do as an organisation.

So we will have a chance by April 26 to have a different name.

But look, the name to me is not important.

It's what our services do day by day.

You two live and breathe Muscle Scolitis Services.

Your services must be called something dynamic, Muscle Scolitis Services in Norfolk, Cambridgeshire, Donington, wherever we're doing it.

That's the important bit.

We also need to get right, not get caught out by the name of the organisation because that just gets into vanity.

Sam, have you got anything else?

No, I suppose the only thing for me is just because, I suppose, looking at the kind of board level, because I think we talk a lot about just our staff, but we kind of forget the board and the boards are still our staff.

Would you see potential in the future deputies and stuff like that, quite similar to kind of what you have at the moment with a deputy in CCS and a deputy in NCH&C?

I think that's a really important aspect.

So the answer is yes.

And thank you for thinking about the board.

That's kind.

Yeah, it is chuff.

And I'm having one-to-one conversations that are now getting into the nitty gritty of how things change.

And that really is tough for people.

This is their livelihood.

For our non-executives, their appointments, and this is very much part-time for them.

But even so, they put a lot of effort into our organization.

I think the exciting thing, if I can finish on this, and maybe this can be a future kind of addition, is we need to formalize clinical leadership better across both organizations.

I mean, how we really get operational clinical directors probably working hand in glove with our senior leaders to drive things together.

We've got elements of that right in both organizations, but there are big gaps, and we need to develop that.

What I would say is we're not going to be able to do that straight away as we make this initial change on board, but nothing stays the same, and we need to plan that together for the future.

And I'm not promising this, you MSK professionals, but if you had a clinical director of MSK to work alongside your operational leaders, then we need to train, develop someone to be that role, and give them the skills and the expertise to do that.

And that might take us 18 months to get there, but that has to be the future direction, and a good direction for us as a health and care provider that we need to get right, which goes to your point about, it's not just about the directors, it's about the broader leadership team.

But Tom, maybe we can come back to that as a future discussion.

I think we can.

That sounds like an excellent idea.

For now, thank you, Matthew, and thank you both for your time today.

It's been a fascinating discussion, and I hope colleagues will find it useful as we continue on this journey.

A quick reminder to everyone listening that you can find all the information about Building Trust, the case for change, frequently asked questions and contact information if you've got any questions on the dedicated website, which is www.nhsbuildingtrust.info.

Do check that out if you haven't already, and keep an eye out for more engagement sessions coming soon.

But for now, thank you all again.

Until next time, bye bye.