One of the things that makes life interesting (and sometimes frustrating!) is that we are surrounded by paradoxes.

As we all know only too well, we find ourselves focusing on the urgent rather than the important, we concentrate on process rather than output (or even outcome), we talk system but operate in silos. There are strong (and sometimes good) reasons for this, but one of our roles as senior leaders is to climb out of those situations and look more widely. The joint DASS/DPH/DCS/NHS session on 27 April was just such an opportunity.

Martin Samuels - Strategic Director of Place, Dudley Council

Two things stand out for me from the event. First, although we know there are such fundamental connections between the goals we are all seeking to achieve, and interdependencies between our activities, our sectors have created worlds that draw us inward, pulling us away from each other. As a result, unless we try really hard, we can easily find ourselves in joint meetings struggling to find the common ground and shared language. Second, once we do manage to overcome that initial awkwardness, the discussions rapidly focus on outcomes and cross-sector responses that would help secure these. In particular, we don’t find ourselves talking about narrow actions to improve performance against A&E 4-hour waits, or speed of processing safeguarding referrals. Instead, we start to explore the economic impact of our ways of working (what proportion of daytime vehicle traffic is created by our reliance on face-to-face appointments rather than embracing phone calls, or even Skype?) or how to attract more people to work in the care sector (should there be a clear career path for care assistants to become nurses, or for junior operational managers in the NHS to become registered managers of care homes or GP practice managers?).

Clearly, the daily processes and specialist language exists for a reason and we do have much to do within our own sectors. But we also need to work out how to make it easier and more natural for all of us to step out of our own worlds, connect with our wider system partners and consider the bigger picture. Only in that way can we genuinely understand the challenges facing us and come up with the actions that will do more than just keep the show on the road.

Martin Samuels, Chair of ADASS WM and Strategic Director for People, Dudley Council

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