The spaces for operational leadership figures in the NHS to come together and reflect are few and far between. The NHS Executive Strategy Summit on 7th November provided one such space, and the day brought together a diverse range of experiences and practices in the spirit of collaboration and learning best practice. As we reflect upon the event, Distilled Post is speaking to NHS leaders about some of the issues the Summit covered, including winter pressures and the potential for digital innovation to navigate these pressures. We sat down with Edwin Ndlovu, the COO of the East London NHS Foundation Trust. Edwin’s background is as a mental health nurse - he was the Borough Lead Nurse and Associate Clinical Director for Newham adult mental health services from 2009 - 2015 before becoming the Borough Director for Tower Hamlets in 2016. Edwin is a recipient of the Nye Bevan Healthcare Leadership Programme award. 

The conversation began with some reflections on the event. “I recognise the importance of every so often taking a moment to just stop and think together”, Edwin said. He is well aware of the importance of being part of a community, as a nurse and as a member of the Jabali Men’s Network, a group that brings together senior men in nursing leadership from across the NHS. Edwin was impressed by the number of mental health representatives present at the event - Claire Murdoch, the National Mental Health Director for NHS England, delivered one of the keynote speeches. “I think historically, these events mainly focus on the physical health or the acute care side of things… it’s really important that the mental health conversation is held at this level in these spaces. A lot of the time, it’s when things have gone wrong that people start to talk about mental health.” He welcomed the opportunity to talk about mental health in the broadest sense of that service and on par with physical health care and using spaces like the NSS to focus on improving quality and the patient experience. Ultimately, Edwin assessed the value of such events as being in “that we can bring learning, new ideas back into our own part of the world and test them out”. I would like to see more explicit service user or people participation involvement at these forums in a more active way because without them then we are not really going to have sustainable improvement.

The Summit gave leaders an opportunity to discuss pressing issues, including patient flow. “We are seeing an increasing number of patients who are stranded in our beds, and these are patients whom we struggle to place beyond the episodes of care”, Edwin commented. He pointed towards a greater emphasis placed on community care provision to help remedy this, but acknowledged that often people are not able to access community care in time and therefore end up being admitted. He also highlighted how family connections, charities and the wider fabric of community support have been eroded in the wake of the pandemic, observing, “People don’t have that natural safety cushion that allows them to manage some of life's challenging events or help them to be quickly moved out of hospitals”. He also saw preventative measures as an inherent part of the solution to fixing patient flow: “There’s a lot of conversation around people who are waiting longer in Emergency Departments (EDs), but I try to say ‘no’ - let’s focus on what we can do to stop people rocking up to EDs in the first place”, this take collective efforts and events such as NSS are really helpful and providing platforms to learn together, design together and deliver together. 

The potential of digital strategies to alleviate some of the aforementioned issues was a hot topic at the Summit, and Edwin saw clearly the possibilities of technology. He was mindful of considering all the variables when it comes to digital implementation: “there’s an equity conversation that needs to be always had, front and center, when we start talking about digital solutions”. He was keen to make it clear that “some of the people we’re talking about here don’t even have access to food or other basic things needed in living. So if somebody cannot eat, then they’re not going to be thinking about Wi-Fi or a smartphone”. Despite this, he recognised that the potential is abundant: he referenced significant opportunities in the field of talking therapies, and in terms of back office functions to free up staff to do necessary work. Ultimately, digital solutions can empower the workforce while giving patients flexibility and choice in their care. There was still, Edwin acknowledged, “a challenge in that we focus a lot of diagnosis using digital platforms. But when it comes to the treatment part there are fewer digital solutions”. But the possibility of technology, Edwin summarised, is “an opportunity to repurpose ourselves as human beings to do other things”.