Rachna Vyas, Chief Operating Officer for NHS Leicester, Leicestershire and Rutland ICB, offers her perspective on NHS-wide knowledge sharing, integration and why her system is scrapping a ‘winter plan’.

Our teams are at the heart of what makes the NHS tick. The onset of this winter follows a series of mounting pressures through the year including the impact from industrial action across sectors, the constant challenge to manage patient flow, and an evolving way in which our patients expect services to be delivered across the year. Leaders at every level, operational and strategic, are making key decisions on how to best tackle these issues across systems on a day-to-day basis, which is why events like the NHS Executive Strategy Summit 2023 are so important. The event, organised by Meet Health Events and Proud2bOps, will bring together strategic and operational leaders from across the wider health and care system to discuss these challenges and engage in collective problem-solving.

Distilled Post had a conversation with Rachna Vyas in the buildup to the event. Rachna is the Chief Operating Officer at the NHS Leicester, Leicestershire and Rutland Integrated Care Board (ICB). Rachna began her NHS career in 2005, and her previous roles include the Executive Director for Integration and Transformation for the three Clinical Commissioning Groups in Leicester, Leicestershire and Rutland. In this role she led the design and implementation of transformed models of care for urgent care, elective care, children’s services, all age mental health and learning disability services.

Rachna sees plainly the value of the NHS: “We can do wonderful things with people, achieving the best outcomes for them and their loved ones on a daily basis.” But when the system is presented with challenges such as those we see as winter pressures, she sees protecting the wellbeing of staff as paramount - “Our teams are tired. We’ve had a really difficult couple of years… there’s more and more pressure on services, with inflation and the cost of living impacting on people personally also”. For the NHS to function as it should in these difficult times, Rachna says “we've got to look after the well-being of staff groups across the entirety of pathways that we've got, because without them at their best, the NHS does not work at its best.” Rachna revealed that the NHS Leicester, Leicestershire and Rutland ICB “no longer has a winter plan. We have developed a surge and resilience plan across health and care services covering all seasons.” She explained the shift away from viewing winter as a specific season to prepare for: “we know that ‘winter pressures’ just doesn't seem to stop for health and care services. So we are now looking at seasonal pressures… this is not just about winter anymore. This is now about sustainable services, dealing with surges just like any other sector would.”

The conversation turned to the potential role of greater care in the community in alleviating pressure on the NHS. When asked whether there were patients in her ICB area that might benefit more from care in the community, Rachna had this to say: “I don't think you'll find a trust up and down the country that would tell you that we haven't got patients like that…if you can provide services outside of an acute setting, safely and in a timely fashion, that's absolutely what we should do as its what the majority of our populations ask for regularly” One of the difficulties lies in managing the fact that patients are most often admitted with multiple conditions; Rachna identified dealing with this complexity as a key issue for care in the community, but pointed towards GPs and specialists working together as a potential solution - “Partnership teams like these are used to handling risk in a very different way to individual specialist colleagues and we can evidence improvements in both patient experience and patient outcomes when we work across these boundaries”. 

Initiatives such as care in the community will help to improve patient flow, but only when supplemented by other good practices such as enhanced digital strategies: “it’s about digital transformation as well as clinical transformation”. Echoing many other operational leaders in this interview series, digital integration was a key phrase for Rachna. “I think we need to do better as a set of people and a set of organisations on how we share data safely across these systems so that we've got one plan.”

Rachna feels positive about the potential of the NHS Executive Strategy Summit: “Because somebody's always doing something better than we are, and sharing how somebody's made something happen is incredibly important”. Giving the space for operational leaders to learn from a variety of approaches, as well as to contribute to a supportive and understanding environment, is vital as they face the challenges ahead. As Rachna concluded, “it's time and headspace to listen, to learn and to think differently, which is invaluable when you're in these roles”.

The NHS Executive Strategy Summit is on the 7th of November in London, organised by Meet Health Events and Proud2bOps.

To learn more about the event, visit: https://www.meethealthevents.com/nhs-executive-strategy-summit-ness-2023

To learn more about Proud2bOps, visit: https://www.proud2bops.org