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Amy Gibbs, Chair of Tower Hamlets Together - March Briefing

Posted on: 15 March 2021

This month's THT Board was a candid and reflective meeting, focussed on diversity and inclusion, workforce, wellbeing and restoration. Two years into doing this role, it felt like a real shift to a space where leaders can be held to account -by people with lived experience and by each other -listen and learn, and lead the cultural change we need to see throughout the system.

First up we had an excellent presentation from Abdi and Mukhtar of Coffee AfrikCIC, a Somali social enterprise founded and led by people with lived experience. What began in 2018 as a community crisis cafe for people with serious mental illness or special educational needs has evolved into numerous award-winning community programmes. These include a Somali women's digital mental health peer support group, designed in response to the high level of need and the mistrust of mainstream services among the community due to previous poor experiences, anxieties about immigration status, and cultural stigma. Coffee Afrikhas also played a vital role during the pandemic, providing food parcels for 3211 clients, collecting 598 medicine parcels, and carrying out 1566 befriending at safe distance visits. A recent vaccination workshop led to increased willingness to have the vaccine, showing the importance of community leadership and trust in improving uptake.

Abdi and Mukhtar held a mirror up to us and the system -making clear how far we need to go on representation and inclusivity within the Board itself, throughout the THT workforce (especially at senior levels), and to deliver consistent culturally appropriate care. We have to be honest about the inequities that persist -Black men are more likely to be sectioned under the Mental HealthAct, have suicidal thoughts, and experience excess deaths -so we can move forward as a partnership. Action to improve access to language support, meet faith-related needs, provide culturally appropriate food, ensure gender-specific services, increase ethnic diversity and lived experience in the workforce, call out and reduce experiences of racism are all vital.

Board members welcomed the constructive challenge -we are not diverse and it's taking too long to achieve racial justice throughout health and care. We must look at each partner and the specific actions we need to take to address inequities. For example, the council's adults, health, and community directorate workforce is overall 2/3 Black, Asian, and minority ethnic groups, but this shifts to only 1/3 when looking at people earning above £60k. This pattern is mirrored when looking at senior levels of large NHS providers and the ethnicity of headteachers. For some partners, we first need to do more work to get underneath workforce data and trends, so we can target change.

Inclusion is a live discussion in all organisations but we need to step up the pace and do the work ourselves as system leaders -anti-racism workshops for THT Board led by charity prepare in the pipeline. As a white leader and chair, I'm thinking hard about how best to use -and ultimately give up -my own privilege and power to bring more diverse voices and lived experience leadership to the fore, both at the Board and throughout the partnership.

Given these discussions, it was timely to receive the integrated workforce strategy, which was warmly approved by the Board. This has been in development since 2019 but the pandemic has led to a greater emphasis on goals around inclusion and wellbeing. As a partnership, we know our staff is the single most important factor in the quality and delivery of care, so the strategy is a guiding framework to support and develop the local health and care workforce. The four areas of focus are capacity and supply; diversity, equity, and inclusion; leadership and organisational development; enabling systems working. I'm excited to see how this rolls out and as ever welcome any feedback -it will only be successful if it genuinely works for staff from the frontline through to all parts of the partnership.

Finally, we heard from each partner about the current picture of staff wellbeing, almost one year into the pandemic. The pace of working has varied for different services and teams -the hospital and care homes have faced constant high pace, while the voluntary sector has stepped up especially in this latest wave and some council services are now getting busier, due to wider impacts of Covid. We recognised the trauma and burnout across the workforce, often being bottled up while people continue to respond to Covid amid central pressure to restore other services and a general backdrop of relentlessness. Frontline staff has kept going, but the current mood is weary and apprehensive.

It was reassuring to hear about how partners are seeking to support staff, offering a range of small interventions since what helps will be different for everyone. Everything from silent discos and wellbeing dogs at Bartsto directly employing teachers for a Zoom school at ELFT. There's a real commitment to respite and encouraging uptake of annual leave, especially for staff that was redeployed, and to offering support to cope with the personal impact of loss and trauma, including by training managers to have compassionate conversations.

We concluded by reflecting on the very difficult journey faced by staff at all levels throughout the pandemic and the need for leaders to recognise their own vulnerability, given the significant decisions taken in the face of uncertainty and tragedy. Being mindful of individual resilience and leading by example -for example by taking leave and using support on offer –
are crucial actions too.