Introduction by Marcus Longley, Director of WIHSC and Professor of Applied Health Policy
This week’s blog in our ’20 blogs for 20 years’ series is by Stewart Greenwell, whose entire career has been devoted to helping people improve the quality of their life, most recently as Director of Social Services, Housing and more in Torfaen and then Newport. He reflects on what health and social services should really be about, and how improving people’s quality of life starts with understanding the worlds of both clients and staff.
20 Years of Learning
20 years of WIHSC has made me reflect on my own journey over the last 20 years, albeit now retired, but still working – a conundrum that is becoming clearer by the day!!
In 1995, I was regional manager in South West England for CCETSW, the social work training council, that followed 10 years, between 1982 and 1992 as an academic.
I wanted to get back into local authority social services, to the amazement of friends, my family and colleagues. Eventually I returned in 1997, as Area Director in Gloucester, finding, unsurprisingly, that it was still about working alongside people who were, amongst other things, experiencing poverty and finding it tricky to lead successful lives and to provide for those around them.
I had always been interested in community development, making as many links with key local people and agencies as possible, to understand the neighbourhoods in which I worked. So on my return to local government in 1997, I sought out opportunities to again build links with other agencies in the city and the establishment of Primary Care Groups, the predecessors of PCTs, was one that I seized upon.
It was a large group, probably 20 in all, with about 10 GPs, giving us all the chance to find out more about what other people and agencies could contribute to the health of the population. I was the sole representative from social services and gave a lot of time to listening to GPs to understand their world view. There was very little consistency between them, but my understanding developed, such that I became a local expert on phlebotomy services (probably because I admitted to not knowing what phlebotomy meant) with GPs regularly suggesting that I should do presentations on the importance of the service, as I seemed to have ‘got the message’.
That has continued, ie getting the message. I moved to Wales in 2000, as Assistant Director, Performance and Partnerships for Torfaen CBC and was mainly responsible for the relationship between the council and the NHS. Eventually I was appointed Chief Officer, Social Care and Housing in Torfaen, meaning that I had to develop understanding of the ‘housing’ world, as well as the NHS.
I challenged the barriers between these different and at times competing worlds, winning small battles, but struggling to find and suggest a different way of responding to demand.
In 2009, I moved to Newport, holding the responsibilities of director of social services, as well as being responsible for ‘customer care’, something that I cherished but had found little real evidence of it, as a dominant cultural and organisational characteristic.
A new railway station was built in the city to coincide with the Ryder Cup in 2010. Most of the old railway station has lain unused for the previous 30 years, only the ground floor operating as a booking office and entrance to the station. The five floors above were empty and deteriorating. The city council wanted to develop one Face to Face centre in the city, to save money on the many offices offering public-facing services in the city: a council tax office, a social services office, a housing/homelessness office, an adult learning office and many more.
On appointment I set out to experience what it must feel like to try to access services in the city. It was not good, most reception areas were unwelcoming, with poor displays of information and generally a feeling that if you had the misfortune to need to go into social services, the local general hospital or the CAB, you were probably desperate and left with a sense that desperate people are difficult to help. We eventually stumbled across the idea of refurbishing the railway station and, working with Network Rail, secured a deal that led to the opening in January 2011 of ‘The Information Station’. Staff were trained in customer care skills, the environment was planned to be welcoming and all the city council’s front-of-house services were located there, with the majority of other front-line staff based on the other floors. The experience of seeking out public sector services in the city had been transformed, or, at the very least, significantly improved.
So what has all this got to do with the 20th anniversary of WIHSC?
Everything!! An Institute for Health and Social Care could set its stall as only being concerned with the world of NHS and social services. Or it can get its hands dirty.
I believe that WIHSC, by getting out there, has also discovered and added academic weight to many of the simple things that make a difference to people’s lives.
I discovered early on how it made a difference to homeless people having a freshly painted wall when they moved into a temporary home, or the rubbish moved from outside, which previous tenants had left.
I discovered how important it was to understand the paradigm that GPs used in their daily contact with people and with other professionals. I had to do that, if I was to expect them to understand the world view of a social services manager.
I experienced the nonsense of ‘process over people’ and the intensification of that nonsense when two or more public sector agencies are involved. I had trouble making sense of it and I assumed, quite rightly, that people outside of the professional world would find it even more daunting.
I spotted the importance of housing to us all, it is the difference between feeling ok and feeling unwell, depressed, unwanted and worthless and all of which can easily become the business of health and social care.
I also saw what a difference it makes to the relationship between local people and professionals when we created an environment that gives a message that says: ‘you are worth the effort of creating a setting that welcomes you, makes you feel as if you are important and treats you with dignity and respect’.
All these are critical characteristics of decent health and social care and to its credit, WIHSC has spotted them too!!