Bromley By Bow Health Staff blog: Thinking about the holistic well-being of patients
Emma Owen-Amadasun, Assistant Director of Population Health at the Bromley By Bow Health, has written a blog piece for our Knowledge Share Programme with her thoughts on how the pandemic has impacted the work at the BBB GP practices and what learning she takes away for the longer term future.
Health has arguably never had such a big global focus, and the NHS and its services have come into sharp focus. The last few months have been a rollercoaster of not only looking after those who are acutely unwell, but also finding ways to make sure that people stay well and avoid becoming unwell. I have purposefully avoided the use of Coronavirus here because if we have learnt anything in the last few months, it’s that health means so much more than whether you have the virus or not.
Thinking about the holistic well-being of patients
We have a deep and entrenched belief that people’s well-being is inextricably linked to their socioeconomic environment. This is not new for people who are familiar with Bromley By Bow Health and Centre, but this foundation has truly enabled us to provide the support that people have really needed at this difficult time. Much of the work has been about championing and preserving this approach, ensuring that it is built into to ‘business as usual’ conversations, and that it edges our whole team (clinicians and non-clinicians) to think about people’s well-being in its broadest sense.
The NHS and its constituent parts are well known for being slow to change, clunky and reactive, but the last few months at Bromley By Bow have shown the complete opposite. Across the Bromley By Bow model, we have witnessed a new flexibility, and we have been able to move extremely quickly to implement and adapt services that would have otherwise taken perhaps years. We have naturally adopted a ‘test and learn’ approach – modifying as we go and adapting our offer based on what we learn each week.
Collaboration within and between teams
This has been largely possible due to the autonomy of the Centre to work flexibly with the Health partnership, amazing working relationships, and a staff complement that have been willing to go above and beyond to do what is needed to deliver high quality and relevant services. And of course, this has all been done remotely, with many staff themselves facing tricky personal circumstances that have arisen due to the pandemic.
I work on delivering high quality support to patients, but as a manager, I have also tried to focus on the well-being of my team. This is done by ensuring that we have check-ins at intervals that suit the team, as well as being available for important ad-hoc check-ins, maintaining good levels of communication and, importantly, ensuring that we all share and understand a common goal. This has allowed us to quickly and easily expand the team, as well as share working practices with others – particularly at PCN level.
It has also felt important to keep the door open for innovations and suggestions for improvements – I have taken risks and tried things that I previously would have been much more adverse to! Which has felt rotten at times, but overall I have felt supported by colleagues and I have really valued the trusting relationships which have made these decisions all the more easy!
Another aspect of management in this time has been about holding reflective spaces for the team to step back and consider changes and developments to offset the rapid pace at which things are changing in the external environment. There have been moments when the right thing to do on Tuesday was the wrong thing by Thursday, and managing emotions, tensions and apprehensions through this has been a delicate balance!
Looking at the future
As a senior manager, my role is often about looking up and out, and designing work that is fit for purpose now, but also meets the priorities of emerging agendas; it has been no different in the current climate! It has been a challenge ensuring that the work we are doing meets present need but also helps us to fulfil longer term strategic goals. I have to say, however, we are now more fully doing many of the things that we have been working towards for a number of years.
To help carry this work forward and beyond the current situation we have had a real focus on capturing the process and outputs (edging towards outcomes) of our work so that we can not only remember what happened, but also start to build evidence for the working practices that we are establishing. Weekly impact reports have also helped us to communicate clearly to the wider organisational team, and has really helped others to see the value of proactive, holistic and targeted work.