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An open letter to Amanda Pritchard

Bev Fitzsimons and Richard Smith The Point of Care Foundation 23 September 2021

An open letter to Amanda Pritchard, Chief Executive of NHS England & Improvement.

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Dear Ms Pritchard,

Congratulations on your appointment to this important office. We’re writing to you now, no doubt along with numerous others, because your tenure as NHS chief executive has begun at a pivotal moment for the NHS, its workforce and the millions who depend on it every day. 

This is for two main reasons. First, it is essential to act on the emerging crisis of staff fatigue and burnout, as documented in the Health and Social Care Committee’s recent report. The pandemic has shown us what the NHS and its workers can do when the chips are down, but they now need our urgent help. Second, Integrated Care Systems offer a huge opportunity for communities to be placed at the centre of more localised systems, offering a real chance to tackle long-standing health inequalities, which have been exacerbated by Covid.

The Point of Care Foundation is a social enterprise that works to humanise health and care. We have practical, evidence-based ways to work with both staff and patients. We believe this mission is of paramount importance for the future of the NHS, for both patients and staff. 

Modern healthcare can be dehumanising even at the best of times. The industrial scale of the system, volume of activity and sheer numbers of people can cause staff and patients to feel like cogs in the machine. The last 18 months have arguably been the worst of times, so what can be done?

You may know that the Point of Care Foundation is the sole license holder for the implementation and support for Schwartz Rounds and Team Time in the UK and Ireland. These are reflective practice interventions for staff which have been clearly shown to reduce psychological distress in those attending regularly. These have been rapidly adapted to work online during Covid, and we are reaching ever more dispersed staff who might have found it difficult to get the benefit of Rounds in normal times. But still we reach only 65% of NHS trusts, and there is enormous untapped potential in medical schools and other healthcare universities, and in care services, where this sort of support for the difficult demands made on staff is patchy. 

We know there is an evidence-based link between staff experience and both patients’ experience of care and their clinical outcomes. Morally it is the right thing to do to look after staff as best we can, but we know that if we do, they in turn can give their very best for patients. 

But beyond these impacts on individual staff well-being, we are increasingly being approached by Integrated Care Systems because they can see that the implementation of reflective practice across the places within an ICS footprint helps to create a common culture which puts communities at the heart of local services. We want to build on our work with ICSs and make an offer to support this culture change in every ICS in the country. To do this we need your help through modest shared funding to get ICS Schwartz Rounds off the ground, and support at the policy level to communicate the value of this and other interventions which build system resilience, alongside personal and individual resilience. 

We wrote an open letter to your predecessor Sir Simon Stevens in July 2020, and recently engaged positively with colleagues in the Workforce Team. But the wheels of government sometimes turn slowly and we feel that more urgency is needed. Our Trustee Sir Robert Francis QC has also recently written to Prerana Issar to express similar concerns. 

We would love to have the opportunity to share with you what we have learned from our work with NHS staff over the last 15 years, and how we can help in an immediate, tangible, and practical way. I hope you will accept our invitation to attend a Schwartz Round and see the process in action. Indeed we would be delighted to offer the Executive Board of NHS England its own Schwartz Round, in order that you and colleagues can experience this intervention at first hand. 

Yours sincerely,

Bev Fitzsimons

Chief Executive, The Point of Care Foundation

Richard Smith

Chair, The Point of Care Foundation