Committing to matrix working

By Andrea Gray Mental Health Development Lead for Wales, Improvement Cymru

Andrea Gray

Close working arrangements have often existed at a national leadership level in mental health, this has frequently been because of personal relationships that have grown and developed over time as well as a genuine commitment to wanting to support services to deliver the best possible care.

However we have all had our own team workplans, expectations, lines of accountability and governance. Whilst efforts have sincerely been made to share what we have been doing, not having our own ‘central guiding hand’ has, at times, led to services having mixed messages about what’s important and areas to prioritise. Shorter term imperatives have often trumped longer term planning for truly supporting the delivery of safe, timely, efficient, equitable, efficient and person centered care.

We now have the chance to change this. Joining together across the NHS Wales Executive to begin, agree and develop the strategic programme for mental health, is in my view what I have grandly called a “once in a generation opportunity”. If we do not grasp that and we all continue to work largely as we have before, we will have just moved the deck chairs around and will as a result get what we have always had.

The challenges facing health and social care are profound – we need to find ways to be both ambitious and realistic. We need to agree our focus, our individual and coordinated approach to the offer we can provide to the system. This of course is not as simple as it sounds, we all come with our own experience, knowledge, understanding and belief in ‘what works’ and have to potentially compromise to reach a consensus which can be hard. But if we can get it right, and in my view we must, the potential is huge. In order to provide system leadership, we need to work as a system that is integrated and effective ourselves. We need to mirror what we believe the system should do.

Creating spaces to come together, to be transparent, honest and willing to hear other perspectives and commit to change is central to quality improvement – we need to apply those principles to the way we work with colleagues across the divisions within the Executive. Becoming more than the sum of our parts is within our grasp if we can be courageous, thoughtful and commit to creating a compassionate and learning Executive that can deliver for those we serve. I’m looking forward to progressing this work further as we become fully integrated into the NHS Wales Executive and excited to share our progress soon.