I believe that encouraging the continued development of clinical networks is vital as we respond to the current challenges we face as a health and care system. So is creating the space for clinicians across sectors to problem solve and collaborate. This will move us toward the new ways of working we need.

Over recent months many of us across Humber Coast and Vale have been taking on roles that are system-facing whilst also continuing in our substantive positions. So I thought it worth reflecting on the challenges that this creates, and whether remote working makes this easier or more difficult.

A couple of areas that I am directly involved in include cancer through my role as chair of the Humber, Coast and Vale Cancer Alliance, and Covid-19 testing through my role as lead CEO.

The world of Covid-19 testing is varied and complex. For example, it involves polymerase chain reaction (PCR) testing available from many different sources within the NHS, but also from commercial suppliers that are directed nationally.

Policy changes have been fast moving, and the profile and spotlight of making antibody testing available to staff has stirred professional groups to take different positions on this.

Additionally, our local government colleagues are charged with managing local outbreaks and engaging their local communities in the journey. Within the NHS we have a clear role in supporting this work and also in trying to influence collaboration, however we should not step on the toes of our partners who lead this work.

So the challenge for us in in Humber, Coast and Vale has been how do we keep hold of all of this? And how can we influence the decision-making of our own organisations, and regional and national bodies without having direct authority?

There are of course many academic references that can guide us. From my experience over recent months the important elements seem to revolve around encouraging co-operation, keeping partners energised and being prepared to make decisions.

Is this easier working remotely? Swings and roundabouts so far, building enduring relationships seems more difficult working remotely, creating an environment for decision-making at pace often seems more efficient.

Cancer services are high-profile at the moment, and within Humber, Coast and Vale we are working hard to scope the challenge as we come out of lockdown.

We are reviewing capacity within our acute settings to ensure patients can access cancer treatment and care as quickly as possible under the current circumstances, and we are also reviewing the demand now starting to present through primary care.

Locally and across the country, oncology capacity is limited and we recognise there are challenges for patients requiring treatment for colorectal cancer. In order to manage the demand on endoscopy services within our region, we need to maximise the use of our current system capacity whilst identifying longer-term actions that maintain patient safety and allow timely access to services.

To respond to these challenges we will need to develop new ways of caring for our patients, and we may also have to make decisions about prioritising treatment.

These decisions should predominantly be clinically-led. So how do we influence this when our clinicians are already working in conditions and in environments that are creating demands upon them that are unprecedented?

What legitimacy do I have as a manger working remotely? I have often felt compromised knowing that valued clinical colleagues have been working tirelessly in general practice, in hospitals, and across the community. It has pulled hard at my personal and professional values trying to square this.

In this respect I have often felt compromised. However I believe that encouraging the continued development of clinical networks is vital, so is creating the space for clinicians across sectors to problem-solve and collaborate, this will move us toward the new ways of working we need.

Across Humber, Coast and Vale we have started to establish clinical and professional groups that can guide this. My role remotely within the Cancer Alliance has been to encourage more of this, to keep nurturing collaboration, and trying to create the conditions for partnership, and to keep energy levels high when the going is so tough.

So what I have learned over recent months? Probably not enough, but adaptability seems more important than ever, especially as we start to think about balancing remote working with a potential return to physical environments. And undoubtedly the skill of influencing across our system without direct authority will be needed more than ever.

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