We Work Together is our podcast about working in partnership to improve the health and care of people in West Yorkshire and Harrogate, and the relationships between the people involved. In this episode, Partnership Director Ian Holmes talks to Richard Stubbs, CEO, Yorkshire and Humber Academic Health Science Network, about innovation, diversity and what we can learn from health and care innovators from around the world, from India to Austin, Texas.
Hello and welcome to we work together a podcast about working in Partnership to improve the health and care of people in West Yorkshire and Harriet and the relationships between the people involved in this episode partnership director Ian Holmes talks to Richard stubs Chief exec of the Yorkshire and humbur academic Health Science Network
About Innovation diversity and why’d like to take us to Austin Texas morning Richard um so you’re the chief executive of the Yorks and Humber academic Health Science Network can you tell us a little bit about your career Journey so far and how you ended up in
In that role morning yeah I mean I’ve been at the um the academic Health Science Network called the HSN for about six years now which is probably the longest I’ve been anywhere actually in my life but um and I came I came to the age of 10 as a
As a commercial director straight out of NHS England but I think you know my my job all my jobs over the last 10 years have have all really been about when you kind of think think about it it’s been about Innovation it’s been about spread it’s been about culture but but it’s
They’ve all been around you know if if you boil if you boil it all down how do we in the UK know what’s best about the care that we deliver and how do you get that best to happen everywhere and I’ve tackled different aspects of this um so
For instance you know one of the jobs I had previously was to create something called the the NHS Innovation Challenge prizes and that was all about can you have a a national program of recognizing and celebrating the Fantastic work that our innovators do because that’s a big
That’s a big part of the spread piece you know you’ve got to you’ve got to create the condition so so a lot of the work that I’ve done has been around been around that but I’ve I’ve um I’ve got a very um I do a lot of talk talks on my
Career and and I’m always really Keen I think particularly for b um colleagues who may be listening to talk about the fact that there’s a LinkedIn version of my life so there’s a there’s a potted history of my career which in hindsight in the rearview mirror you can make look
Incredibly um uh you know attractive and and and pre-planned and nothing was you know further from the truth it’s um it’s been a you know it’s been an interesting ride and it’s that you know it’s been a bit of a Rost right to get to where I am
Now but um all sorts of different fixed term contracts and different uh opportunities I um I absolutely understand that I’ve never had a real plan for where I’m getting to you just you just look at the next thing and say that looks interesting and uh and go from there
Sometimes don’t you um so in terms of the HSN role what what aspects of that job do you like the best and and what aspect of it frustrate you I guess as well I mean I love this job actually um I love working for the HS 10 it’s a
Privilege it’s genuine privilege and I say that a lot because actually we’re given the head space to to really I think uh explore and think and and investigate you know what what’s the best of the NHS and um and that’s where we spend all our time um which I think
Suits me down to the ground I you know I’m somebody who goes where where the energy is and normally when you when you find out what’s working well you normally find you know enthusiastic upbeat people who are getting things done and it’s a great it’s a great place
To be in most of the time but you also get to kind of live in the future which sounds a bit clear but it’s true you know you get to work with some incredibly um clever people you know academics researchers clinicians inventors and others and and you know if
You’re somebody like me who’s a NHS manager by background you can kind of just about grip onto their coattails and understand what they’re talking about but you can readily understand how what they may be working on if spread across the country would just transform an aspect of our Healthcare and that for me
Is the best bit the best bit is being able to see the future and say if you could make this happen everywhere wow wouldn’t it be fantastic I think I think the frustration is as always you you kind of have that Vision you have that inspirational first meeting and then you
Kind of sit back and think and how do we do it and then that’s that’s when you just think oh you know this is going to be inch by inch person by person you know hearts and Minds every step of the way and you know if we get if we get it
Done in five years six years s years it would be a massive success and I think if you could change anything that that’s the bit that’s the bit I yeah um so just on that theme then so you’ve you said you’ve been in the job for for six years
Now and um and a big part of the role is supporting NS organizations to adopt stuff that’s good and that’s out there that we should be we should be adopting and and using um have you noticed any changes over the last six years in terms of the receptiveness of NHS organization
To change because one of the the things that’s often been said about NHS organizations is they’re brilliant at innovating but they’re not very good at adopting from elsewhere and I’m just interested in your sense of whether you think that’s moved at all yeah I mean
It’s still it’s still the case but it is getting better and I think um and I think our our understanding of of how to do that is also getting better certainly the the whole I suppose you know notion of innovation isn’t just invention you know Innovation is is
Invention plus plus scale I think is something that leaders in particular understand a bit more now but also I think this you know stealing with pride type of Mantra is something that’s that’s fantastically well used and understood so it’s good so things have changed I mean I think when I came into
The arsn and actually before then I was um deputy director of innovation at NS England it’s a similar job actually but um but obviously on a national scale and in both those jobs I used to talk about the the virtual um queue to my front door which was you know all these
Fantastic innovators both you know inside the NHS and outside the NHS but they were there every morning in that virtual sense with that showand tell you know built this thing what do you think is there a problem you can find that this solution fits and that was the the
Kind of the we had it the wrong way rounds you know we had people coming to us um you know in the hn world in the nland world you know saying this is something I’m passionate about and and now we need to make the service um
Flexed in order to be able to fit it in I think what’s really changed in this six-year period has been the NHS has got a lot better at both identifying but also broadcasting its needs yeah yeah I think the long plan and and um you know the 5year forward viw both helped that
You know it created that conversation scps ics’s in the same way put people in the room and started to say if we could fix five things in this region what would be the five things that we’ fix and then that gives people like me the ability to then broadcast that out and
Start saying to innovators both you know internal but also industry as well this is where our challenge is so if you got stuff in this space you’re going to have a great conversation but if you’re coming to us with stuff that just isn’t on this list then you
Know even though the value proposition Stacks up even though it makes logical sense and it’s good for patients then you’re not going to get the appetite and the energy but here you know whether that’s cancer mental health inequalities whatever it may be this is where the
Action is and I think that’s been one of the biggest changes it allows us to be a lot more selective about the kind of things that we bring into the system so we can bring things into the system with a degree of confidence that that conversation’s going to be welcomed but
Also we can get involved at the earlier stage in terms of the work we do with innovators so we can we can especially for smaller smmes who haven’t got the bandwidth and the capacity to waste years on something that the ls doesn’t want you can get in there early you can
Have those those surgery conversations where you saying actually if you could pivot towards yeah mental health or whatever it may be this is where the market may be in the next 6 to 12 months and here’s some evidence and some confidence about why that’s the case and
You can show them ICS sdp Place plans that says this is a market so that’s that’s been one of the massive changes I think for me of the last six years but to be honest the biggest change has happened in the last three to four months and that’s you know with with the
Pandemic that’s where you’ve really seen action on the ground translating into phenomenal um transformation at a pace that at a pace that I’ve never seen we have seen huge um progress in digital Innovation haven’t we in the last three or four months and and the use of uh
Digital means rather than face Toof face uh you know um contacts Etc one of the risk I suppose that that poses is um the issue of digital exclusion so some folk are much better able to you know to access the the facilities to work digitally than others and um what’s your
Thoughts on that and how do you think we how do you think we should address that issue I think we digital exclusion obviously is is a massive issue and it’s something that we can never forget I guess I’ve got a bit of a I suppose a bit of an
Outlier view on this which is that one of the things I think we do um wrongly in the NHS is we believe that all service offers need to be accessible to all and I think we’re going to get more comfortable over time with the view that you can segment our population
I’ I’d much rather I mean don’t get me wrong we need to think about digit solution we need to make sure people aren’t left behind but I’m quite attracted to the notion that if you have digital access to Primary Care Services which take out maybe 40 or 50% of a of a GP
Practice workload in a way that can be easily dealt with for both the patients who want to access services in that way but also for the for the um CLS and the and the and the team behind that delivery of that service then you’re freeing up face to-face capacity for the
People who need it most the people who may actually be digitally excluded so I’m I’m really taken by this notion of as somebody who’s you know touchwood you know fairly well but also I’m unlikely to visit a GP practice between 9:00 and 5: on a Monday to Friday if I can deal
With my thing in a in a digital platform and get out of somebody else’s way and eventually give the opportunity for somebody with you know chronic conditions to spend 20 25 minutes 30 minutes with the GP I’m all for that so for me it’s it’s about not being too
Polarized in the conversation I think if we get if we get to a point where we’re talking about digital exclusion needs to be minimized as much as possible but if we can also be comfortable with the fact that if we can take out a proportion of our of our
Patients in a way that suits them and Suits the the caregiver then all we’re doing is freeing up capacity for face to face and I think that that for me is where I land on yeah that’s really helpful and and thinking about it as a as a kind of a
Blended approach that’s that’s right for the you know the person at the end of it is is is clearly the way to go rather than it’s actually it’s got to be this or it’s got to be that I think that’s really helpful um one one of the other
Things that we’ve seen during the past four months is the the impact of the the the pandemic on black Asian minority ethnic groups um so we know that they uh you know those those groups are likely to have a high rate of infection and and um and that translates through to a um
High sort of chance of complications Etc um do you think as a system we’re doing enough to understand and address those issues and what else do you think we could be doing so I think I mean I obviously you know I’m a massive fan and supporter of of the the attention this
Has being given in West gean haran I think the partnership certainly you know for my prob bit you know fairly limited view of other systems this partnership is um an Exemplar in terms of both the way it has um I suppose claimed accountability for the issue but also
The very practical steps it’s it’s taking and and you know I’ve been pretty close to that work and and it’s stuff that I you know in my job of course my job is to find best practice and spread it and and actually your approach to how you’re handling this is for me best
Practice that’s needing to be spread and it’s something that we’re doing so you know it’s it in a way it’s Innovation um to me yeah Innovation doesn’t always have to be about Kit and Tech and digital and and wizzy gadgets it’s about saying this is how to handle it so I
Think it’s so the way that we’re handling it in the partnership the attention it’s being given the focus it’s being given the fact that it isn’t a conversation that has to happen just because people feel well we need to now be talking about this because we’re expected to be talking about this I
Think for me the the the clear evidence is the fact that the partnership was talking about this long before the pandemic long before black lives matters and I think that’s one of the um I suppose the the the foundations that we’re now building on as we come into
This kind of more crisis mode and we’ve got real work real conversations real commitment that’s already been expressed that I think allows us to then take that to the next level and I think that that for me is absolutely amazing I think where we need to to go next is we need
To um I suppose position Health inequalities as as as the reason why the partnership exists the reason why the infrastructure is here so it’s still um we know we and I don’t mean this generally to the partnership but across the NHS we still talk about the other
You know it’s still the other we have our population and then we also have groups that also need to be P for and I think mainstreaming that um is I think one of the one of the biggest next steps and it’s a it’s a cultural thing it’s a
Conscious thing it’s you know how can we stop ourselves from othering other groups and having this notion of a default member of society in our mind and then there’s also somebody else and that I think is is something which will only ever come um from in inside people
Um you know it’s it’s it’s the same as other isms you know but you can’t tell someone not to express an ism it has to come from inside them it has to be something that’s felt but certainly I think in terms of mainstreaming the conversation instead of in Terms of
Saying this isn’t the last item on the agenda this is the first item on the agenda and it’s the biggest item on the agenda that’s how you start to see this as not something else that needs to be done but the thing that needs to be done
And I think that for me is is the next step and I’m I’m pretty sure this partnership will get there ahead of other systems in the country want to move us on a little bit in terms of the um you know the wider sort of IC and the Health and Care
Partnership so um you know obviously the academic Health Science network is a is a partner within the the IC and an important partner within the the IC what what do you think makes that relationship work why do you think it’s it’s working as well as it is working yeah I mean it’s interesting
Isn’t it and I think it’s something which has really improved in last you know two three even maybe four years now but I I think it starts with um two things one is I think there’s a a credible evidence base of the types of innovations that we can bring to the
Partnership so back to what I said about you know this virtual queue in a way you know looking upon the HSN as a bit of a filter for the partnership how do you take a thousand emails that all offer you know Promises of of innovation and greatness and and whistle them down to
The 15 conversations that the partnership needs to have I think is something that we’re very conscious of in the atsn and you’re kind of only as good as your last referral almost um so that’s something we take really seriously but ultimately it’s about relationships and it’s about trust and
One of the things I think that’s really enhanced the relationship between the ATN and the partnership has been the clear level of joint accountability that we’ve all had for delivery of of these programs you know we have a we have a range of programs that we believe you
Know very passionately are things that um would benefit um the of West yor and Harriet and instead of saying well off you go then uh you know we kind of give you permission to to travel around the pent and make these things happen we’re doing it together as a team and that I
Think is the biggest um single um U variable that has really transformed the relationship is that if you guys buy into something that we think is good we all then say how do we collectively make this happen and and if we went into barriers it’s our Collective problem I
Think that that is that is great for our team because they feel that they’re part of a of a bigger something but I think that’s also the way that that things get can happen just on that theme then what are the things that you think we might
Do better or what do you think the next steps are in terms of you know further kind of reinforcing and cementing the relationship I mean I I think whenever I think about you know the reset of of the NHS and and you know we we’ve spend a
Lot of time talking about reset and and work looking on is there an opportunity here in the midst of a crisis to to really radically change our notion of what health and healthare looks like and and maybe there’s an inflection point here where if you look back with the
Long lens you know hopefully 50 60 years time people will look at 2020 and say is this the point at which the NHS absolutely moved from a 1948 model to you know the the 2020 model as we know it I mean and I hope it is but for me
Com back to your point is about West Jor and haret the partnership this is a place that makes things happen so I think the next stage of our conversation the next you know how do we make it better is to say so what are we really
Up for you know what does a radical shift in care delivery look like from an innovation and transformation point of view and and are we up for this because this is going to be really tricky this is all culture this is all hearts and Minds yeah this is this is fear about um
You know is is AI going to destroy jobs across the patch this is fear about are we going to be turning um highly experienced um hugely um capable um Cs and staff into into digital you know people sat in front of screens all day and and of course this
Is not the vision but that’s the that’s the fear so I think there’s a real leadership role for the partnership to to have a conversation with itself and with its staff and with our patients and our public to say are we up for this are we up for this collectively this this is
The kind of thing it could look like I mean it’s it’s it’s things like you know so you know some of my favorite Innovations are the really well I call them the simple ones I mean they’re not but I guess what I mean by simple is they’re simple to understand um you know
As often things that just need someone’s smartphone to use like healthy IO and its urine testing system and it’s about saying to people look this is the way we’ve always done care because this is the way we’ve always done care but actually did you know you could get
Something posted through your um letter box you open the box you do your sample you do your own dip test and you use your own smartphone to take a picture that’s it end off there 10 minutes people love it 96 year olds across the country are doing it every day and it’s
A paradigm shift in our thought process of how you deliver that kind of service and and there are thousands of examples like that and it’s it’s about saying you know are we really really up for just transforming that type of understanding of what care might look like yeah yeah
You know I think as we’ve shown the last few years we all really up for that conversation so it’s something we can all look forward to um you get to travel all around the world in this job um which is I did you did yes for the last
Four months um I guess um so this question is about you know based on what you’ve uh seen and learned from other Health Systems all around the world um you know what would be the one or two things You’ think actually if we could just do this in west yorkin harate or
Across yor and Humber it would make such a difference what are those you know brilliant innovations that you’ve been most impressed with I guess yeah and I think and I think I’ve got like um two two examples from kind of different different ends of the spectrum I mean I
Think I spent a lot of time in the states um we’re doing a lot of work taking UK companies Yorkshire companies out to the states and and getting them embedded in the UK US um Healthcare System so that we can start to create more jobs back here and I think if you
Look at somewhere like um Texas as an example and you look at um Houston in particular particular and you look at the Texas Medical Center it’s it’s like cathedrals of care you know the the money the investment that they put into um into care providers is astonishing and I know obviously there’s a
Difference um for starts we haven’t got the oil that Houston has but um you know there’s a different model here but the intertwining of health and the economy and understanding that I suppose that symbiotic relationship between you know better Healthcare means better Innovation better Innovation means creativity It Means Jobs it means spin
Outs it means growth it means Better Health and you know that virtuous circle I think is something that you can see you can see it in front of your eyes as you’re as you’re walking down the street at the Texas Medical Center in Houston um and I think especially with the work
That we’re doing in the partnership around Medtech and around all the great capabilities we’ve got in this region we’re at the foothills of that but that for me is is one thing we could learn and Austin actually you know sticking with Texas Houston obviously has decades
And Decades of doing this but I spend a lot of time in Austin which is probably more of a Le sized city um and you can then look at Austin and say this has happened within 10 to 15 years and and Austin is now flourishing as an economy
In terms of um you know headquarters from all around the US coming into Austin um because of the quality of life um and a lot of this is is Healthcare driven it’s um it’s amazing the the relationship when you dig deep and you find out how important it’s been for the
The tech industry The Innovation industry and and health of course being a big part of that so so understanding that relationship and using it to power our our cities I think is is a big thing to learn and and looking at a place like tin as in a case study and saying that’s
What we could be that’s you know that’s exactly how how we could do this I think is something I’ve taken and you know if I could have one wish to take West Geor leaders over to Austin for a couple of weeks which is you know not likely to
Happen is it in in the near future but but just to just to just to hear that story firsthand because I think I find it fascinating but at the other end of the spectrum you know thinking about spending time in India and to a certain extent China actually mainly India you
Look at the work around Frugal Innovation and and I’m a massive fan of of frugal Innovation um you know this isn’t always about getting more and more complicated and Technical in fact sometimes it’s about being really simple and and sometimes you know necessity being the mother of all invention you
Look at the health outcomes from the way that um you know certain um chains in India deliver their cataracts for example and you just think we’ve got a lot to learn there um you know there are there are um uh Pathways of care that cost you know more far less than they do
In the UK even when you allow for you know um wages and the differentials in in cost of living and cost of provision and yet the outcomes are the same is not better so there’s a whole piece of work that we could learn around from around the world about Frugal and about ation
How to do things cheaper smarter better outcomes and um yeah it’s a bit different from the Texas model which I don’t think they do Frugal but certainly you know we could we could take stuff from both those examples I think and and both those examples would make us
Richer you know that link between the um you know the the health system and the and the wider economy mean that symbiotic relationship you described really well obviously there’s the West Yorkshire Devolution deal which was announced just before um the lockdown what what are your aspirations of of
That deal as a potential accelerant for some of this work yeah I mean it’s interesting isn’t it about I mean one of the things that um Devolution I don’t think will come with um outside of Manchester is you know the Devolution of of the Health and Care System you know
This is this is this is outside of that and I think from as a fan of the NHS and very much keen on that n you know I’m a big I’m a big advocate of that so Devolution isn’t about can we manage our our health services better because
Obviously they they are well managed as they are and it’s better to be I think nicely within the mothership of of the NHS so then you think well so what is Devolution going to do from a healthcare perspective and I think for me the biggest thing is to start to get health
Leaders to recognize their their leadership role their strategic leadership role in the kinds of economic grow conversations of what happen as a result of devolution and that’s very true obviously for the West Yorkshire deal which is you know hugely significant and these are the conversations that you know I know I
Know you guys are starting to have and they’re the right conversations but it’s about saying particularly in a living with covid era you know we’re about to go through a massive recession if not depression there will be um areas of the country hit harder and we have to
Recognize that that’s a that’s a health challenge um if nothing else so how do we as health leaders start to have conversations on in economic growth forums um to make sure that the evolution investment is spent in a way that’s going to generate the kind of drops that are going to maximize Health
Outcome so for example in in an economic renewal plan you can look at jobs at any cost or you can look at good jobs and good work yeah know that you know Health outcomes are going to come from giving people um jobs that give them a platform to
Excel and to improve and to upgrade their standard of living that’s going to help their kids to get into better education that’s going to help them to get better housing all those things are going to factor into our health outcomes so it’s about influencing those kind of
Conversations you know do we want to be known as an area that focuses on on Logistics jobs and other types of low paid wages that aren’t really going to do anything other than trap people in a cycle of of economic decline or are we going to see it as a as a health
Investment and are we going to help our leaders who will be holding those Devolution per strings to have health as one of the investment factors as make those decisions over the next two to three years yeah last question from me um you had to pick one thing uh in the
Last six years from your role that the HSN that you’re most proud of you know think actually we we delivered that and that’s led to this Improvement for people um what would that one thing be oh gosh there’s so many of them um this is one of those you your favorite kid
Exactly um yeah I mean I’m gonna I’m gonna um I’m going to wimp out of naming a particular Innovation because I just have you know 299 innovators on my back saying I can’t believe it wasn’t me but what but the thing I think the thing I’m personally most proud of actually is is
Some a piece of work that I started last year which is it’s back to the diversity agenda we were just talking about but specifically it’s around diversity and Innovation and I kind of realized with a bit of horror actually that although I’ve always been passionate about diversity passionate about Workforce
Representation particularly the Snowy Peaks and all those kind of um cliches that we know about despite working in this field for like 10 years I’d never really thought about diversity within the within the Realms of innovation research and obviously spending a lot of my time in kind of academic circles clinical
Academic circles those kind of things you realize that actually it’s quite an interesting demographic of the people working in those kind of jobs so I did a piece of work um for the HSN but also nationally for the HSN Network which was really around trying to start to um
Showcase why greater diversity and Innovation is important and and for me there’s two things there’s one is we need to ensure that the kinds of people with great ideas are well we we are farming those ideas from all sections of our Workforce and all sections of our
Society you know if if just over 90% of our of our staff are from B backgrounds if they’ve not got access to our Innovation pipeline at any point then that’s 20% of our of our potential ideas or or solutions for the future that just are never going to get heard so there’s
Something about can everyone with an idea can everyone within Innovation have the same kind of access to the kinds of support that we give to our innovators that’s thing number one I guess and within that of course we talk about the demographics of the people who naturally
Inhabit those kind of jobs and what can we do to improve that but also it’s about the business case about why that’s important I mean it’s important for our staff it’s important for for for how we run our organizations but also it’s important because when you look at
Innovators who do come from diverse backgrounds almost always you see that they can approach Solutions or they can come with experiences which improve the innovation in a way that perhaps we wouldn’t have got if we have just got those kinds of solutions from somebody from the white majority so I’m talking
About diabetes programs that are born out of experience of you know diabetes in Southeast Asia for instance or or things that recognize um you know the language barriers to particular you know we talked about digital exclusion people who come up with language barri um Solutions in in digital Tech those kind
Of things but there’s almost always a um a beneficial layer that’s placed kind of baked into Innovation when it comes from somebody from a diverse background and I think recognizing that we talked about you know covid we talked about health inequalities we talked about how do we mainstream our service and our thinking
Of people from um different um communities and backgrounds having diverse Innovation from diverse innovators I think is a really important part of that so so that’s what the the work is all about and I’m really proud of it it’s it’s got traction you know it’s sticky it’s it’s known about and it
Doesn’t end I guess you know we we we we’re continuing to work we’re continue to work with people like the um the shy Network and others so it’s yeah it’s probably the thing I’ve done most that kind of came directly out of my head and
Has has landed and has and has stayed so yeah I’m I’m pretty proud of that