Leadership & tacking health inequality Liz Cregan Chief Nurse, East & Mid-Lothian CHP

Why is leadership important? Inequality is one of the biggest challenges facing the health service and health practitioners

Why do we need to develop leadership on this issue? It is complex to tackle – no one answer We have to learn how to do it effectively – we don’t have a blueprint Has to involve partners Has to involve communities Requires service change and new practise Change needs to be sustained – not a short term project All this means that this is an issue that is difficult for organisation like the NHS to address. We have not been good at tackling complex issues that cross service boundaries and areas of responsibility. We will have to do this in a tightening financial situation – where services need to change we will have to do it within existing budgets Leadership is the key to learning about what we need to do and how we are going to face the problems in implementing that learning in a sustainable way

Who are the leaders ? We all have to be We need a distributed model of leadership Leadership is not the same as management

Accountability Communicate Leaders need to be accountable – and your normal managerial and professional accountability applies – but the key for accountability as service or community champion for support from the start is communication Communicate the vision – what Support from the Start is trying to do Communicate what you think your service / community can do to tackle health inequality Communicate what you learn and what you are doing to tackle inequality Communicate what you think makes the difference for children and parents

Leadership within the test site Strategic planning board Planning groups eg. Integrated Early Years Planning group Service champions Community Champions This provides a framework to support and develop leadership on this issue The framework for leadership and accountability is there for this issue – but it doesn’t matter how good the organisational structures is it take individuals to make a difference

Leadership & the test site But leadership requires individuals to: – Be able to share their Vision – Inspire fellowship or create allies – Show commitment to the cause – Be able to advocate for early years and health – Be able to make decisions – Show entrepreneurship (be willing to take a risk) - Have the courage to step up to the mark You may not as individuals be good at all of these but as a team of champions you will find that your strengths compliment each other – we are looking to you as individuals that can lead on this issue as part of a service and as part of a team – it is not an expectation that you have to carry this issue on your own nor are you expected to be a Barak Obama, a Gandhi or God forbid a Stalin

Key issues You have management support We have to communicate We have to learn We have to take action As chief nurse I would urge you to use the opportunity of being nominated as service and community champions to think about yourself as a leader on this issue – to learn what this means for you and the services you are a part of and that you work with. However, the test site is not about personal development it is about making a difference for children and parents – we need to hear what you think will make a difference for children and parents in communities and how services can make a greater impact on inequality. The test site is an excellent opportunity for east Lothian communities and services – but only if we all work together to make it work. For me – above all else – I think this means communication within and between services, with and within communities. So make your voices heard!