Coronavirus days – part 1

I dimly remember – was it really only a couple of months ago? – a presentation on global risks from our insurers. We do this every year as part of our review of our business continuity plan and our Pandemic Response plan (yes we really did have one!) Having these has been literally invaluable in shaping our initial response and how we now deal with this day-in day-out. Anyway back to the presentation where we learnt that international companies viewed extreme weather events as having a high probability and high impact whilst an international spread of an infectious disease was considered low probability and low impact. Perhaps a new crystal ball would have helped.

As we prepared to present our thinking to our Board on how our strategic risk map might change, coronavirus landed and here we are.

In this blog I am going to describe the approach we are taking, with absolutely no conceit that it is the best or right course of action or that we’re doing things we won’t later regret. If other leaders find something to take from these words, tonight’s keyboard bashing will have been worth it. Whilst it might not feel like it during lockdown we are all in this together, so I hope other leaders will reciprocate and share their reflections.

As the severity became clear to me I wanted us to be really clear what our priorities were going to be – and there are just three –and they are all equally important as they are all inter-dependent.

1. To keep the people we support alive.
2. To keep our colleagues safe, healthy and focussed on our first.
3. And to ensure we emerge from the pandemic with a fit-for-purpose organisation.

Everything – and I mean everything – my colleagues and I have focussed on ever since has been on achieving one or more of these three priorities.

We quickly established a regular rhythm. The 5pm governmental briefing gets reviewed and analysed, and I wake up to a report highlighting things we need to do, respond to and decide. Management indicator reports are ready on our shared folders so we understand how many staff are self-isolating, how well our IT systems are holding up and how our invoicing and cash collection is going. Our Pandemic Emergency Team call at 8am is followed later if necessary by an Executive Team call. Over lunchtime we have a Pandemic Question Time for our managers. Our day ends with separate internal communications bulletins for our managers and for all our colleagues. And so the cycle begins again. Tomorrow – Saturday 28th March – is our first Saturday without a scheduled 8am call. More recently we’ve built in the VODG calls and scanning their various Hubs into our regime.

I’ve never felt as part of the leadership of Dimensions that we can hold everything in the centre – we have to empower our regional and local managers to make decisions locally. So this centrally driven rhythm began as something that felt novel and quite uncomfortable. However, our experience to date is that operational teams are grateful for unambiguous instruction and additional resources in this moment of crisis. One person fed back recently that our briefings have become “…an anchor point…” they are a “…trusted source where I get my information which means I’m not having to constantly scan emails and the TV. I know absolutely when I’m getting what I need to know and what I need to do.” This has allowed us to create space for our leaders to take ownership of their local situations and to think in person centred ways when implementing their service-level contingency plans and in reshaping support plans to take account of the lockdown.

I remain in constant awe of our operational teams. Of their capacity to rise to the most trying of circumstances. Of their collective dedication to assuring the health and wellbeing of the people they support. Of their leadership, their creativity, their quality. Of their extraordinary individual commitment – take, for example, support worker Alex who has a child with some underlying health issues. To avoid the risk of infection and continue to keep the vulnerable people he supports safe, Alex has chosen to stay away from his family (in a motorhome!) at this time. Today and for the foreseeable future he’s camped out on a driveway in one of our services in Somerset. It is only through the efforts and contribution of Alex and thousands of other Dimensions colleagues that we are  keeping the people we support safe.

At the same time, events are unfolding beyond Dimensions’ borders that will have a profound long term impact on the people we support now, and those that may need us in the future. For example, the coronavirus emergency bill was passed yesterday and the NICE guidelines on critical care were reviewed after an over-hasty launch. We have raised the alarm but it remains the case that the legislation, passed in haste, risks undoing decades of societal progress. We hope to be involved in shaping the code of practice as it now emerges, to minimise these risks.

Readers who know me or who have read previous blogs will know that I have fought throughout my career on behalf of people with learning disabilities and autism. To improve rights, tackle prejudice, develop practice. To support people to achieve meaningful choices in and greater control over their lives. To get people out of horrible places and minimise the number of people who need crisis placements. To ensure they are supported by good colleagues whose jobs are fulfilling and well compensated. I’m the first to also acknowledge not everything has gone well and we have let some people down. I know many of our services can be a lot better and some of the people we support can have a better life than we’re currently helping them achieve. However, we have achieved a lot for many people. This virus, and how the country is coping with it, threatens to undo much of that. As a leader it was incredibly difficult for me personally to determine that a priority for my organisation was ‘keeping people alive.’

Yet as I write this I’m reflecting on how many people on Friday saluted our key workers through #ClapforCarers. Am I being too optimistic to believe after we’ve got through it – and together we will get through it – social care and the NHS will be acknowledged in the same breath? And as more and more stories of sacrifice like that made by Alex begin to circulate, because every provider has loads of Alex’s, we cannot allow social care priorities to play second fiddle to the NHS.

These are elements of our approach to tackling the coronavirus challenge. I’ll be sharing updates as our thinking and practice develops over time. I’d love to hear yours.